Cocaine
What is it?
Cocaine is an addictive stimulant made from the leaves of the coca plant, native to South America. Cocaine increases the activity of several chemicals in the brain, including dopamine, norepinephrine, and serotonin. This creates feelings of energy, alertness, and euphoria. Cocaine is commonly known as coke, crack, blow, charlie, speedball, snow, dust, or powder.
People use cocaine by snorting it, rubbing it on gums, injecting it, or smoking it.
Important: Cocaine can be mixed or laced with fentanyl, a powerful opioid that can cause an overdose even in tiny amounts. You can’t see, smell, or taste fentanyl, so it’s impossible to know if cocaine contains it without testing.
Learn how to stay safe.
Naloxone is a medication that can reverse an overdose caused by opioids like fentanyl. It will not harm someone that hasn’t taken opioids. Experts recommend using naloxone even during stimulant overdoses since stimulants and opioids are sometimes mixed.
How it works
Cocaine activates reward circuits in the brain, releasing a surge of dopamine. Dopamine is the chemical linked to pleasure and motivation. Normally, after dopamine is released, it's recaptured and stored by brain cells to be used again. This recycling helps your brain stay in balance.
Cocaine blocks that recycling process, causing a buildup that creates an intense high.
Over time, the brain adapts by making less dopamine, since it can rely on cocaine. When the brain makes less dopamine, it can be harder to feel pleasure from everyday things like food, friends, or hobbies.
Short-term effects
- Burst of energy, alertness, and euphoria
- Increased heart rate, blood pressure, and body temperature
- Decreased appetite and need for sleep
- Restlessness, anxiety, or paranoia
- Possible heart attack, stroke, or seizure, even with first use
- Dangerous when mixed with alcohol (creates cocaethylene, which is toxic to the heart)
- Extremely risky when mixed with opioids like fentanyl or heroin, greatly increases overdose risk
- Mixing cocaine with other stimulants (like Adderall or caffeine) increases strain on the heart and raises overdose risk.
Long-term effects
Brain and mental health:
- Reduced sensitivity to natural rewards (food, relationships, etc.)
- Increased anxiety, irritability, and depression when not using
- Tolerance (needing more for same effect)
- Sensitization (the opposite of tolerance. Over time, one may have a stronger reaction to the same dose)
- Higher risk of severe mental disorders and panic attacks
- Impaired memory, attention, and decision-making
Physical health:
- Heart damage, heart attacks, and strokes
- Weight loss and malnutrition
- Gastrointestinal issues (ulcers, intestinal tears)
- Seizures and movement disorders
- Risk of HIV or hepatitis C (if injected)
Route-specific damage:
- Snorting: Loss of smell, nosebleeds, nasal damage
- Smoking: Lung damage, worsened asthma
- Injecting: Track marks, infections, allergic reactions
Cocaine and mental health
Cocaine initially boosts mood, energy, and alertness by flooding the brain’s reward system with dopamine, the chemical linked to pleasure and motivation. With repeated use, however, the brain adapts by producing less dopamine and reducing dopamine receptors, making it harder to feel pleasure without the drug.
This imbalance can lead to or worsen depression and anxiety. Sleep disruption, irritability, and fatigue are also common and can further impact mental health.
Over time, these changes can create a cycle of low mood and craving, as the brain seeks relief through more cocaine use.
FAQ's
How long does it last?
How long does it last?
Cocaine’s effects last from a few minutes to an hour, depending on how it’s used.
Can you overdose on cocaine?
Can you overdose on cocaine?
Yes. Cocaine overdose can happen even the first time you use it. Signs include chest pain, rapid heartbeat, extreme anxiety, high body temperature, or seizure. Mixing with fentanyl or other substances greatly increases overdose risk.
Naloxone is a medication that can reverse an overdose caused by opioids like fentanyl. It will not reverse a cocaine overdose but will help if the cocaine contained any opioids. Nalaxone will not harm someone that hasn’t taken opioids. Learn more about naloxone and where to get it for free
Is cocaine addictive?
Is cocaine addictive?
Yes. Cocaine is highly addictive because it strongly affects the brain’s reward system. Over time, your brain produces less dopamine naturally, leading to cravings and dependence.
What happens if you mix cocaine with alcohol or other drugs?
What happens if you mix cocaine with alcohol or other drugs?
Mixing drugs can be very dangerous, but some people mix drugs to amplify or alter the effects of a substance.
Mixing cocaine with alcohol creates a toxic chemical called cocaethylene. This chemical increases stress on the heart and risk of liver damage or sudden death.
Mixing with fentanyl, heroin, or prescription opioids significantly increases overdose risk.
Combining with other stimulants (like Adderall or caffeine) raises heart strain and anxiety.
What are signs of cocaine dependence or addiction?
What are signs of cocaine dependence or addiction?
- Strong cravings
- Needing more to feel the same effect
- Using even when it causes problems
- Feeling anxious or low when not using