Cocaine Overdose: Signs, Symptoms, and What to Do in an Emergency

You’re at a club partying with friends and having a great time. The drinks are flowing and everyone’s feeling a little tipsy. That’s when your friend taps you on the back and tells you to follow them into the bathroom. She whips out a tiny baggie of coke and starts raking up lines for both of you.

Four hours later, it’s three in the morning, and your seventh trip to the bathroom with your friend. After she hits her line, she starts to feel dizzy and clutches her chest before collapsing in the stall, unconscious.

Cocaine overdose—it’s a real thing, and thousands of Americans experience this life-threatening event every year.

Coke is a really, really powerful stimulant drug that acts on the brain, CNS, and cardiovascular system. You experience its effects almost immediately after sniffing a line, giving you a heightened sensation of euphoria and energy, sharpening your awareness and making you feel chatty and sociable. It’s no wonder so many people enjoy it.

Visit any nightclub or bar in LA or New York, and you’ll find people using the drug. It’s become  socially acceptable to use it for recreational purposes, and most people who are introduced to the drug and develop an addiction to it start out as recreational users and end up hardened addicts.

Using cocaine might seem fun at first, but we need to remember this is a highly toxic illegal drug that’s unregulated, with no quality control involved in its manufacturing process. Simply put, you don’t know what’s in the powder you’re sniffing—it could be cut with anything.

But even if you get clean coke, there’s always the risk of overdosing on it if you take too much, or its purity is better than you expected.

What Causes a Cocaine Overdose?

Stimulants are powerful substances, and even legal compounds—like caffeine—can cause life-threatening results if you use too much of it. Panera Breads “Charged Lemonade” was a great example of how consuming too much caffeine can cause fatal results, with two customers dying from overstimulation of the CNS and cardiovascular system.

Cocaine has a stimulant effect on the body and mind. It increases heart rate, blood pressure, and the risk of stroke or heart attack in chronic users. It’s a highly toxic compound and contains elements like gasoline—and many others that don’t belong in your body.

But what is the mechanism of action for a cocaine overdose? Let’s look at the impact the drug has on your body and brain and how an overdose plays out.

How Cocaine Affects the Body and Brain

Cocaine is a dopamine inhibitor, meaning that it stops the reuptake of this neurotransmitter in the brain, leaving it to recirculate in the blood where it creates a state of pleasurable euphoria. The rush of dopamine caused by sniffing a line applies pressure and tension to the central nervous system resulting in elevated heart rate, increased blood pressure, and vasoconstriction, resulting in cardiovascular complications that can lead to a heart attack or stroke in the user.

If a user has a pre-existing health disorder relating to the CNS or cardiovascular system, the risk of overdose increases, as does the probability of developing life-threatening complications.

Coke also induces a state of hyperthermia, a life-threatening condition where body temperature increases to a point where it can initiate organ failure. Along with affecting dopamine production, cocaine use increases electrical activity in the brain, making the user feel sharper and keenly aware of their surroundings.

The hyper-stimulation of neurotransmitter production in the brain can leave the user in a state of confusion and mental agitation, resulting in the onset of paranoia or hallucinations.

The problem with coke is that—like all “hard” drugs—it can cause overdose in new or seasoned users. Because the rush provided from a line is only short-lived, users may frequently top-up their high to make the effect linger, and the accumulation of cocaine in the body brings them closer and closer to experiencing the harrowing effects of overdose.

Mixing cocaine with alcohol and other drugs significantly increases overdose risk. Despite this, many people use the drug alongside alcohol so that they can keep drinking without feeling the depressant effect of alcohol on the brain and CNS. But when alcohol and cocaine combine in the body it creates a compound called “cocaethylene” that further stresses the heart and liver.

Despite cocaine being a highly addictive substance, some people find they can use it recreationally. They might take a few months off using the drug and then try it again on a random night out. Unfortunately, they aren’t aware that the dose they’re used to is too strong for their newly sober state, resulting in overload of the CNS and cardiovascular system, and the onset of an overdose.

Recognizing and Responding to Cocaine Overdose

A cocaine overdose is a life-and-death situation and if you don’t act immediately, you could end up punching out of life. Recognizing the early warning signs of a pending overdose could save your life or that of your friends.

Early Warning Signs of Cocaine Overdose

The signs of cocaine overdose show up unexpectedly and quickly and evolve into life-threatening symptoms fast if you don’t know how to recognize the signs of taking too much. The heart is usually the first organ to produce noticeable signs of overuse and overdose on coke. The user might start experiencing heart palpitations and “tachycardia,” a condition where the heart beats much faster than its resting HR.

Users that take too much of the drug may also spiral into a state of restlessness that evolves into a full-fledged panic. The hyper-stimulation of the brain caused by cocaine use produces feelings of agitation which progress to extreme anxiety and eventually, paranoia. At this stage, the user might start acting irrationally and out-of-character, or they might start experiencing a feeling of impending doom.

If the user starts sweating profusely, it’s a sign that their body temperature is increasing and they’re at risk of their condition progressing to “hyperthermia”—leading to dehydration, organ failure or damage, and death.

Other early warning signings of impending cocaine overdose include the user experiencing nausea and vomiting as the body tries to purge the toxins, leading to dehydration risk.  The drugs stimulant effect creates hyperactivity and a state of heightened awareness and hyperexcitability, but when an overdose emerges, the user might start to experience symptoms like confusion, trembling, and the eventual loss of consciousness.

Severe Symptoms of Cocaine Overdose

As a cocaine overdose progresses in our physiology, it becomes most noticeable in its effects on the heart and cardiovascular system. As mentioned, coke is a “vasoconstrictor,” meaning that is causes constriction of the blood vessels, veins, and arteries, increasing blood pressure and placing the user at risk of heart attack. Even young users with healthy cardiovascular systems are at risk of overdosing on cocaine and experiencing the cardiovascular complications of the condition.

The early symptoms of a pending overdose include feeling an intense pressure on the chest, like someone is squeezing your heart. You begin experiencing shortness of breath and you might notice a pain down your left arm, lower back, or your jaw which is an indication that your heart is about to give up.

A cocaine overdose can also initiate seizures and convulsions as the drug disrupts normal brain function and its control over the central nervous system. Involuntary convulsions, loss of consciousness, breathing difficulty, and brain damage are all on the table when it comes to the devastating effects of a severe cocaine overdose.

Some users develop trouble with breathing, leading to gasping, suffocation, and collapse of the respiratory system. Loss of consciousness or coma are real risks when the user falls unconscious during a cocaine overdose. If they stop breathing or they experience limited breathing, the lack of oxygen to the brain can cause irreversible brain damage.

The impact of a cocaine overdose on the circulatory system and the CNS may lead to users developing signs of stroke. Paralysis, confusion, and slurred speech are common indicators that the user is at risk of enduring a stroke.

Act Immediately When You Notice the Signs of Cocaine Overdose

If you or a friend start overdosing on cocaine, take immediate action. Don’t worry about the legal consequences—there is much more on the line than your reputation. Call emergency services immediately and 911 will dispatch EMTs to the scene to help.

Every minute is precious during a cocaine overdose, and paramedics provide life-saving interventions on the way to hospital. The patient will need to stay calm, so having someone there to talk them down and reassure them that they’re going to make it is comforting and prevents the user from spiraling into a state of paranoia and despair.

If the user passes out and stops breathing, initiate CPR if you know how to use the technique. CPR drives oxygen to the brain, lessening the risk of organ and brain damage and stroke. Use chest compressions to maintain the user’s cardiovascular function while you wait for the cavalry to arrive on the scene.

Don’t move the patient or try to get them to drink water. These actions could cause choking or agitation in the user, resulting in further complications that could become life-threatening. Keep them safe and calm and wait for the EMTs.

Treatment Options for Cocaine Addiction

Cocaine is readily available in every city across America. It’s become a part of party culture, and many people use the drug, despite its life-threatening potential and the risk of addiction to the substance that they can’t control.

No cocaine user ever starts using the drug with the intention of becoming a full-blown “cokehead.” But given cocaine’s incredibly powerful addictive properties, people go from casual users of the drug to full-blown addicts in a relatively short period. Like most drugs, some people take longer to develop signs of cocaine addiction than others—everyone is different.

But despite these nuances, the result is always the same—if you use cocaine for long enough, eventually it becomes part of your experience, and you find yourself dependent on the drug to function. The “high” doesn’t even matter to you anymore, you’re just feeding the compulsion to use. 

If you’re deeply addicted to cocaine, quitting it by yourself is possible, but it’s highly unlikely that you’ll succeed. The compulsion to use is very strong, and you’ll find yourself falling back into your old habits.  The only way to get properly clean of the drug and give yourself a chance of living a sober lifestyle is by checking into an inpatient treatment program.

Inpatient Recovery Programs for Cocaine Addiction

Being addicted to cocaine is a harrowing experience for anyone to endure. Constantly chasing the next high is devastating on your mental health and the financial cost of fueling your habit can leave you broke or result in you stealing from friends and family to feed your addiction.

The only way to get through it and make it out the other side sober is to sign into an inpatient recovery program. These treatment facilities let you stay on the property while you recover, with 24/7 monitoring and assistance to help you get clean.

When you arrive at the facility and check in, you’ll be assessed by a medical doctor and a qualified psychotherapist who conduct a “dual diagnosis” of your physical and mental health. The issue with addiction to any substance is the mental health complications caused by the rewiring of the brain and changes in neurotransmitter production and function.

Remapping the brain requires a medical detox to get you clean, followed by intensive therapy for up to 12 weeks in a controlled inpatient setting. You’ll learn coping strategies to control your compulsion to use and unpack your trauma and the root causes of why you use drugs to cope.

After you graduate your inpatient program you’ll start your outpatient program where you attend therapy sessions and support groups for at least the next year. With dedication and a new approach to life, it’s possible to break free from cocaine addiction and remove the risk of overdosing on this dangerous compound.