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Can You Overdose On Cocaine? Learn The Risks

Medically reviewed by Dr. Po-Chang HsuJune 3, 2024
Written by
On June 3, 2024

Table of Contents

Key Points

  • Cocaine is a highly addictive and illegal stimulant.
  • Cocaine overdose is dangerous as cocaine impacts the cardiovascular system, which can lead to cardiac arrest, stroke, seizure, or death.
  • Cocaine overdose requires immediate medical attention.
  • While the high from cocaine is brief, it can linger in a person's system for three days.

Can you overdose on cocaine?

It is possible and highly dangerous to overdose on cocaine. The most common reason that a cocaine overdose occurs is due to taking too much cocaine, taking too concentrated a dose of cocaine, or mixing cocaine with other drugs. 

A cocaine overdose can result in a heart attack, stroke, seizure, and death. If you suspect you or a loved one is experiencing a cocaine overdose, seek emergency medical treatment immediately by calling 911.

What is Cocaine?

Cocaine is an addictive, illegal stimulant drug made from the leaves of the Coca plant found in South America.[1]  It affects a person’s central nervous system, causing the brain to release higher-than-normal amounts of chemicals into the body (including dopamine, serotonin, and norepinephrine). 

Cocaine is available in two primary forms: a water-soluble hydrochloride salt and a water-insoluble cocaine base, known as freebase. The hydrochloride salt form can be snorted or dissolved in water and injected, while the freebase form, which does not dissolve in water, is typically smoked. Cocaine Injected intravenously enters the bloodstream the quickest, increasing the effects felt. Smoking is the second fastest way to have cocaine enter the bloodstream, followed by snorting or rubbing the cocaine on one’s gums. 

All ways of administering cocaine can result in lethal overdose side effects of heart attacks, strokes, seizures, and death.  

Some people use cocaine recreationally or occasionally, while others use it regularly and compulsively. 

Using cocaine typically results in feelings of euphoria and a high; however, excessive use can lead to cocaine intoxication, characterized by severe impairment and adverse physical symptoms. Reasons for cocaine intoxication or overdose  include [2] 

  • taking too much cocaine or too concentrated of a dose of cocaine
  • used cocaine during hot weather, if a person is dehydrated, they will experience more harmful side effects
  • mixing cocaine with other drugs. 

The risk of overdose with cocaine is high due to its unknown potency to the user, and cocaine users need higher doses of the drug to experience a high the more they use. 

Symptoms of cocaine intoxication include [3]

  • Feeling high: excited, excessive talking, rambling- about bad things happening
  • Anxiety: agitation, restlessness, confusion
  • Muscle tremors: often in the face and fingers
  • Enlarged pupils: pupils do not get smaller when a light is shone into the eyes
  • Increased heart rate and blood pressure
  • Lightheadedness
  • Paleness
  • Nausea and vomiting
  • Fever, sweating

Signs of a Cocaine Overdose

A cocaine overdose involves severe, life-threatening side effects that require medical attention immediately. [4]

  • Seizures
  • Loss of awareness of surroundings
  • Loss of bladder control
  • High body temperature, severe sweating
  • High blood pressure
  • Very fast heart rate or irregular heart rate
  • Lack of circulation: blue skin
  • Fast or difficulty breathing
  • Death
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Meth Overdose

Responding to a Cocaine Overdose

Seek emergency medical attention immediately if you believe someone is experiencing an overdose of cocaine.[5] Call 911 - a cocaine overdose can be fatal and requires immediate medical attention.

Most states have enacted Good Samaritan Laws as a way to prevent drug overdoses.[6] In the past, people were reluctant to call for help if they or someone they were with was experiencing an overdose for fear of criminal prosecution. Good Samaritan Laws protect the person who calls for medical help and those who need medical help from criminal charges. Saving someone’s life is the priority.

Things to be aware of while you wait for emergency medical services to arrive:
  • Excessive amounts of cocaine can make the person paranoid, as well as have delusions or hallucinations.
  • If the person has a seizure, do not hold them down or put anything in their mouth. Focus on protecting them from injury by removing anything around them that could cause them harm; if possible, gently hold their head to protect it and roll them to their side should they vomit to prevent aspiration.
  • If the person is experiencing a high body temperature and sweating, ways to help them cool down include slowly drinking cold water, placing a cold towel on the back of their neck, holding an ice pack, and sitting near a fan.
  • If the person becomes unconscious and you are unable to wake them up, you can give them a dose of naloxone (Narcan). Naloxone does not treat a cocaine overdose. However, many drug overdoses are due to multiple substances being used at the same time, sometimes without the person knowing. There has been an increase in cocaine overdose deaths, and it is due to an increase in the combination of cocaine and opioids.[7]
  • If the person stops breathing, you can begin rescue breathing; if the person’s heart stops, you can begin CPR. These should continue until the person’s heart begins beating on its own, they begin breathing on their own, or emergency medical services arrive and take over treatment
Treatment of Meth Overdose

Treatment for a Cocaine Overdose

Emergency department treatment for a cocaine overdose includes monitoring the person’s vital signs: temperature, pulse, breathing, and blood pressure. Treating symptoms as needed, including [8]
  • Breathing support: this may involve providing additional oxygen, a breathing tube, or a ventilator.
  • IV Fluids: these are used to treat dehydration and other symptoms.
  • Medications: to treat pain, nausea, anxiety, agitation, seizures, and high blood pressure.
  • Other treatments: depending on the medical needs of the person, they may require more intensive treatments to address complications involving the kidneys, heart, brain, or muscles.

Long-Term Treatment for a Cocaine Overdose

Long-term treatment for cocaine addiction and overdose includes substance abuse treatment, mental health counseling, and possibly medical treatments should the person experience long-term health conditions due to cocaine use.[9]  There is no medication approved by the Food and Drug Administration to treat cocaine addiction. 

a group offering support to one another

Seeking Treatment to Overcome Cocaine Addiction

Cocaine is a dangerous stimulant due to its high potential for overdose and death.  As soon as a person can enter recovery from cocaine, the less likely they are to experience long-term physical and mental health consequences. Seeking treatment also reduces one's risk of death, accidents, and arrests. 

If a person is experiencing a cocaine overdose, they need emergency medical treatment immediately. Once they are medically stable, treatment options that may involve inpatient or outpatient treatment can be explored. Cocaine addiction treatment is paid for by many insurance companies.  

Frequently Asked Questions About Cocaine Overdoses

Drug overdose deaths in the United States have risen significantly. In 2015, there were 6,784 cocaine-related deaths, which rose to 15,883 in 2019 and then to 24,486 in 2021.  Cocaine-involved deaths rose nearly 54%  between 2019 and 2021.[10]

Other health problems related to a cocaine overdose include [11]

  • Collapsed lung
  • Thrombosis (Blood clots)
  • Inflammation of the endocardium (the tissue line of the heart chambers)
  • Pseudoaneurysm (a hematoma outside the artery)
  • Cellulitis
  • HIV
  • Aneurysm
  • Abscess
  • Tetanus
  • Necrosis of veins, arteries, and organs
  • For those who experience neuropsychiatric symptoms as part of their overdose, some people are only partially or never able to recover fully.

Substance use disorder treatment for cocaine addiction involves behavioral health treatment, which may be done in inpatient or outpatient programs, depending on the person’s needs. If the person is at high risk of relapse or in need of detox treatment, residential treatment may be best for them. 

Many treatment programs use Contingency Management or Cognitive Behavioral Therapy as part of their addiction treatment. [12] 

Contingency Management programs provide vouchers as a reward system for those who have abstained from cocaine use that can be used toward prizes, cash, or other rewards. 

Cognitive Behavioral Therapy teaches people skills that support abstinence. CBT teaches individuals how to identify situations where they are most likely to relapse and use cocaine, how to avoid those situations, and how to cope with life problems that may have previously caused them to turn to cocaine use.

Signs of cocaine use may include [13] 

  • Dilated pupils
  • Runny nose (snorting)
  • Nosebleeds (snorting)
  • Track marks (injecting)
  • Burned lips or fingers (smoking)
  • Finding small glass pipes (crack cocaine)
  • Finding small empty plastic bags around the house

Cocaine is a white powder that people typically inhale, rub on their gums, or dissolve in water and inject. It is not commonly smoked in its powder form because it burns at a high temperature, which destroys much of the drug; instead, it is the base form of cocaine, known as crack cocaine, that is commonly smoked. The high lasts twenty minutes to two hours. 

Crack cocaine is processed cocaine into small brown rocks that people smoke with a glass pipe or mix with other drugs such as tobacco or marijuana. When processed, it makes a crackling noise, which is how it got its name.[14]  The high lasts fifteen minutes. 

While the high from cocaine and crack cocaine is brief, it can stay in one’s system for up to three days.

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[1,12] NIDA (2024). Cocaine. Retrieved from https://nida.nih.gov/research-topics/cocaine on April 19, 2024.

[2, 3,4,8,9] Medlineplus.gov (2023). Cocaine Intoxication. Retrieved from https://medlineplus.gov/ency/article/000946.htm on April 19, 2024. 

[5] SAMHSA (2018). Opioid Overdose Prevention TOOLKIT: Five Essential Steps for First Responders. Retrieved from

 https://store.samhsa.gov/sites/default/files/five-essential-steps-for-first-responders.pdf on April 19, 2024.

[6] GAO (2021). Drug Misuse: Most States Have Good Samaritan Laws and Research Indicates They May Have Positive Effects. U.S. Government Accountability Office. Retrieved from https://www.gao.gov/products/gao-21-248 on April19, 2024

[7,10] NIDA.gov (2023). Drug Overdose Death Rates. Retrieved from 

https://nida.nih.gov/research-topics/trends-statistics/overdose-death-rates on April 19, 2024.  

[11] Richards, J.R., Le, J.K. (2023) Cocaine Toxicity. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK430976/ on April 19, 2024. 

[13] NARCANON (n.d.) Signs and Symptoms of Cocaine Use. Retrieved from https://www.narconon.org/drug-abuse/signs-symptoms-cocaine-use.html on April 25, 2024. 

[14] Cleveland Clinic (2023). Cocaine (Crack). Retrieved from https://my.clevelandclinic.org/health/articles/4038-cocaine-crack on April 25, 2024. 

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