Cocaine Overdose Symptoms and Treatment

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The rate of cocaine-related drug overdose deaths in the U.S. nearly tripled from 2013 to 2018.1 Often, cocaine overdoses involve opioids like heroin and prescription painkillers. In 2019, there were nearly 16,000 cocaine-related overdose deaths that involved opioids as well.2 It’s important to know the signs and symptoms of a cocaine overdose so you can seek treatment for yourself or someone else immediately.

What is a Cocaine Overdose?

Cocaine overdoses are different than what is traditionally considered to be a drug overdose. Overdoses on central nervous system (CNS) depressants, such as opioids, benzodiazepines, or barbiturates, typically involve using a large amount of the drug that the body cannot handle. Using too much of one of these substances can lead to profound respiratory depression and sedation.

But in the case of cocaine, which is a CNS stimulant, an overdose can occur even at low doses. As with all other drugs, a cocaine overdose can be life-threatening so it’s important to seek emergency treatment right away.3

Cocaine Overdose Symptoms

The signs and symptoms of a cocaine overdose may include:3,4

  • Seizures
  • Nausea, vomiting, and diarrhea
  • Dangerously high body temperature
  • Severe sweating
  • Increased blood pressure and heart rate
  • Irregular heart rate
  • Cardiac arrest
  • Respiratory arrest
  • Increased respiratory rate
  • Loss of awareness
  • Confusion
  • Loss of bladder control
  • Aggression
  • Agitation
  • Hallucinations
  • Tremors
  • Rhabdomyolysis, which can lead to kidney failure
  • Coma

If someone is overdosing on cocaine, you may also notice a blue-ish skin tone and non-responsiveness.4 Recognizing these signs and symptoms and calling 911 right away can mean the difference between a non-fatal and fatal overdose.

Who is at Risk for Cocaine Overdose?

Cocaine overdose can happen to anyone who uses the stimulant drug. You can overdose the first time you use it or after many uses. The amount you take and the purity of the drug can contribute to an overdose, but overdoses have also been reported with relatively low cocaine doses.3

That said, the following behaviors can increase your risk of experiencing a cocaine overdose:5,6,7,8,9

  • Using cocaine while you have a medical condition: For example, if you have a heart-related medical illness and use cocaine, you could experience cardiac arrest or other potentially fatal cardiovascular events. Cocaine increases heart rate beyond its natural rhythm, overexerting the body’s organs.
  • Mixing cocaine with alcohol, which can lead to overdose and death: When cocaine and alcohol are combined, a metabolite called cocaethylene is created. This chemical is much more toxic than both cocaine and alcohol separately. The risk of overdose is much higher when cocaethylene is present.
  • Mixing cocaine with opioids: In 2017, nearly 73% of cocaine-related overdose deaths involved opioids, such as heroin or prescription opioids.
  • Taking cocaine while also taking prescription medications: Some prescription medicines can cause fatal drug interactions. For example, mixing cocaine with monoamine oxidase inhibitors, tricyclic antidepressants (TCAs), alpha-methyldopa, and reserpine may have life-threatening consequences. These drugs alter the metabolism of epinephrine and norepinephrine and, when used with cocaine, they increase adrenaline in the body to dangerous levels.

How to Treat A Cocaine Overdose

If you recognize the symptoms of a cocaine overdose, you must immediately call 911 for help. Provide as much information as possible to help the 911 operator assess the severity of the situation. Stay on the phone with the 911 operator until help arrives. If an overdose escalates, the 911 operator can help you provide CPR to the person in crisis.10

Because cocaine raises the body’s core temperature, do what you can to reduce the temperature. You may want to apply ice, wet towels, or cool blankets to the body. However, apply the cooling methods for limited amounts of time to avoid reducing the temperature to a hypothermic level.10

Other important steps you can take include:10

  • Place the person on their side if they are breathing but unconscious.
  • Remain calm and try to keep the person calm.
  • Continue to monitor their vital signs until first responders arrive.
  • Prevent the person from taking more drugs.

If the person has mixed cocaine with opioids, you can administer naloxone, also known as Narcan. This medication is an opioid overdose reversal medication that can save someone’s life. That said, it only works if they’ve used opioids; in the event of an overdose on cocaine only, Narcan will not be effective.11

Entering Cocaine Addiction Treatment After an Overdose

Once you’ve been medically stabilized at the hospital following a cocaine overdose, you may want to consider transitioning into a cocaine addiction treatment program. Inpatient rehab or outpatient treatment can help you quit abusing cocaine and prevent any future cocaine overdoses. Cocaine addiction treatment can help you:12

  • Break the cycle of addiction and avoid using cocaine and other drugs that can lead to overdose.
  • Learn to use healthy coping skills so you won’t feel like you need to self-medicate with cocaine.
  • Heal underlying psychological conditions that may contribute to your use of cocaine.
  • Recognize triggers for relapse and how to prevent them.
  • Build positive habits.
  • Establish healthy boundaries.

While in rehab, you will receive several types of interventions, such as individual therapy, group counseling, and family therapy. The types of therapies may depend on the specific counselor, program, and treatment philosophy, but behavioral therapies are quite common. A popular behavioral therapy for the treatment of cocaine addiction is contingency management (CM), which involves using incentives to motivate you to abstain from drug use. Cognitive-behavioral therapy (CBT) is another commonly used therapy. In CBT, you examine the connection between your thoughts, feelings, and behaviors so that you can change your negative, drug-seeking behaviors and replace them with positive ones.13

Community-based programs like Narcotics Anonymous or Cocaine Anonymous can also be beneficial because of the peer support. You get the opportunity to connect with others who understand your struggle, as well as find ways to cope with triggers and improve personal relationships. These 12-step support groups are a great way to make a new social circle of sober friends.

We can help you find the program best suited to meet your needs. Call 800-681-1058 (Info iconWho Answers?) now and let us help you get back on track to the healthy, happy life you deserve.


  1. Centers for Disease Control and Prevention. (2020). Increase in drug overdose deaths involving cocaine: United States, 2009-2018. 
  2. National Institute on Drug Abuse. (2021). Overdose Death Rates.
  3. Food and Drug Administration. (2021). Highlights of Prescribing Information.
  4. U.S. National Library of Medicine. (2019). Cocaine Intoxication. MedlinePlus.
  5. Kim, S. T., & Park, T. (2019). Acute and Chronic Effects of Cocaine on Cardiovascular Health. International journal of molecular sciences, 20(3), 584.
  6. Herbst, E. D., Harris, D. S., Everhart, E. T., Mendelson, J., Jacob, P., & Jones, R. T. (2011). Cocaethylene formation following ethanol and cocaine administration by different routes. Experimental and clinical psychopharmacology, 19(2), 95–104.
  7. Heard, K., Palmer, R., & Zahniser, N.R. (2008). Mechanisms of acute cocaine toxicity. Open Pharmacology Journal. 2(9): 70-78.
  8. Centers for Disease Control and Prevention. (2021). Opioid Overdose.
  9. Gallelli, L., Gratteri, S., Siniscalchi, A., Cione, E., Sirico, S., Seminara, P., Caroleo, M. C., & De Sarro, G. (2017). Drug-Drug Interactions in Cocaine-users and their Clinical Implications. Current drug abuse reviews, 10(1), 25–30.
  10. U.S. National Library of Medicine. (2021). Drug Use First Aid.
  11. Substance Abuse and Mental Health Services Administration. (2020). Naloxone.
  12. Gerstein, D.R. & Harwood, H. J. (1990). Treating Drug Problems: Volume 1: A Study of the Evolution, Effectiveness, and Financing of Public and Private Drug Treatment Systems. Chapter 4: Defining the Goals of Treatment. Institute of Medicine (US) Committee for the Substance Abuse Coverage Study.
  13. National Institute on Drug Abuse. (2021). Research Report. How is Cocaine Addiction Treated?
Dr Susanne Reed, PhD, MA
Author, Adjunct Professor
Susanne Reed has a PhD in Education and a Master's degree in Psychology. She worked for more than 20 years in the mental health and substance abuse fields as a counselor, director, and Addiction Counseling business owner. She has been a blog and article writer since 2016 for individual therapists, treatment facilities, sober living homes, and addiction specialists, as well as other industries. She