Cocaine is also referred to as coke or blow and is a Class A drug made from the leaves of a cocoa plant native to South America.

What Is Cocaine?

Pure cocaine is usually called freebase cocaine and looks like white or off-white crystals. Freebase cocaine is normally smoked. Most commonly, cocaine is found in powder form. Over the last three decades, cocaine use has increased worldwide and what was once considered a “middle-class” drug is now a widespread problem. 

What Is Cocaine Cut With?

Dealers cut cocaine with other substances to make it go further or intensify the effects. This allows dealers to make more money out of a smaller amount of cocaine. Adulterants and cutting agents typically change the colour of cocaine powder to off-white or pale pink. They are added to cocaine that can be smoked, snorted, or injected. 

Not only does this reduce its purity and increase the risk of dangerous reactions, but some substances are also extremely hazardous. Cutting agents used to cut coke include:

  • Laundry Detergent can contain over 25 toxic chemicals and is a carcinogen, meaning it can cause cancer. Many detergents contain sodium borate, which can damage the reproductive and endocrine systems. Another common chemical, ethanolamine, found in detergent, can damage the lungs and cause respiratory failure. 
  • Boric Acid is a substance that is not intended for human consumption. Chronic use of cocaine cut with boric acid can cause kidney failure. If it is taken in large quantities over a short period of time, it can be fatal.
  • Levamisole is an agricultural drug that is used to kill parasites in cattle. Previously up to 70% of cocaine tested in America by the Substance Abuse and Mental Health Services Administration (SAMHSA) contained this drug. Long-term use is extremely dangerous as this drug destroys white blood cells, which protect the body from infections. Several deaths have been linked to infections due to cocaine cut with Levamisole
  • Local Anesthetics: Lidocaine, Benzocaine, and Procaine are all types of local anaesthetics. When they are cut with cocaine, various serious detrimental effects include respiratory failure, cardiovascular (heart) damage, and brain damage. 
  • Amphetamine and Methamphetamine are stimulants and increase the risk of overdose, seizures, cardiovascular (heart) arrest, and stroke. Long-term use has also been associated with an increased risk of neurological conditions, such as Parkinson’s disease.

Cocaine and Alcohol

It is not uncommon for people abusing cocaine to mix it with alcohol. Alcohol is a depressant and can intensify feelings of pleasure while reducing the negative effects of a comedown, which can cause irritation, anxiety, insomnia and twitching. However, combining alcohol and cocaine can be extremely dangerous and sometimes even fatal.

Some of the dangers of mixing cocaine with alcohol include increased risk of:

  • overdose 
  • stroke
  • intracranial haemorrhage (bleeding in the brain)
  • cardiac arrest (heart attack) 
  • cardiac toxicity, which can cause damage to the heart muscle or valves. 
  • cardiac arrhythmia (irregular heartbeat).

Cocaine Habit vs Addiction

Cocaine use often starts on a casual basis, and this may be considered a cocaine habit, not an addiction. Someone with a cocaine habit may be able to go long periods without using cocaine, or they can be addicted to taking small amounts erratically, without realising it. 

Cocaine addiction is characterised by the overwhelming need to obtain and use cocaine, typically resulting in regular use. Addicts cannot control their cocaine use and will not be able to take into account any negative consequences that might occur.

How Addictive Is Cocaine?

Cocaine is a highly addictive drug, and once you find yourself stuck in the cycle of cocaine addiction, it is extremely difficult to stop without some form of intervention. Cocaine works by reacting with the body’s central nervous system to produce feelings of extreme pleasure and euphoria. 

It’s a popular party drug because of its ability to make you feel more confident and keep you alert, awake and talkative for many hours. Felt almost instantly, the effects of cocaine are intense, which can increase reliance on the effects. Additionally, the effects of cocaine wear off quickly, which is why when you use it, you are often left craving more. 

Cocaine Addiction and the Brain

Cocaine works with the brain’s neuropathways to release pleasure hormones like dopamine. When the brain naturally produces dopamine, it is then reabsorbed, but when produced by cocaine, the brain does not reabsorb it.  The build-up of chemicals results in a surge of pleasure. 

Your brain quickly learns to associate the drug with pleasure and reward, which brings about obsessive cravings and the desire to use it again. With continued abuse, the brain tries to adjust to the sudden increase in dopamine levels by releasing fewer dopamine chemicals each time you use cocaine.  This results in diminished feelings of pleasure and euphoria also referred to as increased tolerance.

Signs and Symptoms of Cocaine Addiction

The signs and symptoms of cocaine addiction can be behavioural, psychological and physical. Someone suffering from cocaine addiction may become very good at hiding the true nature of their habit. However, repeated use becomes harder to hide and we have listed some of the most common cocaine addiction symptoms below.

Behavioural and Physical Symptoms

  • very talkative
  • hyperactivity
  • aggression
  • insomnia
  • sweating
  • gurning
  • constantly sniffing
  • rapid heart rate
  • dilated pupils
  • regular nosebleeds.

Psychological Symptoms

  • paranoia
  • depression
  • anxiety
  • heightened confidence
  • reckless decision-making
  • irritability
  • psychosis.

Am I Addicted to Cocaine?

It is scary to think that you could be addicted to cocaine. As withdrawal symptoms are psychological, it is easier to be in denial about cocaine addiction than other substances. When you spend most of your time thinking about cocaine and feel anxious when you run out, this strongly indicates that you have a cocaine addiction. 

Other effects of cocaine addiction include:

  • Not wanting to spend time with family and friends
  • Only wanting to socialise with other cocaine users
  • Obsessing about getting more or when you can next use cocaine
  • Feeling like cocaine is needed to function and stay motivated
  • Loss of interest in previously enjoyed activities
  • Poor job performance and attendance.

When you initially start using cocaine, you will often feel in control and addiction will creep up on you over time. If you are struggling with any of the above symptoms, you can call us confidentially for free help and advice 24 hours a day.

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Long-Term Effects of Cocaine Addiction

As is the case with most substance abuse, prolonged use of cocaine can do long-term physical and psychological harm. Common long-term damage to the body and brain includes:

  • Tears and ulcerations in the gastrointestinal tract,
  • Ruptures in the Aorta (major artery carrying blood out of the heart) 
  • Increased risk of stroke
  • Increased risk of cardiac arrest (heart attack)
  • Bleeding in the brain
  • Parkinson’s disease
  • Impaired cognitive functions.

Long-term effects can depend on the preferred method of use. Snorting cocaine can result in damage to the nasal passages and difficulty swallowing. Smoking freebase cocaine, also known as “crack”, can cause asthma, coughing and lung damage. 

Cocaine Addiction and Depression

Cocaine addiction and co-occurring illnesses such as depression often go hand-in-hand. Cocaine is often used for the temporary high it releases to help lift low mood during a depressive episode. However, the stark reality of drug addiction is that it often contributes to, and even causes, depression.

Cocaine Withdrawal Symptoms

When you stop using cocaine, you may experience withdrawal symptoms as the brain tries to adjust to the absence of dopamine. Initial withdrawal symptoms are commonly referred to as a “comedown” or a cocaine crash, which occurs soon after the last time you use cocaine. “Coming down” refers to the effects of cocaine wearing off. Your withdrawal symptoms can be mild to severe depending on the duration and how much cocaine you have used. During a crash, you will experience intense cravings for more cocaine. 

Common withdrawal symptoms include:

  • Increased appetite
  • Exhaustion
  • Anxiety
  • Irritability
  • Depression
  • Paranoia 
  • Hypersomnia (sleeping for long periods).

Although the comedown and withdrawal period can be uncomfortable, the psychological aspect of cocaine addiction is the most difficult to overcome.

Cocaine Addiction Treatment

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At Step-by-Step Recovery, we are dedicated to providing the very best quality of care for each and every one of our clients and our ultimate goal is to provide you with the tools you need to maintain a clean and sober life free from cocain addiction.

Suffering from cocaine addiction can seem like an endless cycle. The obsession with finding and using cocaine often consumes every waking moment. As your cocaine use increases, so does your tolerance, and you will require more and more to feel any buzz at all. 

Although withdrawal symptoms may not be severe when you stop taking cocaine, the psychological addiction can drive you to use cocaine again. This is why the best way to overcome cocaine addiction is with a medical detox and an addiction treatment programme.  During addiction treatment, the psychological aspects of addiction are also treated to give you the best chance of maintaining a clean and sober life.

At Step by Step Recovery, we offer free advice on treating alcohol, drug and cocaine addiction. We exist to provide non-judgemental support to help individuals break free from addiction permanently. Please complete our online assessment form or call our understanding team on 0800 170 1222 for free, confidential advice to help you or a loved one.


Cocaine can disrupt your brain’s natural chemistry, specifically its dopamine system. This significantly impairs your brain’s ability to feel pleasure from regular activities you usually enjoy. If you begin abusing cocaine by taking large amounts more often, you will start to build a tolerance, meaning you’ll require higher doses to achieve the high you’ve become used to. 

Cocaine highs are typically short-lived, and the intensity of the effects depends on the method of use. Within an hour of your last dose, you will start to “crash”. During this time, you may experience feelings of anxiety, irritability and paranoia, along with powerful cravings for more cocaine.

If you want to know whether someone has just taken cocaine and is currently high, several signs might give you an indication. These include bursts of confidence, excessive sweating, dilated pupils, and hyperactive behaviour.

Yes, a cocaine overdose or adverse reaction to cocaine can result in death. Cocaine can be deadly when taken in large doses or when mixed with other drugs or alcohol.  Cocaine-related deaths often occur due to heart failure. Using cocaine and drinking alcohol or mixing cocaine with other drugs also increases the risk of overdose and death.

Absolutely, if you want to. And you are serious about getting help. One of the hardest parts of recovery is admitting that you have a cocaine addiction and need help to stop using cocaine.

The best treatment for cocaine addiction is a medically supervised detox, alongside therapies such as cognitive behavioural therapy, one-to-one, and individual counselling and trauma therapy (if needed).

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Page revised in March 2023, by Danielle Byatt, a Level 4 addictions counselling, Level 5 in Leadership & Management, BA applied social work. and Treatment Director at Step by Step Recovery.

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