Cocaine Overdose

Cocaine Overdose: The Risk Is Real

If someone is showing signs of a cocaine overdose, call 911 immediately.

The word “overdose” creates a scary image for those struggling with addiction and for their loved ones. The thought of overdosing ourselves or finding a loved one in an overdosed state is terrifying.

If you or your loved one has overdosed or is at risk of overdosing from cocaine use, you may be asking questions such as: How did we get to this point? Where do we go from here?

To address some of these questions, we will define cocaine, cocaine overdose symptoms, how to best respond to a cocaine overdose, risk factors leading to cocaine use, stimulant use disorder, the consequences of cocaine use, cocaine withdrawal symptoms, and treatment that is available at Pathways Recovery.

To illustrate the journey of a person struggling with cocaine use, we will follow Cory’s journey.

Defining Cocaine

Cory is a 23-year-old male that arrives by himself at an addiction facility. The treatment counselor asks Cory when he first began to use cocaine. Cory shares he was first introduced to cocaine about a year ago while at a party.

The person who introduced Cory to cocaine said that it might be fun to have a “high” to balance out the “low” he was feeling from drinking while at the party. Cory snorted a line of cocaine and has been craving the first high he experienced that night ever since.

According to the “Experience Psychology, Fourth Edition” textbook by Laura A. King, cocaine is an illegal drug derived from the coca plant. Cocaine may be snorted or injected and comes in powder or crystal form (crack). Crack is a powerful form of cocaine that contains chips of pure cocaine that are typically smoked. Crack is one of the most addictive substances of all illegal drugs.

Cocaine and the Brain

Cory recalls feeling on top of the world after having his first hit of cocaine. Cory discusses the “high” sensation, followed by the extreme “low” feelings. Cory says this up and down cycle he went through was tiring and led to feelings of depression. Cory is here at the treatment facility to learn different ways to cope with hard feelings other than repeating this cycle of use. Cory discusses how exhausting it is to feel like cocaine is driving his life. Cory says he wants to be in the driver’s seat of his own life.

“Experience Psychology, Fourth Edition” explains that cocaine rapidly floods the bloodstream and produces a rush of euphoric (pleasurable) feelings that last about 15 to 30 minutes. This rush drains the brain’s supply of the neurotransmitters (chemical messengers) dopamine, serotonin, and norepinephrine, which results in an agitated, depressed mood state for the person using cocaine.

Cocaine Overdose Symptoms

The counselor at the treatment facility asks Cory if he has ever overdosed while taking cocaine. Cory is unfamiliar with what a cocaine overdose would be like. The counselor reviews various physical and psychological symptoms that can occur during a cocaine overdose.

Cory recalls a night in which he had access to more cocaine than usual and inhaled the drug very rapidly. Cory says after taking so much cocaine, he felt like his heart would pound out of his chest, and this led to overwhelming feelings of panic. Cory recalls feeling immediate regret for taking so much cocaine so quickly. Cory shares he worried he would die and told himself if he survived that, he would take the brave step of seeking out treatment.

The symptoms of cocaine intoxication include:

• Feeling high, excited, talking and rambling, sometimes about bad things happening
• Anxiety, agitation, restlessness, confusion
• Muscle tremors, such as in the face and fingers
• Enlarged pupils that don’t get smaller when a light shines into the eyes
• Increased heart rate and blood pressure
• Lightheadedness
• Paleness
• Nausea and vomiting
• Fever, sweating

The symptoms of cocaine overdose include:

• Seizures
• Loss of awareness of surroundings
• Loss of urine control
• High body temperature, severe sweating
• High blood pressure, very fast heart rate, or irregular heart rhythm
• Bluish color of the skin
• Fast or difficulty breathing
• Death

What’s Next After a Cocaine Overdose?

It is extremely important to call 911 and seek medical assistance immediately when a person has overdosed.

What to do if a loved one overdoses on cocaine:

1. Call 911

• Seeking professional medical attention is the most effective way to treat a cocaine overdose and prevent life-threatening consequences.

2. Stay on the Phone

• It is common when abusing an illegal drug like cocaine to be worried about seeking help, but the person you are with needs you.
• Stay on the phone with 911 until help arrives and do as the 911 operator instructs.

3. Turn Them on Their Side

• If the person is throwing up or having a seizure, turn them on their side. This action can help keep their airways clear and keep them from choking on their own vomit.

4. Remove Immediate Dangers

• If the person is having a seizure, try to remove any objects that are sharp or could fall on them from their immediate area.
• Do not put anything in their mouth.

5. Stay Calm

• It is normal to feel panicked when someone is experiencing a cocaine overdose, but do your best to stay calm. Do as the 911 operator tells you.
• If the person has temporarily stopped seizing, do not take this as a sign that danger has passed.
• Continue to seek emergency medical attention right away as seizures may recur.

Once the overdosed person has been connected with medical care, the medical care provider will:

• Measure and monitor the person’s vital signs, including temperature, pulse, breathing rate, and blood pressure.

The person may receive the following medical interventions:

• Breathing support, including oxygen, a tube down the throat, and ventilator (breathing machine)
• IV fluids (fluids through a vein)
• Medicines to treat symptoms such as pain, anxiety, agitation, nausea, seizures, and high blood pressure
• Other medicines or treatments for heart, brain, muscle, and kidney complications

How Common Is Cocaine Overdose?

The addiction treatment counselor discusses the dangers of cocaine overdose, which could ultimately lead to death. Cory has a strong desire to not overdose again and has a strong desire to live a healthy lifestyle.

Cory has many reasons to live. Cory talks about his dreams of becoming a counselor himself to help others overcome addiction. Cory has visions of being the first in his family to go to college and graduate. Cory wants to travel — see the Eiffel Tower in person, look over the vastness of the Grand Canyon, and feel the warmth and sand on the beaches of Hawaii. The counselor instills hope that change is possible and sustainable with treatment.

In 2019, cocaine was involved in about one in five overdose deaths. Additionally, over five million Americans, or 2% of the U.S. population, reported current cocaine use in 2020.

Risk Factors for Cocaine Use and Addiction

Cory has mental health struggles including depression, anxiety, and post-traumatic stress disorder (PTSD). Cory says he has never had a formal mental health diagnosis but has had mental health symptoms such as a sad mood, difficulty sleeping, and worrying frequently. Cory shares having a history of child abuse and trauma. Cory talks about often having flashbacks related to his past abuse and trauma. Cory discusses waking up in the middle of the night panicked.

Cory describes having lived in an unstable home environment. Growing up, Cory was raised by a single mother that worked multiple jobs. Cory shares that his family frequently relocated to make sure his mom had adequate employment to support the family. Cory says that often he was left home alone. Cory learned quickly how to care for himself and his younger siblings.

According to the “Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition” (DSM-5), published by the American Psychiatric Association, there are temperamental (mental health) and environmental risk factors that may lead to cocaine use and then stimulant use disorder.

• Temperamental (mental health) risk factors
  • Co-occurring mental health disorders
    • Bipolar disorder
    • Schizophrenia
    • Antisocial personality disorder
  • Presence of any other co-occurring substance use disorders

• Environmental risk factors
  • Prenatal cocaine exposure
  • Postnatal cocaine use by parents
  • Exposure to community violence during childhood
  • Living in an unstable home environment
  • Associating with dealers and others that use substances

What Is Stimulant Use Disorder?

Cory and his counselor discuss a condition called stimulant use disorder. The counselor explains this is a way to better understand the effects of Cory’s cocaine use. Cory shares that within the past year, he has had the following symptoms: taking cocaine in larger amounts and longer than intended, not being able to stop cocaine use by himself, spending much time thinking about and working to get cocaine, having strong cravings, and having work-related problems due to cocaine use.

Cory currently works two jobs as a waiter and a cashier. Cory says that after his shift as a waiter is done, he will often get high at home. Cory shares that after the high at home, he has a low, and this will cause him to oversleep. Cory talks about being late or missing his cashier shifts altogether. Cory is at risk of losing his cashier job if he continues to be late or miss shifts.

Cocaine use is listed under the description of stimulant use disorder in the DSM-5. Per DSM-5, the following criteria are used to diagnose stimulant use disorder:

• A pattern of cocaine use leading to significant impairment or distress as evidenced by at least two of the following symptoms within a one-year time period:
  • Cocaine is taken in larger amounts or longer than was intended
  • Ongoing desire or unsuccessful attempts to reduce or control cocaine use
  • Much time spent in activities geared toward getting cocaine, using cocaine, or recovering from its effects
  • Craving, desire, or urge to use cocaine
  • Continued cocaine use that results in failure to fulfill responsibilities at work, school, or home
  • Significant social, work, or recreational activities are given up or reduced due to cocaine use
  • Continuing to use cocaine even when it can be physically hazardous
  • Cocaine use is continued even when it is causing physical or psychological problems
  • Tolerance
    • Need more cocaine to achieve the same high or desired high
  • Withdrawal
    • When cocaine is reduced in amount or frequency, notice bodily withdrawal symptoms
    • Cocaine is taken to relieve or avoid experiencing withdrawal symptoms

Consequences of Cocaine Use

Cory often has nosebleeds as a result of his cocaine use. Cory shares feeling embarrassed to have frequent nosebleeds. Cory discusses how nosebleeds are not sanitary and get in the way of him successfully completing his shifts as a waiter.

Per DSM-5, the possible consequences of cocaine use include:

• Medical conditions may occur depending on the ways in which cocaine is used.
  • Intranasal cocaine use often leads to:
    • Sinusitis or sinus infection
    • Irritation
    • Bleeding of the nasal mucosa or the tissue that lines the nasal cavity
    • Perforated nasal septum
  • Those who smoke cocaine are at increased risk for respiratory problems such as:
    • Coughing
    • Bronchitis
    • Pneumonitis
  • Those who inject cocaine tend to have:
    • Puncture marks and “tracks” typically on their forearms
    • Increased risk of HIV infection
  • If those who use cocaine are also engaging in unsafe sexual activity, there is a heightened risk for contracting sexually transmitted diseases.

Cocaine Withdrawal Symptoms

Cory shares he has not taken cocaine since yesterday evening. It is now late afternoon. Cory says he feels tired, has cravings for cocaine, and wants to eat endlessly. The counselor notes his bravery in coming into treatment today instead of going out and getting the next high. The counselor recommends that Cory be evaluated by a medical professional to assess and provide care for his withdrawal symptoms.

Per DSM-5, the following criteria are used to diagnose stimulant withdrawal:

• Stopping or reducing cocaine use
• Dysphoric (dissatisfied mood) and two or more of the following physiological changes that occur within a few hours to several days after stopping or reducing cocaine use:
  • Fatigue or feeling tired
  • Vivid, distressing dreams
  • Insomnia (trouble with sleeping) or hypersomnia (excessive sleeping)
  • Increased appetite
  • Psychomotor retardation (slowed speech, slowed movement) or agitation
• Physiological changes described above cause clinically significant distress or impairment in social, occupational, or other important areas of functioning

Cocaine Use Treatment at Pathways Recovery

Cory expresses being hopeful for treatment — hopeful to gain immediate help to manage his withdrawal symptoms and then hopeful to gain better self-insight with therapy. Cory shares he has never been to counseling before and is looking forward to learning how to deal with hard feelings and situations without going back to using cocaine again.

Pathways Recovery offers cocaine overdose treatment, detox, and rehab at a medically supervised facility located near Sacramento, California.

Contact Pathways Recovery for Compassionate Care

Cory’s story is representative of many real-life stories that you or your loved one may be going through right now. We are here to help you or your loved one struggling with cocaine use. To get quality, compassionate care for cocaine use, please contact Pathways Recovery at (916) 735-8377.