Learn / Can You Overdose on Cocaine? Risks, Signs, and Treatment

Can You Overdose on Cocaine? Risks, Signs, and Treatment

Kayla Gill
 December 20th, 2023|   Clinically Reviewed by 
Rajnandini Rathod

Key Points

  • Cocaine is a powerful stimulant. Using it in any form can lead to an overdose.
  • Cocaine-related overdose deaths are rising in the U.S.
  • If you suspect a cocaine overdose, call emergency services immediately.

Cocaine is a powerful stimulant that carries a dangerous risk of overdose. It can impact every organ in the body, but its most lethal effects are on the heart. Dangerous side effects include rapid heart rate, irregular heartbeat, high blood pressure, and narrowed coronary arteries. Cocaine overdose can cause a heart attack, stroke, and even death. 

If you suspect someone has overdosed on cocaine, call 911 immediately or take them to your nearest emergency department. 

A cocaine overdose can happen to anyone. You can help someone in this critical situation by understanding the warning signs and steps to take if you suspect an overdose. 

Understanding Cocaine

Cocaine comes from the leaves of the coca plant, indigenous to South America. Because it’s addictive and potentially lethal, cocaine is a Schedule II drug.1 It’s also a major public health concern. In the U.S., 4.71% of drug-related hospital visits are related to cocaine.2

Cocaine is a stimulant3 that hijacks the brain’s reward system and floods it with the “feel-good” hormone dopamine. It works by causing dopamine to build up in the brain and send stronger signals. This results in an intense, short-lived euphoria, which is also why cocaine is addictive. Long-term use leads to tolerance, meaning the body needs more cocaine to feel the same effects as before. This can quickly develop into a cocaine addiction. 

People take cocaine in different ways, including snorting, injecting, or orally. Crack cocaine is a solid (rock) form of cocaine that’s nearly always smoked.

What Is a Cocaine Overdose?

Many people wonder, can you overdose on cocaine? The answer is yes. Cocaine overdose is a potentially life-threatening reaction to cocaine.4 It can happen within a few minutes to hours of use. Also known as cocaine toxicity, it has a serious impact on the heart and brain and requires quick action. 

Cocaine overdose can escalate fast and lead to life-threatening complications like seizures, lack of oxygen, heart attack, or stroke. Because of its immediate and powerful effect on the body, it can be fatal. This is true even for small amounts of cocaine. 

Anyone can overdose on cocaine. Some people are more at risk than others, such as young adults, males, and people with heart conditions—even mild ones. Long-term cocaine use changes the heart structure5 and increases your risk of overdose. Other risk factors relate to how you take cocaine, like using too much or mixing it with other drugs.

Explore Cocaine Treatment Centers

Signs and Symptoms of Cocaine Overdose

Signs of cocaine use include dilated pupils, hyperactivity, appetite loss, and more. Recreational use can quickly escalate into an overdose. A cocaine overdose isn’t just uncomfortable for the person experiencing it—it’s also very dangerous. Someone overdosing on cocaine may show a combination of physical and psychological signs:

  • Elevated heart rate or irregular heartbeat
  • Increased body temperature
  • Sweating
  • Rapid breathing or difficulty breathing
  • Chest and stomach pain
  • Nausea and vomiting
  • Anxiety and paranoia 

If someone is showing signs of a cocaine overdose, get help right away. Call 9-1-1 immediately or take them to the nearest emergency room.  

Deaths from cocaine overdose in the U.S.6 are rising. The number of deaths from cocaine increased from 15,883 to 24,486 (almost 54%) between 2019 and 2021.

What to Do in Case Someone Overdoses on Cocaine

A cocaine overdose is a critical situation that calls for quick, immediate action. If you suspect someone has overdosed on cocaine, follow these steps:

  • Call emergency services. This is the first and most urgent step. Dial 9-1-1 for emergency services if you’re in the U.S. Give the operator clear information about the person’s condition. 
  • Never leave the person alone. Cocaine overdose symptoms can escalate quickly. Monitor the person’s condition while you wait for help to arrive. Stay with them until medical professionals get there. 
  • Try to remain calm. Once you’ve called emergency services, know that help is on the way. Your calm presence and support can make a big difference.
  • Check their breathing and pulse. If their breathing is shallow, or they’ve lost consciousness, check their pulse. If you don’t know how to perform CPR, call emergency services to guide you over the phone. 
  • Give emergency responders as much information as possible. When help arrives, give detailed information about the person’s condition and any substances they may have taken. They may need to go to the emergency room. 

Quick action and professional medical care can save someone’s life.

Risk Factors for Cocaine Overdose

Certain factors increase the risk of cocaine overdose: 

Polysubstance Use

Combining cocaine with other substances, like alcohol, stimulants, or opioids, puts a dangerous strain on the heart. 

Purity Levels

The purity of cocaine varies. With the strength unknown, you could accidentally take an unsafe amount. Street cocaine is cut with other agents, like laundry detergent, caffeine, laxatives, and more. Some cutting agents can cause poisoning or other dangerous adverse reactions. 

Cocaine Laced With Fentanyl

The rise in cocaine-related overdose deaths is linked to cocaine laced with synthetic opioids like fentanyl. Fentanyl is potent and deadly, even in very small doses. The number of cocaine overdose deaths7 jumped from 6,784 to 24,486 between 2015 and 2021, due in large part to the introduction of fentanyl. 

Cocaine Tolerance

Drug tolerance increases the risk of taking a toxic amount of cocaine. People with a history of cocaine use build tolerance. They may take higher doses to feel the desired effects.


People often overdose during a relapse, because they take the same amount of cocaine they used to, but their tolerance is lower from being sober for some time. When you help someone who has relapsed on cocaine, you’re also saving them from potential overdose.

Heart Conditions

Underlying health conditions magnify the dangers of cocaine use. Its stimulant effects could trigger a life-threatening reaction in people with heart conditions. 

How to Prevent Cocaine Overdose

The best way to prevent a cocaine overdose is to not use it at all. With cocaine, there’s always a possibility of overdose. 

While abstinence is the safest approach, harm reduction strategies can help minimize some of the risks associated with cocaine use:

  • Education is a powerful harm-reduction tool that helps you stay dose-aware. Sticking to clear use limits and avoiding binge use may reduce the risk of an unintentional overdose.
  • Never use drugs alone. A friend or support person can be a lifeline. If you accidentally overdose, they can assist you right away and improve your chances of survival. 
  • Test the purity of your substances. The U.S. is facing an alarming rise in cases of cocaine cut with fentanyl.8 The combination is lethal. Testing kits, or fentanyl test strips, help check substances for traces of fentanyl. 

If you can’t stop using cocaine despite the risks, this may signal a deeper concern. Treatment can help you address the root cause of cocaine use. It takes honesty and strength to ask for help. As intimidating as it may seem, the payoff is life-changing. 

Treatment for a Cocaine Overdose 

To treat an overdose, get immediate medical help. Medical professionals will manage symptoms and work to stabilize the person’s condition. Depending on the situation, treatment for cocaine overdose9 includes oxygen support, blood pressure medication, CPR, and more. Currently, there’s no medication to reverse a cocaine overdose.

Find Recovery From Cocaine Addiction

If you’re caught in a cycle of cocaine use, recovery is possible. Because it’s a common problem, experts have been developing various treatment options for years. 

Detox is usually the first step. Cocaine withdrawal and detox isn’t life-threatening, but it can be uncomfortable. Detoxing under medical supervision can ensure your experience is as safe and comfortable as possible. 

Different types of talk therapy are used in addiction treatment. Contingency management, which targets the brain’s reward system,10 shows promising results for cocaine addiction. One study found that it’s especially effective in early recovery.  

Residential rehab is effective for treating cocaine addiction.11 Programs usually last 30 to 90 days. During this time, you live on-site in a therapeutic environment away from triggers. Daily schedules are usually an intensive mix of therapies, recovery activities, and downtime. 

Group therapy offers a safe space for sharing experiences with others who’ve faced similar struggles. You can find ongoing support through your rehab’s aftercare program, ongoing therapy, and in-person or online support groups. 
Treatment paves the way for a healthier, more fulfilling, and sustainable lifestyle. Search cocaine addiction treatment options and compare by price, location, insurance accepted, and more.

Frequently Asked Questions About Cocaine Overdose

What are the signs and symptoms of a cocaine overdose?

Signs of a cocaine overdose include elevated heart rate, increased body temperature, sweating, rapid or shallow breaths, chest and stomach pain, nausea, and more. Symptoms can show up within minutes to a few hours after you last used cocaine. If someone is showing signs of a cocaine overdose, call 911 immediately.

What is the treatment for a cocaine overdose?

There’s currently no medication to reverse a cocaine overdose. Medical professionals will work to stabilize the person’s condition. Treatment may include oxygen support, blood pressure medication, or CPR. Seek immediate medical attention if you suspect someone has overdosed on cocaine. Overdose can happen whether or not someone has a cocaine addiction.

What are some signs that someone may have laced cocaine with fentanyl?

Signs that someone may have laced cocaine with the opioid fentanyl include:

• A strong chemical smell
• A different color or consistency than usual
• A smaller amount of powder than usual

Dangerous physical symptoms of cocaine laced with fentanyl include stronger effects than usual, chest pain, difficulty breathing, nausea, and vomiting. You can use a test kit to check substances for traces of fentanyl.

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