Cocaine Addiction: Signs, Recovery, and Finding the Right Treatment

What Is Cocaine?

Cocaine is an incredibly powerful stimulant drug that is derived from the coca plant found in South America. Cocaine is classified as a Schedule II controlled substance because of its large potential for abuse and limited accepted medical application.[1] Cocaine can primarily be found as a white powder that is snorted, dissolved and injected, or processed into a solid and smoked as crack cocaine. Regardless of how it is used, it causes a temporary rush of dopamine in the brain, creating a surge of euphoria, energy, and alertness.

According to the Substance Abuse and Mental Health Services Administration (SAMHSA),  there were approximately 4.8 million people in the United States who reported using cocaine in 2021.[2] There has also been an increase in overdose deaths associated with cocaine use over the past several years, as illicit cocaine is increasingly combined (or contaminated) with fentanyl.

Cocaine Addiction and Abuse

Cocaine has a massive potential for addiction due to the speed and intensity at which it affects the brain’s dopamine system.[3] The primary action of the drug is to block the reuptake of dopamine, which floods the brain’s reward circuits with far more dopamine than the body produces naturally. The brain learns to crave this intense euphoria very quickly, and because the high only lasts a short period—generally 15 to 30 minutes if snorted—it drives fast and frequent re-use during a single session.

Continued use causes the brain to adapt by decreasing its natural dopamine production and the sensitivity of dopamine receptors. As a result, a person needs to keep using just to feel “normal.” This neurological shift is at the root of cocaine use disorder and is the reason why stopping is so difficult, even when a user truly wants to quit.[4]

Factors like a family history of substance use, co-occurring mental health concerns, early exposure, and your living environment all contribute to the risk of developing an addiction.

Signs of Cocaine Use and Addiction

Signs that an individual is using or has developed an addiction can be very apparent and develop quickly. Common signs include:

• Extreme periods of energy, talking too much, or being emotionally driven
• Eye dilation and increased heart rate
• Not eating and rapid weight loss
• Constant sniffing and bloody noses caused by deteriorating nasal membranes
• Acting erratically, engaging in risky behaviors, or showing impaired judgment
• Extreme mood changes, irritability, or paranoia
• Financial problems or frequent requests for money
• Loss of interest in family relationships or previously enjoyed activities
• Continuing to use despite clear negative consequences
• Having intense cravings when the drug is not available

The Cocaine Comedown

The “cocaine comedown” is one of the most significant clinical features of this addiction. When the effects wear off and dopamine levels drop below the normal baseline, there is a sudden and extreme change in mental state.[5]

This includes:

• Severe fatigue and exhaustion
• Deep depression and emotional numbness
• Intense irritability and anger
• Overwhelming cravings for more cocaine
• Severe anxiety and an inability to sleep
• The inability to feel pleasure from anything (anhedonia)

This comedown is a powerful motivation to keep using because the most immediate relief from this discomfort is more cocaine. This leads to binges that far exceed what the person intended to use. As time goes on, the cycle of use and withdrawal continues to expand.

Cocaine Addiction Treatment at Meridian Recovery

Since there are no FDA-approved medications for cocaine, the basis of treatment is behavioral therapy.[6] Our programs address the psychological patterns of addiction along with the underlying life factors that keep the cycle going.

All treatment for cocaine addiction at Meridian Recovery is done on an outpatient basis. We will give you a full clinical assessment once you arrive for treatment, and if your situation requires a higher level of care, such as detoxification or inpatient treatment, we will refer you to a trusted detox facility in the area. Once you are stabilized, you can begin treatment with us.

Cocaine and Co-Occurring Disorder Treatment

People with cocaine use disorder commonly have co-occurring disorders like bipolar disorder, anxiety, ADHD, or depression.[7] Often, cocaine use starts as a way to self-medicate these conditions. 

If the underlying mental health issues are addressed, recovery is much more achievable.[8] Meridian Recovery offers an integrated dual diagnosis program that treats both at once for a clinically sound start toward long-term wellness.