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Risk factors, physical effects, and why recovery is possible

Once touted as a “glamour drug,” cocaine has caused addiction and serious problems for people of all incomes, ethnicities, and ages. It doesn’t matter why someone starts using cocaine — as a means of finding pleasure, as a reward for getting through a tough week, as a way to forget bad memories, or for another reason. Too often cocaine use leads to painful psychological effects (such as mood swings, paranoia, memory loss, and hallucinations) and health effects, including weight loss and neurological symptoms. But recovery from cocaine addiction is possible.

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Risk factors

Some people can use cocaine a few times with no problem, while others find it difficult to stop using once they start. Certain circumstances make some people more likely to develop problems with cocaine:

  • Genetics. Some people are more likely to develop problems with cocaine because of a family history of addiction. Some studies suggest that genetics play a particularly strong role in developing problems with cocaine.
  • Frequent use. Over time, using cocaine can actually change the wiring in someone’s brain, making the user crave more cocaine more often.

Signs of a cocaine problem

For many people, it can be difficult to identify when cocaine use becomes a concern. While changes in lifestyle or behavior may be signs of a drug problem, cocaine users may develop particular symptoms:

  • Decreased sensitivity to natural rewards, such as relationships and food
  • Tolerance (needing more cocaine to feel the same high)
  • Sensitization (feeling toxic effects, such as anxiety and convulsions, with lesser amounts of cocaine)
  • Paranoia, irritability, and panic attacks
  • Increased displeasure and bad moods when not using
  • Loss of appetite; significant weight loss

Because cocaine can be ingested in a variety of ways, some signs of use are specific to the method of administration.

  • Snorting
    • Loss of smell
    • Nosebleeds
    • Hoarseness
    • Difficulty swallowing
    • Runny nose
    • Inflamed nasal cavities
  • Smoking (crack cocaine)
    • Lung damage
    • Asthma; other breathing problems
  • Injection
    • Needle marks (“tracks”) in forearms

Cocaine and the brain. Cocaine comes as a solid or a powder and can be dissolved in water. When cocaine enters the body, it makes its way to the brain. There, it keeps the brain from getting rid of dopamine, the chemical that controls feelings of pleasure. That’s why cocaine users experience a high — and, as the brain returns to a normal cycle, why they may experience withdrawal symptoms.

Cocaine withdrawal

Cocaine releases chemicals in the brain that cause a feeling of euphoria, a powerful high, that is followed by a crash. The symptoms of withdrawal from cocaine aren’t always physically obvious, so they can be difficult to recognize.

Symptoms of withdrawal:

  • Craving cocaine
  • Feeling down or depressed
  • Feeling tired or exhausted
  • Feeling on edge or irritable
  • Feeling anxious
  • Feeling frightened, suspicious, or paranoid

Some people use medications or alcohol in an attempt to relieve the symptoms of withdrawal. But reliance on another substance to manage withdrawal can pose problems or lead to other addictions if withdrawal is not supervised and monitored by a medical professional. Learn more about the symptoms and timeline of cocaine withdrawal.​

Getting cocaine treatment

Taking the first step toward treatment can be daunting, but it’s an important step toward changing a life.


Though there is ongoing research in this area, there are no specific drugs approved by the U.S. Food and Drug Administration to manage cocaine addiction. During treatment, a doctor may prescribe medications to alleviate withdrawal symptoms or other issues.


Cognitive behavioral therapy (CBT) has been effective in preventing relapse once someone has stopped using cocaine. CBT helps patients imagine new ways to approach tempting situations and build skills to understand lingering problems from cocaine use. Some CBT courses are available online or by phone for easy and convenient access.

Therapeutic communities are an effective treatment option for people who have the flexibility to live elsewhere for six to 12 months. Away from common triggers, people in recovery work together to understand their relationship with drugs and plan for continued recovery. Some communities also offer support services, including career counseling or legal support.

Contingency management is a proven treatment option for cocaine use disorders. Contingency management provides participants with rewards for negative drug test results, giving patients one more reason to quit.

Learn more about different therapy options.

Making treatment work for you

Recovery is a lifelong process. Along with continued therapy, many people have found organized groups in their communities helpful as they adjust to life in recovery.

Cocaine Anonymous

Cocaine Anonymous is a free resource for people recovering from problems with cocaine or other drugs. CA is a safe and open community that follows a 12-step program to support members on their recovery.

Find Support near You