Cocaine is a fast-acting stimulant made from coca leaves, usually sold as a powder (cocaine hydrochloride). Crack contains the same active drug in a form usually smoked. See the crack cocaine guide for lung risks and how smoking changes the effects.1
Get emergency help now
What is cocaine and what does it do?
Powder cocaine is usually a white crystalline powder, often called coke or blow. It is commonly snorted and can also be injected. Cocaine blocks the reuptake of dopamine, which helps explain its reinforcing effects.10 It can briefly increase energy and alertness, while raising heart rate and blood pressure and reducing appetite. Anxiety, sweating, restlessness, and enlarged pupils can also occur. Cocaine is a stimulant. An opioid such as fentanyl can be present in the same supply.124
How long does a cocaine high last?
After snorting, effects can begin within a few minutes and the high often lasts roughly 15 to 30 minutes. Timing varies by route and other factors. The end of the high does not tell you whether the drug is still detectable or whether a new symptom is safe to ignore.15
Short and long term effects of cocaine
Repeated use can affect sleep, appetite, mood, and the heart. Cocaine can trigger an abnormal heart rhythm, heart attack, stroke, or seizure, including during a single episode. Injecting adds risks such as bloodstream infections and exposure to HIV or hepatitis when equipment is shared.124
What is cocaine nose?
Snorting cocaine can cause nosebleeds and reduce your sense of smell. Repeated exposure can damage the lining and the septum, the wall between the nostrils. Get persistent nosebleeds, pain, or a change in your sense of smell checked.14
What happens when you mix cocaine and alcohol?
When both are in the body, the liver can produce cocaethylene, a compound linked to added cardiovascular risk. Alcohol does not protect against cocaine toxicity. Treat chest pain or fainting after using either together as an emergency.26
Signs of cocaine use and cocaine addiction
Recent use may cause enlarged pupils, restlessness, a fast heartbeat, or a runny nose after snorting. These signs have other possible causes. Cocaine use disorder is assessed from a pattern over time, such as repeated attempts to cut back, strong cravings, or continuing to use despite harm to health, work, or relationships. A clinician can help assess the pattern even if you’re unsure how serious it is.14
If you’re worried about someone, describe what you’ve noticed in a calm moment and offer to help them arrange an assessment. See help for families.
Cocaine withdrawal symptoms and timeline
A cocaine comedown or crash can involve exhaustion, low mood, irritability, and an urge to use again. After repeated use, cutting down or stopping can bring withdrawal symptoms such as increased appetite, disturbed sleep, vivid dreams, slowed thinking, and cravings. The first day often brings sleepiness and irritability. Some symptoms, including low mood, anxiety, or sleep problems, can persist for weeks or longer. There’s no fixed timeline.47
Seek prompt help for severe depression or worsening symptoms. Call 911 if someone is in immediate danger. Tell the clinician if you also use alcohol, benzodiazepines, or opioids. Withdrawal or overdose risks from other substances can change what care you need.4
Cocaine detox and addiction treatment
A first appointment can help you decide whether outpatient care or a more structured setting is appropriate. The clinician can assess withdrawal symptoms, mood and sleep, heart or other medical concerns, substance combinations, and what support you have at home. Support during withdrawal is one part of care. Ongoing treatment helps with cravings and situations that make it hard to cut back.47
What to ask a cocaine rehab program?
- Do you offer contingency management? It provides tangible rewards for agreed treatment goals, such as attending sessions or submitting drug tests that are negative for stimulants. It has the strongest evidence for stimulant use disorder.4
- Can I get cognitive behavioral therapy or community reinforcement, and can you address anxiety, depression, or alcohol use in the same care plan?4
- What does a first visit cost, do you accept my insurance, and what support can I get between appointments?
There’s no FDA-approved medication specifically for cocaine use disorder. A clinician may consider off-label medication for some people, alongside behavioral care, or prescribe medication for a co-occurring condition. Peer groups such as Cocaine Anonymous can add support.47
Start with our treatment finder or a licensed clinician. Contact programs directly to confirm that they treat stimulant use disorder and offer the services you need.
Sources
Sources (11)
- MedlinePlusCocaine use
- CDCStimulant overdose prevention and response guide
- CDCWhat to do if someone may be overdosing
- ASAM and AAAPClinical guideline on stimulant use disorder
- ARUP ConsultDrug half lives and urine detection windows
- van Amsterdam and colleaguesSystematic review of cocaine and alcohol cardiovascular risks
- MedlinePlusCocaine withdrawal
- CDCFentanyl and fentanyl test strips
- MotherToBabyCocaine in pregnancy and breastfeeding
- NIDACocaine research and drug facts
- DEAPink cocaine
Sources are checked and updated periodically.
