Cocaine Overdose

person snorting lines of cocaine

Cocaine is a psychostimulant drug that is used for its ability to produce euphoric effects and increase mental alertness. Cocaine is highly addictive and chronic use of cocaine is associated with negative effects on physical and mental health. Besides having long-term consequences, even acute cocaine use can result in life-threatening effects. Some of the effects of cocaine overdose include cardiovascular toxicities, stroke, respiratory failure and death.

How Do Cocaine Overdoses Occur?

There is a widely held misconception that cocaine overdose only occurs at high doses. However, cocaine intake can result in toxic effects regardless of the amount consumed, route of administration and frequency of use.

Cocaine overdoses have been reported fatal at low doses involving only a few hundred milligrams, while consumption of multiple grams of cocaine has been shown to be non-lethal in other cases. Chronic use of cocaine may result in the development of tolerance, with higher doses of the drug being required to produce the desired effects. Tolerance causes higher doses of cocaine intake while resulting in anatomical and neurochemical changes that increase the chances of an overdose. For example, regular cocaine intake results in ventricular hypertrophy that can increase the chances of arrhythmias and myocardial ischemia.

The route of administration can also affect the possibility of an overdose, with the methods of administration that cause a rapid increase in the levels of cocaine in the bloodstream more likely to cause an overdose. The intravenous injection of cocaine is more likely to cause an overdose, followed by smoking and snorting. Toxicities due to cocaine intake are likelier when cocaine is used with other substances including alcohol and heroin. For example, cocaine interacts with alcohol to form a compound called cocaethylene, which is similar to cocaine but is more toxic and stays in the body for a longer time.

Cocaine Overdose Signs and Symptoms

Many of the symptoms of a cocaine overdose overlap with those caused by other psychostimulant drugs like MDMA and amphetamines. They involve the excessive activation of the sympathetic nervous system (the fight-or-flight response). Some of the physical and psychological symptoms are also caused due to the increase in the levels of the neurotransmitters dopamine and serotonin due to cocaine intake.

Some of the physical signs of a cocaine overdose include:

  • Nausea and vomiting
  • Increased heart rate and blood pressure
  • Chest pain
  • Breathing difficulties and hypertension
  • Headaches
  • Seizures
  • Sweating
  • Dilated pupils

Some of the psychological symptoms of a cocaine overdose include:

  • Hallucinations
  • Paranoia
  • Anxiety
  • Panic
  • Severe agitation

What Happens During An Overdose?

The commonly observed symptoms during an overdose include seizures, hyperthermia, excessive sweating and heart palpitations. Some individuals may also lose consciousness due to an overdose. Other common symptoms include chest pain, breathing difficulties, extreme agitation, anxiety and blurred vision.

If an overdose is suspected, call 911 immediately.

Cocaine Overdose Duration

Cocaine has a short half-life of 45 to 90 minutes, so the symptoms of a cocaine overdose, although intense, do not last for a long time. Although a cocaine overdose can be fatal, many individuals respond to medical intervention or even recover spontaneously. However, an overdose can lead to permanent damage involving cognitive deficits, chronic anxiety, a decline in heart functioning, kidney failure and muscle damage.

Dangers of a Cocaine Overdose

Cocaine overdose can lead to cardiovascular toxicities, respiratory failure, kidney failure, seizures, stroke and excited delirium. Toxicities involving the cardiovascular system include arrhythmias (irregular heartbeat), myocardial ischemia (lack of oxygen supply to the heart muscles) and myocardial infarction (heart attack). The aforementioned symptoms may also result in death. Some of the effects of cocaine overdose may be permanent. Such effects include chronic anxiety, psychosis, cognitive deficits, kidney failure, muscle damage and reduced cardiac function.

Cocaine Overdose Statistics

Cocaine overdose was the cause of death in 13,942 cases in 2017 opposed to 10,375 deaths in 2016, as reported by the CDC. This statistic represents a 34.4% increase in fatalities caused by a cocaine overdose. In addition, in deaths involving cocaine use:

  • Males accounted for 10,021 cases out of 13,942 deaths caused by a cocaine overdose
  • Cocaine accounted for 19.7% of all deaths caused by drug overdose in 2017
  • Opioids were involved in more than half (50.4%) of the fatalities caused by a cocaine overdose

Cocaine Overdose Deaths

A cocaine overdose can be fatal. The major causes of deaths due to cocaine overdose include seizures, cardiac arrhythmias, and hyperthermia. Other causes of death include stroke, respiratory failure, excited delirium and myocardial infarction.

Cocaine Overdose Treatment

There are no medications that can reverse the effects of a cocaine overdose. Treatment for cocaine overdose generally involves the management of the symptoms (i.e., supportive care). The course of treatment depends on the presentation of symptoms. Treatment begins with the assessment of the vital signs including body temperature, breathing rate and blood pressure by the first responders or emergency room doctors. These vitals are monitored closely throughout the treatment process.

Breathing support or intravenous fluids may be provided to the patient. Benzodiazepines are generally the first-line of treatment for cardiovascular symptoms and agitation. Antipsychotics such as haloperidol or olanzapine may be used in combination with benzodiazepines for the treatment of agitation. Various cooling methods including immersion in an ice bath may be used for lowering a person’s body temperature. Medications are also used for the treatment of other symptoms involving hypertension, high blood pressure, seizures and complications involving the heart, kidney, muscle and the brain.

Cocaine Overdose Prevention

Cocaine overdose can occur regardless of the dose used and the frequency of use, making even low doses of cocaine life-threatening. Furthermore, cocaine has a high potential to cause addiction and chronic and acute use of cocaine has negative effects on mental and physical health.

If you struggle with cocaine use, contact The Recovery Village Ridgefield to speak with a representative about how addiction treatment can help. Take the first step toward a healthier future, call today.

Kaye, Sharlene; Darke, Shane. “Non‐fatal cocaine overdose among injecting and non‐injecting cocaine users in Sydney, Australia.” Addiction, October 2004. Accessed August 1, 2019.

National Institute on Drug Abuse. “Cocaine.” July 2018. Accessed August 1, 2019.

Kariisa, Mbabazi; et al. “Drug Overdose Deaths Involving Cocaine and Psychostimulants with Abuse Potential — United States, 2003–2017.” Morbidity and Mortality Weekly Report, May 2019. Accessed August 1, 2019.

MedlinePlus. “Cocaine Intoxication.” January 2019. Accessed August 1, 2019.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.