What Are the Signs of a Cocaine Overdose? Here’s When to Call 911

What are the signs of a cocaine overdose?

A cocaine overdose will look and feel very different from the wanted effects of the drug. Someone under the influence of cocaine may experience:

• Euphoria and a sense of confidence

• High levels of energy and little need for sleep

• Little to no appetite

• Increased physical and mental sharpness

When an overdose occurs, these effects give way to concerning mental and physical symptoms. Someone overdosing on cocaine may experience:

• Chest and stomach pain

• Changes to their heart rhythm

• Rapid breathing

• Dangerous increase in body temperature

• Nausea and vomiting

• Twitching and convulsions

During a cocaine overdose, someone may experience psychiatric symptoms like:

• Paranoia

• High anxiety and panic

• Confusion

• Aggression, agitation, and violence

• Sudden mood changes

• Restlessness

In the most serious cases, cocaine overdose, sometimes called cocaine toxicity, can result in:

• Heart attacks

• Strokes

• Seizures

• A lack of oxygen due to breathing problems

• Coma

• Death

These symptoms can worsen quickly. Any time you notice possible signs of a cocaine overdose, contact medical professionals immediately. Call 911, or go to the nearest emergency department for the best care.

What to do if someone is overdosing on cocaine

If you notice that someone is showing signs of a cocaine overdose, try to stay calm and get them professional emergency care. The risks of cocaine overdose are too great to manage alone. 

Currently, there’s no medicine to stop or reverse the symptoms of a cocaine overdose. Healthcare professionals will evaluate the person’s physical and mental health status to provide effective treatments. Some people need intensive medical care to stabilize their symptoms. 

You may worry about seeking help for yourself or a loved one due to legal issues. Many states have laws in place to protect you from charges as long as you’re acting to protect someone in need. 

How much cocaine does it take to overdose?

A cocaine overdose can happen with any dose. The amount it takes to overdose on cocaine depends on different factors, including:

• The person’s tolerance to cocaine

• The purity of the drug

• If there are other substances mixed in with the cocaine

• Simultaneous use of other substances (like mixing alcohol with cocaine)

Remember that cocaine is a very powerful substance, and there’s no guarantee that there aren’t other substances mixed in. Overdose death is always a risk with cocaine — even with a small amount.

What are common ways people overdose on cocaine?

People may overdose on cocaine simply by having too much of the substance in a short amount of time. Also, they might not understand the purity of the drug they’re using and consume more than their body is used to.

Changing the method of use can increase the risk of a cocaine overdose as well. Someone who is used to snorting the drug could have a very different experience if they smoke or inject it.

Other people may overdose when mixing cocaine with other drugs. It’s common practice to use it with alcohol or heroin to produce different results.

How common are cocaine overdoses?

Through the early 2000s, cocaine overdose rates were fairly steady. Each year, around 5,000 people died from cocaine-related overdoses.

This trend began to change in 2014 and 2015, when cocaine overdose deaths skyrocketed. In 2022, more than 27,500 people in the U.S. died from overdoses involving cocaine.

At the same time, the overdoses that involve cocaine and human-made (synthetic) opioids together have grown tremendously. It seems that the combination of these two substances can lead to seriously negative consequences.

What happens in the body during a cocaine overdose?

Cocaine has a quick and drastic impact on the body and brain. As a stimulant drug, cocaine speeds up many processes in the body, with significant effects on the cardiovascular system. 

In the brain, cocaine disrupts the normal communication of chemical messengers. With changes to chemicals like dopamine, serotonin, and norepinephrine, the brain is thrown out of balance. So it sends confusing or damaging messages to the rest of the body.

There are three main stages of acute cocaine toxicity. As you can see in the section above on the signs of a cocaine overdose, the body can go through significant changes in a short period of time:

• At first the body may go into overdrive, with a fast heart rate, increased blood pressure, and accelerated rate of breathing. 

• But as cocaine toxicity worsens, these symptoms go to the other extreme. Blood pressure drops, it gets hard to breathe, and a person can experience loss of vital functions. 

• At this point, someone becomes unresponsive.

Beyond the immediate risk of overdose, repeated use of cocaine can lead to impaired brain function and other long-term effects. 

Is there cocaine laced with fentanyl?

When a harmful substance is mixed into cocaine, it can increase the risk of overdose. The Drug Enforcement Administration (DEA) has discovered cocaine laced with fentanyl and carfentanil, two powerful synthetic opioids with a high risk of overdose.

Fentanyl is a human-made opioid linked to many deadly overdoses. Fentanyl is 100 times more powerful than morphine. It only takes about 2 mg of fentanyl to kill someone. 

Carfentanil is another, even more powerful opioid. It’s about 10,000 times stronger than morphine.

Some drug dealers mix in these substances as a way to increase cocaine’s effects. Others mix in these powerful drugs accidentally and without being aware of the consequences.

How to prevent a cocaine overdose

The best way to avoid a cocaine overdose is to not use cocaine at all. Avoidance may not be possible for everyone, so others should consider harm reduction practices.

Harm reduction services can help by:

• Teaching you about drug overdoses

• Preventing and treating infectious diseases from unsterile practices

• Providing testing kits to check the substances you use for fentanyl (called fentanyl test strips)

• Offering opioid reversal drugs, like naloxone, which is offered for free in some places

Not everyone can stop using cocaine quickly and easily. Harm reduction centers offer a safe and practical way to avoid deadly overdoses.

Why trust our experts?

Written by:

Eric Patterson, LPC

Eric Patterson, LPC, has been a professional counselor in school and outpatient settings for over 15 years. Patterson has been cited as a mental health expert in publications such as Today.com, Good Housekeeping, and InStyle.

Edited by:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Karen Hovav, MD, FAAP

Karen Hovav, MD, FAAP, has more than 15 years of experience as an attending pediatrician. She has worked in a large academic center in an urban city, a small community hospital, a private practice, and an urgent care clinic.

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