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Signs of Cocaine Use: How to Tell if Someone is on Coke

Signs of Cocaine Use: How to Tell if Someone is on Coke
Written by Seth Fletcher on November 5, 2023
Medical editor Dr. Chintan Shah
Last update: April 26, 2024

Cocaine is a powerful and highly addictive substance abused for its intense euphoric effects. It is obtained from the coca plant and synthesized into a fine white powder that is snorted, injected, or smoked. The drug goes by several street names – coke, rock, crack, flake, snow, and blow. Cocaine use is often sensationalized in movies as a high-priced way to get high and have fun, but the reality is more alarming. Abusing cocaine leads to severe adverse and often life-threatening consequences. Many people who use cocaine become dependent on the drug and find they need to take the drug to feel normal.

Regular cocaine use changes the brain and makes quitting difficult without help. It’s crucial to spot cocaine abuse early to avoid a potentially tragic outcome. You should act quickly if you suspect that a loved one is abusing cocaine. The Canadian Centre for Addiction explores the signs of cocaine use and how to help someone struggling with cocaine abuse and addiction.

Key Takeaways

  • Cocaine is one of the world’s most cultivated and abused illicit substances.
  • Cocaine use is dangerous and can lead to severe and life-threatening adverse consequences.
  • Genetic, environmental and psychological factors are among the risk factors for cocaine use.
  • People who abuse or are addicted to cocaine often require professional help to break free from the cycle of abuse and addiction.

Why Do People Use Cocaine?

  • Reason One (To achieve the powerful euphoric effects)

People use cocaine to achieve the powerful euphoric effects associated with the drug. Using cocaine triggers the release of dopamine – a chemical in the brain that regulates pleasure and motivation. Cocaine keeps users wide awake, positive, and generally confident. It allows users to release their inhibitions and attempt things they wouldn’t have without cocaine. However, the high that comes with cocaine use is temporary and is followed by an unpleasant comedown. The negative feelings from a cocaine comedown prompt the user to seek cocaine again. Continuous cocaine use in this way creates a vicious cycle that leads to tolerance, dependence, and addiction.

  • Reason Two (Portrayed as a harmless way to have fun)

Another reason why people use cocaine is the mystique that seems to surround the substance. Cocaine is often portrayed as a harmless way to have fun, which can be attractive to people with low self-esteem or who want to get into certain circles.

  • Reason Three (Genetic factors and family history)

Genetic factors and family history may also play a role in cocaine use. Individuals from families with a history of substance abuse may be more likely to abuse drugs like cocaine. People in neighbourhoods where drugs are easily accessible may also have a higher chance of getting and using cocaine.

The Canadian Centre for Addictions helps people struggling with cocaine use and addiction. Our drug rehab centres employ sophisticated recovery strategies in an environment that inspires lasting change. At CCFA, we help people understand their addictions and the healthier coping strategies available by engaging them in one-on-one counselling with certified counsellors, psychiatrists, and mental health professionals.

Call 1-855-499-9446 today for support and counselling if you or a loved one is dealing with cocaine addiction.

How Common Is Cocaine Use?

Along with marijuana and opioids, cocaine is among the world’s most cultivated and trafficked illicit substances. Cocaine use in Canada is the second highest in the world. Around 2% of the population consumed cocaine in some form in 2017. The rate of cocaine use in individuals aged 20 to 24 continues to increase in Canada.

Cocaine has a relatively low price point in Canada despite its status as one of the world’s most expensive illicit substances. The average cost of cocaine in Canada is $85 per gram compared to the global average of $120. In 2020, 62% of stimulant toxicity deaths in Canada involved cocaine.

What Are the Risk Factors of Cocaine Use?

Cocaine use and addiction are usually the result of several factors, including:


Individuals with relatives who struggle with cocaine or other drug addiction are likely to develop an addiction at some point. Studies suggest that genes may be responsible for as much as 70% of cocaine addiction cases.

Environmental and Social Pressure

Individuals living in areas with high incidents of trauma, violence, drug abuse, and other stressors may be more likely to become addicted to cocaine. Peer pressure, media exposure and the mystification of cocaine use can incline certain individuals toward cocaine use.

Psychological factors

Individuals may use cocaine as a coping or numbing mechanism for psychological or emotional discomfort. Cocaine use and addiction may also result from attempts to manage the symptoms of pre-existing mental health disorders.

Dangers of Cocaine Use

Cocaine use, even casually, can lead to severe adverse physical and mental health effects. In the short term, cocaine causes:

  • Diminished appetite and weight loss
  • Dry mouth
  • Heightened startle reflexes
  • Extreme sensitivity to stimuli
  • Elevated blood pressure
  • Increased heart rate

With continued use, an individual will develop tolerance and more cocaine to achieve the same effects. Using cocaine with increasing frequency presents several dangers to your organs and systems, including:

The Brain

Cocaine constricts the blood vessels and reduces the amount of oxygen that gets to the brain, increasing the risk of strokes, seizures, and cerebral atrophy. Long-term use can also affect cognitive functions, impulse control, and decision-making capabilities.

The Heart

Long-term cocaine use increases the risk of blood clots in the heart, potentially causing cardiac arrests, embolisms, and permanently elevated blood pressure.

The Liver

Repeated cocaine use can cause dead tissue to form in the kidneys, affecting their functions. Cocaine use can also cause plaque accumulation in the renal walls, leading to atherosclerosis.

The Kidney

Repeated cocaine use can cause dead tissue to form in the kidneys, affecting their functions. Cocaine use can also cause plaque accumulation in the renal walls, leading to atherosclerosis.

Mouth and Nose

Snorting cocaine can cause extensive damage to the mucous membranes with time. Long-term cocaine use destroys the mucous membrane lining and obstructs blood flow to the nose, leading to a perforated septum and a collapsed nasal structure. Long-term cocaine snorting can also make a person lose their sense of smell or develop difficulty swallowing.


Cocaine prevents oxygen from reaching the bloodstream and increases the risk of pneumonia, asthma attacks, and respiratory distress.


Ingesting more cocaine than the body can handle can lead to death if not addressed immediately. Symptoms of cocaine overdose include:

  • High body temperature
  • Confusion
  • Seizures
  • Irritability
  • Paranoia
  • Vision loss
  • Rapid heartbeat
  • Excessive sweating
  • Coma

Signs and Symptoms of Cocaine Use and Addiction

Several side effects come with drug abuse. The signs and symptoms of cocaine use and addiction could be physical, behavioural, and psychological. These include:

Physical Signs

  • Dilated pupils
  • Irregular heart rhythms
  • Nasal perforation/nosebleeds
  • Runny nose
  • Hoarseness
  • Sexual dysfunction
  • Seizures
  • Strokes
  • Tremors
  • Muscle twitches
  • Heart attacks

Behavioural Signs

  • Anxiety and panic 
  • Talkativeness
  • Restlessness
  • Loss of inhibition
  • Aggressive or violent behaviour
  • Increased mental alertness and decreased need for sleep
  • Erratic behaviour
  • Legal troubles
  • Financial difficulties
  • Presence of drug use paraphernalia (syringes, glass pipes, rolled-up bills, playing cards, and razors)
  • Increased energy
  • Neglecting responsibilities or hobbies
  • Stealing or borrowing money to fund cocaine use

Psychological Signs

  • Intense cravings for cocaine
  • Reckless and risky behaviour
  • Sudden personality changes
  • Poor decision-making and judgment
  • Losing touch with reality
  • Hallucination
  • Rationalizing cocaine use
  • Demotivation
  • Psychotic behaviour
  • Paranoia
  • Mood swings
  • Withdrawal symptoms
  • Suicidal thoughts

How to Approach and Handle Someone Using Cocaine

Approaching and talking to someone using cocaine is a sensitive matter requiring delicate handling. Drug users are likely to deny they have a problem and may react aggressively if pressed further. First, you want to learn all you can about what they’re going through. Learning about their problem lets you know what to watch out for and how best to help them.

Pick a good time and place to talk, preferably a calm place where the person feels at ease. Also, select a time when you know they won’t be under the influence of cocaine. Start the conversation calmly, explaining your concerns in a non-accusatory tone. Bring up specific moments when their cocaine use caused problems and explain why you think they should seek help. Give them time to talk and pay attention to what they’re saying. If they respond positively to your attempts, end the discussion by suggesting the next steps and presenting available options for professional help.

Your attempts may not yield the desired results the first time. Try to end the discussion calmly if they’re getting angry or defensive. You may schedule another talk or involve a professional next time. Understand that you’re not responsible for their behaviour and don’t need to feel guilty if things do not work out as you planned. Ultimately, the decision to quit drug use is up to the individual. Even if they don’t respond positively the first time, your attempts might make them more open to change in the future.

When to Seek Professional Help

Cocaine use is dangerous and life-threatening, even if it’s done only occasionally. Using cocaine will lead to physical and mental health consequences that will eventually permeate every aspect of one’s life. Seeing any of the following signs may mean it’s time to seek professional help.

  • Using larger amounts of cocaine than intended
  • Trying and failing to reduce or stop cocaine use
  • Spending significant amounts of  using cocaine or trying to recover from the effects
  • Continued cocaine  use despite obvious physical, mental, or behavioural health issues
  • Continued cocaine use, even when it’s affecting one’s work, school, or relationships
  • Giving up important activities to use cocaine
  • Cocaine use in dangerous situations like driving or operating hazardous machinery
  • Intense cravings for cocaine
  • Withdrawal symptoms upon reduction or cessation of cocaine use


Cocaine use and addiction symptoms are detrimental to the user mentally and physically and can cause them to inflict harm on themselves, their family, and others around them. If you want to learn how to spot the signs early on and tell if someone is using cocaine, we’ve got you covered. At CCFA, we offer several treatment options to cocaine abusers seeking to break their addiction cycle. If you’re reading this for yourself or a loved one, you’ve taken a great first step. Now, take the most important next step and talk to someone.


What are some common disorders that co-occur with cocaine?

Some common mental health disorders that co-occur with cocaine use include schizophrenia, bipolar disorder, depression, anxiety, and personality disorders.

What are the signs of cocaine withdrawal?

The signs of a coke user in the process of withdrawal are mostly psychological and include:
● Intense cravings
● Anxiety
● Depression
● Fatigue
● Paranoia
● Increased appetite
● Difficulty concentrating
● Irritability
● Inability to feel pleasure
● Changes in sleep patterns (difficulty falling asleep or oversleeping)
● Vivid dreams and nightmares
● Suicidal thoughts

Is treatment necessary for cocaine addiction?

Yes, cocaine addiction is tough to overcome without help. Cocaine addiction changes the brain and affects how the user experiences pleasure. Professional addiction treatment is often required to identify and modify the thinking patterns and behaviours that promote cocaine use.

What drug tests detect cocaine?

The drug tests for cocaine include urine, saliva, blood, and hair testing. The tests detect benzoylecgonine, a marker for cocaine.

What affects how long cocaine stays in your system?

The factors that affect how long cocaine stays in a user’s system include:
● Amount of cocaine used
● Frequency of cocaine use
● User’s metabolic function
● Their age

Certified Addiction Counsellor

Seth brings many years of professional experience working the front lines of addiction in both the government and privatized sectors.

Dr. Chintan is a Board Certified Family Physician with an interest in holistic and preventative care as well as healthcare systems. Credentialed Physician with both American & Canadian Board of Family Medicine. Adjunct Professor in the Department of Family Medicine at the Schulich School of Medicine & Dentistry. Telemedicine clinician.

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