• Cocaine Overdose And Synthetic Opioids

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    Common Signs of Cocaine Use and Overdose Symptoms

    In 2019 there were over 15,000 overdose deaths related to cocaine use, and the trend is continuing upward.1 It is essential for physicians and other medically trained staff to recognize the symptoms of cocaine use and the signs of a cocaine overdose to promptly and accurately treat patients.


    Cocaine overdose and cocaine withdrawal are both serious and potentially life-threatening conditions. Cocaine addiction affects every aspect of a person’s life, and cocaine addiction symptoms can be easily recognized. Some of the most common signs of cocaine addiction symptoms are:

    • Extreme agitation
    • Severe anxiety
    • Paranoia
    • Hallucinations
    • Fever or sweats
    • Increased heart rate
    • High blood pressure


    More serious symptoms occur when a person experiences a cocaine overdose. A cocaine overdose can occur any time that a person uses cocaine, and it is more likely when it is mixed with other drugs or alcohol. These include:

    • Heart attack
    • Irregular heart rhythm
    • Stroke
    • Seizures
    • Difficulty breathing

    Cocaine toxicity occurs quickly and can cause a cocaine overdose even on the first use. When combined with other synthetic opioids, such as fentanyl, toxicity levels quickly multiply.

    Why is Cocaine Overdose on the Rise?

    During the pandemic, there has been a significant rise in cocaine overdoses, with the majority occurring due to extreme cocaine toxicity as a result of the cocaine being laced with fentanyl. In 2020, synthetic opioid deaths increased by 55% to over 90,000 in that year.3

    When used by itself, fatal cocaine overdose is rare. The symptoms of long-term cocaine use are significant as cocaine withdrawal symptoms. However, for those who experience a cocaine overdose, cocaine overdose treatment is typically effective in preventing death.


    When synthetic opioids, such as fentanyl, are laced into cocaine, the drug becomes significantly more potent. Opioid-laced cocaine has led to a severe increase in overdoses. The pandemic has caused more people to turn to alcohol and other illicit substances as a coping mechanism.

    This increase in use is troubling, not only because of the increase in cocaine overdoses but also because having these substances in a person’s system weakens their immune system. A weakened immune system makes them more susceptible to other life-threatening illnesses.


    Over 50% of substance overdoses are the result of polysubstance abuse. When these extremely volatile substances are combined, they cause each other to behave in ways that they normally would not. In turn, this drug use causes the body to respond more severely than it would to a single substance.4

    Another cause of this severe drug interaction is that when a person has already taken one substance, their judgment and intelligence are already impaired when they decide to take another substance. This decision often causes them to take far more than they thought that they were, which further increases their chances of overdosing.

    The most common combinations of polysubstance drug abuse are:

    • Cocaine and alcohol
    • Opioids and benzodiazepines
    • Prescription and illegal drugs
    • Psychedelics and other drugs

    What is the Brain Reward System?

    The brain reward system is a circuit in your brain that causes feelings of euphoria to occur when it registers a significant amount of dopamine. It typically occurs when pleasurable things occur such as being in love, exercising, etc., and thus the brain rewards the person to make them want to do it again.


    This same reward system is activated falsely by drugs because they are designed to trigger a massive dopamine surge, which is often more intense than anything that would naturally cause this surge. In turn, drug use prompts a person to seek out the same rush of dopamine again and again. Factors that once provided a dopamine surge no longer can the same way that drugs can.

    Drug addiction rewires the brain’s pleasure centers and reward systems which is also what makes it so difficult to stop using a drug once a person has started. The severity of withdrawal symptoms increases as more damage is done to the brain’s reward system.

    Cocaine Overdose Treatment

    When symptoms of cocaine overdose are present, doctors will work to alleviate those symptoms as a method of treating the overdose. No medication is currently specifically used for cocaine overdose treatment. Rather, a mixture of other medications and treatment options are used to treat the signs of a cocaine overdose.


    Benzodiazepines are used to lower a person’s heart rate and blood pressure to more manageable and safe levels. This sedative reduces a person’s chance of a heart attack or stroke, and this drug also helps to lower their anxiety. In cases where these sedatives do not work in reducing heart rate, non-dihydropyridine calcium channels blockers may be used instead.

    In some cases of cocaine overdose treatment, antipsychotics may also be given if the patient is agitated, hallucinating, paranoid, violent, or unmanageable.

    Treatment for Cocaine Addiction

    Treatment is possible for cocaine addiction symptoms at any time. It is important to start treatment as soon as possible to limit the chances of an overdose. Unfortunately, many individuals will not seek treatment for their addiction until they have overdosed and have been forced to seek care.

    There is currently no specific medication for cocaine addiction. Although many have been tested, and some have shown effectiveness in managing some of the symptoms of cocaine withdrawal, none have been able to do so with any consistency in research.


    Inpatient detox is the first and foremost treatment option that should be considered for cocaine addiction. Once the patient has fully detoxed and is no longer experiencing severe withdrawal symptoms, then they can begin behavioral therapy to help them from relapsing.


    Inpatient and outpatient behavioral therapy are still the most effective treatment option for helping patients overcome cocaine addiction. These treatments help the patient to understand and manage any underlying causes or conditions that may be causing their addiction.

    In addition, these therapies help patients learn healthy coping mechanisms and help them to develop support groups that will help support their recovery which is essential in long-term sobriety.


    1. https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates
    2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2703432/#:~:text=The%20major%20effects%20of%20cocaine,simultaneously%20in%20several%20organ%20systems.
    3. https://www.npr.org/sections/health-shots/2021/04/22/989833102/overdose-deaths-surged-in-pandemic-as-more-drugs-were-laced-with-fentanyl
    4. https://healthcity.bmc.org/population-health/polysubstance-use-driving-overdose-deaths-adolescents
    5. https://archives.drugabuse.gov/blog/post/word-day-brain-reward-system
    6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2994240/