cocaine powder and needles

Cocaine is a powerful drug. The feelings of pleasure and euphoria make it very addictive even after just one use. You don’t hear much about it but cocaine psychosis is a surprisingly common (and serious) side effect. A 2014 study even revealed that cocaine psychosis occurred in more than 65% of the cocaine-dependent participants. In fact, cocaine can produce a variety of psychiatric symptoms. This can happen during use and during withdrawal.

Can cocaine cause psychosis? Not always. But given those statistics, it’s pretty clear that it’s a real risk that should be better understood.

Who Is at Risk for Cocaine Psychosis?

What is cocaine psychosis? It’s a side effect that can produce episodes lasting a few hours or even a few weeks. Research suggests that the more you use cocaine, the more severe the symptoms can become.

Psychosis causes are likely linked to the effect cocaine has on dopamine. This key neurotransmitter carries information from neuron to neuron. It’s also important in regulating attention and emotions. Scientists have linked abnormal levels of dopamine with psychosis. Risk factors include:

  • Frequency of Use: The more you use cocaine, the more it affects key chemicals in your brain.
  • Dosage: Cocaine psychosis is seen more frequently in people who consume higher doses.
  • Body Mass Index: Research studying the link between body mass index (BMI) and cocaine-induced psychosis reveals that those with a lower BMI are at increased risk.
  • Age: Young age (ages between 16 and 25) is a risk factor. Adults age 65 or older may also be at higher risk. That’s because they’re more likely to experience adverse effects of cocaine and other illicit substances.
  • Gender: A 2010 study showed that women who were dependent on cocaine were more likely than cocaine-dependent men to experience psychosis.
  • Co-Occurring Disorders: Research suggests that patients who also have other psychiatric problems experience psychosis more often. Those disorders can worsen with use.
  • Family History: A Swedish study published in the American Journal of Psychiatry in May 2019 suggests that people with a family history of drug and alcohol addiction are at a higher risk of experiencing cocaine psychosis. So are those with a family history of psychosis.

Signs of Cocaine Psychosis

Cocaine psychosis symptoms will subside, but they can last hours, days or weeks. Cocaine use or withdrawal can cause it. Signs of psychosis often resemble mental illnesses like schizophrenia. Symptoms include:

  • Delusions: Someone experiencing cocaine psychosis may not seem like they’re fully rooted in reality.There are many different types of delusions. They include feelings of having more power or talent than the person may have. Someone suffering from delusions might believe their significant other is cheating on them. Or they might think that people are out to get them.
  • Hallucinations: Cocaine can cause hallucinations. Cocaine-induced psychosis symptoms include visual and auditory hallucinations. It can also make you feel like you have insects crawling over your body.
  • Paranoia: Paranoia is another symptom of psychosis. It’s often one of the earliest symptoms and occurs in up to 84% of cocaine users. Symptoms include illogical mistrust, defensiveness in response to imagined criticism and hypervigilance.

Treating Cocaine Psychosis

Cocaine psychosis treatment requires medical intervention. Doctors will rely on a combination of therapy and medications to control the symptoms. But quitting cocaine use is equally important. Patients should seek help immediately. Stopping use of the substance triggering the condition is essential.

Medication-Assisted Treatment

One of the first steps to treating the condition includes entering a treatment facility. These facilities provide access to doctors and nurses to support patients and help them safely stop using cocaine. The team can also administer medication-assisted treatment. In most cases, the treatment team will work to:

  • Get the symptoms of cocaine psychosis under control
  • Begin the detox process and help manage symptoms of withdrawal
  • Suppress cravings

Many patients start by getting antipsychotics or anti-anxiety drugs. The treatment team will also evaluate the overall health. This allows treatment providers to identify things like:

  • Co-occurring mental health conditions
  • Goals for the patient’s recovery
  • Obstacles to the patient’s sobriety

In many cases, treatment teams combine medication-assisted treatment with other therapies. This could include group or individual sessions. It may also include cognitive behavioral therapy. This is a type of therapy that gives patients coping tools and strategies and helps them to better understand their behaviors.

If you’re ready to stop using cocaine, The Recovery Village at Palmer Lake can help you understand treatment options and find a plan to meet your individual needs. Contact The Recovery Village at Palmer Lake to learn more.


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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.