What to Do in the Event of a Cocaine Overdose

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Kerry Canning, MBChB
Page Clinically Reviewed on by Kerry Canning, MBChB | Medical Editor

Important Notice

This page contains helpful information to support education on cocaine use and overdose. It is not intended as a replacement for professional medical intervention. Cocaine overdoses can be dangerous. If you are concerned about the welfare of an individual, please seek medical assistance.

Cocaine is an addictive stimulant drug.1 Overdoses represent medical emergencies. Understanding the signs of a cocaine overdose and learning how to react appropriately can be life-saving. 

In this article, we’ll examine the risk factors for a cocaine overdose and identify essential steps for managing an overdose event. 

  • What Is Cocaine? 

    Cocaine is an addictive drug made from the leaves of the coca plant, a shrub native to South America. Cocaine misuse is a global problem and it remains one of the most consumed stimulants around the world.2

    It’s the second most commonly used drug in England and Wales, after cannabis. Cocaine-related deaths rose and were more than seven times higher in England and Wales in 2022, compared with 2011.3

    In the UK, cocaine is classified as a Class A controlled drug, meaning that possession, production and supply of cocaine is illegal. Intending to supply, supply or manufacture cocaine can all result in life imprisonment, under the Misuse of Drugs Act 1971.3

    Cocaine works by stimulating the body. This increases the heart rate and can make a person feel heightened emotions including excitement, anxiety or confidence.

    The use of cocaine increases the level of dopamine in the brain’s reward system. This system is usually activated during pleasurable moments, such as eating an enjoyable meal. The boost of dopamine from cocaine is what leads to people feeling happy and talkative, as well as alert. However, cocaine can lead to aggression and an increase in risk-taking behaviours.4

    The excess of dopamine in the reward system also contributes to the addictive potential of cocaine. People who have used cocaine are motivated to repeat use to experience its pleasurable and rewarding effects.1

    The effects of cocaine can vary significantly between individuals. A person’s surroundings and their mood can influence its effects. It is therefore impossible to predict how cocaine will make a person feel.4

Risk Factors for Cocaine Overdose 

  • High Doses/Purity Levels: The purity levels of cocaine can vary between batches. Having a stronger batch and/or taking large amounts can increase the risk of overdose5,6
  • Dangerous Cutting Agents and Adulterants: Various substances can be added during the manufacturing process of cocaine. Research indicates that, in some cases, these other substances can make up 80% of the drug being sold as cocaine. Potent drugs such as fentanyl and other harmful substances have been found in cocaine, increasing the risk of overdose and death4,5
  • Injecting Cocaine: The effects of cocaine are influenced by how it’s taken. Injecting cocaine results in the quickest and strongest effects compared with smoking or snorting the drug. However, these effects can be short-lived, precipitating further use and increasing the risk of a fatal overdose6,7
  • Polydrug Use: Using more than one substance at or around the same time (i.e., polydrug use)6  enhances overdose risks. For example, mixing cocaine with alcohol produces a toxic chemical in the body, called cocaethylene, which impacts the cardiovascular system and raises the risk of overdose7
  • Psychiatric Illness: Having a mental health condition, like depression, can increase the risk of overdose8
  • Cocaine Addiction: People with substance use disorders, such as cocaine addiction,  will have developed tolerance, meaning they require greater quantities of cocaine to get the same effects. Tolerance and physical dependence on cocaine can lead to intense cravings and regular use, which increases the likelihood of overdose 8,9

Essential Steps for Managing a Cocaine Overdose 

A cocaine overdose is a medical emergency that needs immediate, effective intervention. Familiarising yourself with the right action to take can save lives. Here are the steps you should follow in the event of a cocaine overdose.

Recognise the Signs and Symptoms of a Cocaine Overdose

A cocaine overdose is a medical emergency and you should call 999 if you notice any of the following cocaine overdose symptoms.

Physical symptoms of a cocaine overdose include9:

  • Chest pain 
  • Breathing difficulties 
  • Elevated blood pressure, heart rate and body temperature
  • Shaking 
  • Sweating
  • Nausea and/or vomiting Seizures 

Cocaine overdoses can also precipitate various psychological effects, such as6,9:

  • Heightened anxiety
  • Agitation 
  • Confusion
  • Paranoia 
  • Panic
  • Hallucinations (i.e., false sensory perceptions) 

A cocaine overdose can have damaging effects on vital organs, which can lead to heart attack and stroke.9,10 Getting help quickly in these situations can save lives. 

Call Emergency Services Immediately

If you suspect an overdose, call 999 right away. If you know the person has taken cocaine, it is important to let the operator know, as this will allow the medics to provide the right treatment and maximise the patient’s chances of recovery. 

While you are waiting for the ambulance to arrive, stay calm and provide reassurance. It is important to remain with the person and try to keep them awake as their condition could worsen and they could become unconscious.

If you are not sure what drugs have been taken, you can collect any relevant substances or paraphernalia so the emergency services can identify what was taken.11

Provide Basic Life Support

Whilst you remain with the person, you can continue to monitor them. If the person has difficulty breathing or becomes unconscious, you should put them into the recovery position. By lying on their side, you keep their airways clear and minimise the risk of choking.

If the person is unconscious and not breathing normally, you should start CPR. Emergency call handlers can provide basic life-saving instructions over the phone, so can support you in performing CPR. If you feel confident in doing so, you can give rescue breaths in addition to chest compressions. Cycles of 30 chest compressions and 2 rescue breaths can be given until the person begins to recover or help arrives.11,12

Stay with the Individual Until Help Arrives

    Continuing to monitor the person until the paramedics arrive is a vital step in supporting someone through a cocaine overdose. These patients can be incredibly anxious or panic-stricken, so providing a calm and reassuring presence can be extremely helpful. 

    Once the emergency services arrive, you can hand over the situation by explaining what you know about the person’s condition and any substances involved.11

    Follow Up with Medical and Psychological Support

      Following the acute emergency of a cocaine overdose, it is important to provide follow-up care and support. Some patients may be suicidal and should be referred for mental health counselling prior to leaving the hospital. Educating patients and their families and encouraging patients to seek counselling support can help people living with cocaine misuse and addiction on their journey to recovery.13

      Harm Reduction Strategies 

      The following measures can help to reduce the harmful effects of cocaine and mitigate risks of overdose6,9: 

      • Use smaller amounts of cocaine 
      • Avoid daily cocaine use, even of small amounts  
      • Avoiding smoking cocaine as this can precipitate excessive use 
      • Avoid sharing drug paraphernalia
      • Do not take it with other drugs, e.g., other stimulants, or alcohol
      • Do not engage in strenuous exercise while taking it 
      • Rotate nostrils for snorting 
      • Crush the cocaine into a fine powder before snorting to avoid cuts
      • Use a saline spray, or rinse nostrils with water, before, during and after snorting to reduce damage to the nasal passages and sinuses 
      • Eat healthy foods regularly, stay hydrated and get plenty of rest

      The only way to eliminate the risk of an overdose is to avoid cocaine altogether. If your cocaine use feels out of control, it’s important to seek help. 

      Cocaine Addiction Treatment at Castle Craig 

      Our friendly and experienced team are here to support you on your journey to lasting recovery and a fulfilling life in sobriety. 
      01721 546 263 Admissions

      Getting Help for Cocaine Addiction  

      If you have experienced a cocaine overdose, this could indicate that you have an underlying addiction, also known as cocaine use disorder. Cocaine is a highly addictive stimulant drug that can significantly impact your physical and psychological health and well-being. Over time, it changes the structure and function of the brain, causing compulsive drug-seeking behaviours. Addiction can lead to a lack of control over use and intense cravings that can be extremely difficult to overcome.9

      At Castle Craig, we understand the challenges associated with cocaine addiction. We have been helping people to overcome addiction for over 35 years, so we know that with the right support in place, addiction is a treatable condition. Our treatment programmes are tailored to each individual patient and can feature key elements such as:

      1. Medical Detoxification: Our medically supervised detoxification process enables patients to withdraw from cocaine in a secure and supportive environment at our on-site detox unit The medical team at Castle Craig delivers round-the-clock care to support patients through this important first stage in recovery 
      2. Therapeutic Interventions: At Castle Craig, we recognise the importance of delivering evidence-based therapeutic modalities. As part of our comprehensive treatment plans, we offer a range of treatment options, including cognitive behavioural therapy (CBT), individual and group counselling and family therapy. This can help individuals uncover the root causes of addiction, identify unhelpful thoughts and, ultimately, create positive, lasting changes
      3. Psychiatric Support: For those with a dual diagnosis, such as cocaine addiction and depression, we offer psychiatric care. This integrated approach means that we are able to take a holistic approach and treat these conditions at the same time 
      4. Holistic Therapies: At Castle Craig, we prioritise holistic health. Our programmes offer a range of complementary therapies from Indian head massage to mindfulness meditation. These therapies can enrich patients’ physical, emotional and spiritual well-being and support recovery 
      5. Aftercare Planning: Our teams recognise the importance of aftercare in supporting a successful and lasting recovery from addiction. At Castle Craig, we offer all patients a comprehensive aftercare plan, called a Continuing Care Plan, which includes access to outpatient services, support groups and counselling