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Cocaine and Psychosis
Like other drugs, cocaine can produce a wide range of psychiatric symptoms in users.
What is Cocaine-Induced Psychosis?
Cocaine-induced psychosis occurs when a person experiences the symptoms of psychosis during or after cocaine use. These symptoms all revolve around users losing touch with reality: they may feel increasingly paranoid, hallucinate sensations, or become uncharacteristically aggressive or violent.
Cocaine works by triggering your brainās reward system. When a person ingests it, their brain floods with the feel-good chemical dopamine. Studies have found that psychosis can occur when too much dopamine is released by the brain. Cocaine in the form of ācrackā is typically associated with cocaine-induced psychosis, as the drug is more potent and increases dopamine levels more rapidly.

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How Long Does Cocaine Psychosis Last?
Psychosis induced by cocaine typically lasts for a few hours and subsides as the drug leaves your system. However, it can also last days or even weeks. The severity of cocaine-induced psychosis is different for everyone, but often the more you use cocaine, the greater the risk youāll experience it.
Cocaine psychosis is quite common. One study examining the relationship between psychiatric symptoms and drug use found that 68-84% of patients using cocaine experienced paranoia while violent behaviour was reported by as much as 55% of patients. According to the same report, many patients struggling with cocaine dependence have also been diagnosed with a co-occurring psychiatric condition.
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Symptoms of Cocaine-Induced Psychosis
The symptoms of cocaine-induced psychosis are the same as the symptoms of any form of psychosis. These include:
- Paranoia
- Anxiety
- Violent behaviour
- Hallucinations and delusions
- Suicidal or homicidal thoughts
It should be noted that psychosis resulting from cocaine intoxication is not distinguishable from any other kind of psychosis.
Within the context of other symptoms of cocaine use, cocaine-induced psychosis may be more likely to have unpleasant, frightening, violent, agitated, or vengeful characteristics than other forms of drug-induced psychosis. However, hallucinations of this type are by no means exclusively the result of drug use.
Paranoia is also a frequent and pronounced result for persons under the influence of coke, and subsequent hallucinations are more likely to be associated with paranoid fixations.

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Risk Factors of Cocaine Psychosis
While the risk factors for cocaine-induced psychosis are still being studied, doctors have found that several variables may impact your likelihood of experiencing psychosis from using cocaine. These include:
- How much Coke you use: Taking higher doses has been associated with psychosis.
- The methods you use: Smoking or injecting cocaine (as opposed to snorting it) and taking cocaine in the form of crack have all been linked to higher rates of psychosis.
- Length of use: Those who begin using cocaine before age 20 may be at a higher risk for psychosis.
- Combining substances: if you use other drugs alongside cocaine, you may be more likely to experience psychosis, especially if you take other drugs that affect your dopamine levels.
- Pre-existing mental health conditions: If youāve been diagnosed with a mental condition, especially one that already causes paranoia or hallucinations, you may be more likely to experience cocaine psychosis.
- Your weight: Studies have found that slim people experience cocaine-induced psychosis more often than people of average weight and higher.
Treatment Options for Cocaine Psychosis
People suffering from cocaine addiction and experiencing cocaine-related psychosis need specialized dual-diagnosis treatment. Dual-diagnosis patients require complex care, integrated with a comprehensive rehabilitation program, which we offer here at Castle Craig. The first step in recovery is detoxing from cocaine so that the underlying causes of psychosis may be treated as well.
Detox and Withdrawal from Cocaine
Using coke has stimulating effects like increased energy, euphoria, and alertness. During cocaine detox, the opposite sensations are often experienced: fatigue, mood swings, and difficulty concentrating. You may also experience mild to intense cravings for cocaine, along with paranoia or depression.
The duration of detox will depend on how long and how heavily you were using cocaine, and whether you were using any other drugs or alcohol at the same time. While not physiologically dangerous, detoxing from cocaine can be challenging and should not be done alone or at home, especially if you think you may be experiencing cocaine-induced psychosis.
Here at Castle Craig, patients are supervised by our compassionate team of doctors, nurses, and psychologists in our very own medical detox centre. This allows you to get the comprehensive care you need in a safe medical setting, overseen by our highly skilled team of addiction specialists and medical professionals.
While detox is a vital first step in recovery, true healing begins when you can address the root causes of your drug use. Thatās why our patients integrate into our therapeutic process while still in detox. Once cocaine-free, patients then join our residential treatment programme.

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Dual-Diagnosis Treatment at Castle Craig
People experiencing cocaine-related psychosis require specialized care that addresses both their struggles with drug use and the symptoms of psychosis theyāre experiencing. At Castle Craig, cocaine-induced psychosis treatment is personalized to each patient depending on their patterns of use, the length of their use, and other lifestyle factors that may impact their recovery.
From the detox stage onwards, our dual-diagnosis treatment programme combines specialized addiction group therapy, personal therapy, and cognitive behavioural therapy (CBT) to help you recover from cocaine addiction. We also provide family therapy sessions and bereavement therapy for patients who would benefit from them.
We consider our patient’s emotional and mental well-being just as important as their physical health, which is why we provide a range of complementary therapies to help you heal the whole of your being, such as acupuncture, massage, equine therapy, and mindfulness meditation.
After patients complete inpatient treatment at Castle Craig, we continue to support them by providing a two-year continuing care plan, weekly drop-in therapy sessions, and teletherapy. We also encourage patients to become involved with local peer support groups, such as Cocaine Anonymous.
If you or someone you know is struggling with cocaine addiction, contact us today. The road to recovery can be challenging, but with the right addiction treatment and compassionate medical care, itās completely within your reach.

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