What Happens to the Body During Cocaine Overdose?

Cocaine Overdose: Understanding the Body’s Respons

Gain Empowering Awareness about Cocaine Overdose Effects, Prioritize Informed Choices

Cocaine use is full of health risks. A cocaine overdose (OD) is one of them. Users often overlook this fact, thinking that only drugs like heroin and other opioids can cause someone to overdose.

This article will help you to have a greater awareness of all aspects of a cocaine overdose, from cocaine overdose symptoms to how much substance it takes for someone to OD. 

Key Points

  • Many believe that cocaine is pretty inoffensive and safe to play with, but this stimulant is a hard drug, and overdose is possible;
  • Cocaine is an addictive substance, causing a rapid rush of excitement and a short-lived euphoria. Its effects lead even first-time users to re-dose moments after taking a hit;
  • Using cocaine presents numerous health risks. The heart suffers the most from it, as cocaine constricts the blood vessels and makes the heart work harder;
  • Alone or combined with other drugs, cocaine can lead the user to an overdose which can be dangerous, even fatal.
  • The only way to avoid cocaine overdose is to avoid taking cocaine in the first place.
  • There are highly effective treatment options available to help people overcome cocaine addiction. 

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What Is a Cocaine Overdose?

An overdose is the excessive intake of a toxic (poisonous) substance that can lead to a fatal outcome. Not all overdoses are life-threatening. However, immediate medical advice should always be sought if someone has overdosed or if an overdose is suspected.  

Substances most frequently responsible for dangerous and fatal overdoses are alcohol, opioids, and sedative prescription medications like benzodiazepines.

Stimulants, particularly MDMA and cocaine, can also lead to overdoses.

Signs Leading Up to a Cocaine Overdose

According to specialists, stimulant drugs can cause severe agitation, blood vessel constriction, and an irregular heartbeat (arrhythmia), which can eventually be lethal.

The effects and complications of cocaine leading to an overdose differ for each person and depend on the context, but warning signs of an imminent overdose are common.

Be aware of the following indicators that a cocaine overdose is about to happen:

  • Dilated or constricted pupils
  • No pupillary response to bright light
  • Erratic behaviour, such as involuntary movements
  • Tremors
  • Seizures
  • Blue skin or lips
  • Delusions, confusion, or hallucinations
  • Severe anxiety
  • Difficulty breathing – shortness of breath, shallow breathing, etc.
  • Nausea and vomiting
  • Unsteady gait
  • Drowsiness or loss of consciousness
  • Excessive sweating or dry skin
  • Blisters or rashes
  • Low or high body temperature
  • Aggressive demeanour. 

How Much Cocaine Does It Take To Overdose?

According to science, it takes at least 1.2 grams of cocaine for a deadly overdose.

However, each overdose does not induce death, and the risk of cocaine overdose is unique to each individual. 0.2 grams can be dangerous for those with extreme sensitivity or underlying health conditions.

Meanwhile, a heavy user can potentially take up to 5 grams daily without a stroke or arrhythmia. But one night, that person may have a heart attack after taking just a gram of cocaine and two cigarettes.

What Happens During a Cocaine Overdose?

High doses of cocaine cause severe blood vessel constriction, putting a heavy strain on the heart muscle and leaving the user at risk of acute heart failure.

Blood pressure rapidly increases and can cause pulmonic bleeding and thrombosis or spasms in small brain vessels and may result in ischemic or hemorrhagic stroke. Kidney damage might also occur due to constriction of kidney blood vessels.

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Physical and Psychological Signs and Symptoms 

Psychological and physical symptoms of a cocaine overdose mainly depend on how much cocaine is in the system. 

There are three identifiable stages of severity in cases of cocaine overdose. 

Generally, the users’ pupils will be extremely dilated at any stage of an overdose, even with concurrent use of heroin or morphine.

Stage 1

Symptoms include cocaine-induced psychosis, anxiety, a blank stare, feverish behaviour, mild hallucinations, and paranoia. 

What to do: Do not be alone. Stay calm and focus on your breath. In most cases, this should help alleviate the symptoms. 

If the symptoms persist or get worse, you must call for help.

Warning: Do not take benzodiazepines such as Lexomil, Valium, or Xanax while experiencing a Stage 1 cocaine overdose, as it increases the risk of tetanic seizure.

The two other stages of cocaine overdose severity could induce cardiac arrest, breathing problems, heart palpitations, blood vessel rupture, and other life-threatening emergencies that require immediate medical help.

Stage 2

A person may experience symptoms such as a headache, shivering, small involuntary movements, sweating, clamminess, tremors, cardiac palpitations, anxiety, spasms, shortness of breath or panting, a feeling of tightness in the chest, convulsions, and even fainting. Someone should contact trained medical personnel right away.

Stage 3

Stage 3 cocaine overdose is life-threatening. 

At stage 3 of a cocaine overdose, an individual may experience auditory hallucinations (ringing in the ears), irregular heartbeat, nausea, disorientation, delirium, thoracic pain, and severe headache.

Stage 3 cocaine overdose can result in a heart attack, pulmonary oedema, and even death.

Who Is at Risk of a Cocaine Overdose?

Anybody is at risk of overdosing on cocaine, even if it is their first use. 

However, a few things can lead to higher chances of overdosing and greater potential damage. These include taking higher doses than the body can handle, relapsing after detox, and taking your usual dosage when tolerance is decreased. 

Medical conditions associated with the heart or blood pressure also make cocaine overdose more likely and dangerous. It is important to note that such health problems are often undiagnosed – anyone using cocaine may unknowingly have a heart or blood pressure issue. 

What Are the Treatment Options for Cocaine Overdose?

Cocaine overdose, even mild, must be treated right away. 

If a person does not get help soon enough, the damage to their heart, kidneys, and brain may become too severe, and they may die. 

People are often afraid to seek medical attention due to legal complications, but it is essential for managing symptoms and controlling body temperature and blood pressure. 

Even if no medication can reverse a cocaine overdose, doctors will focus on the part of the body most affected by the substance and do what is in their power to help it recover.

Sometimes patients need hospitalisation even after the cocaine has left their system and they start to feel better. Medics take this important precaution to ensure that the overdose event has no other health repercussions.

Preventing a Cocaine Overdose

Ultimately, the only way to prevent a cocaine overdose is to avoid the drug in the first place.

However, you can reduce your risk of overdosing by being extremely careful if you are new to the drug, refraining from large doses during relapse after detox when your tolerance drops, and avoiding mixing cocaine with alcohol, other street drugs or medications.

Peer pressure is strong, and cocaine is known to be a social drug, but giving in and taking more than your body can handle is dangerous and life-threatening.

cocaine overdose

What Are the Dangers of a Cocaine Overdose?

A cocaine overdose is dangerous because you can die from it or have enduring long-term health problems as a result of it.

Overdosing on cocaine can bring about a heart attack, or a stroke, causing vital organs to fail and inducing respiratory distress.

The risk of combined drug intoxication (CDI) rises when you mix cocaine with other drugs or medications, and CDI is the most life-threatening form of overdose.

The vast majority of cocaine-related deaths involve mixing it with other substances.

So What Factors Can Increase the Chances of a Cocaine Overdose?

The risk of a cocaine overdose increases if the user drinks alcohol while taking it, has an undiagnosed heart condition, or is exposed to hot weather. 

Research has shown that when using cocaine, high temperatures enhance the risk of experiencing an overdose and dying from it. 

Take Our Substance Abuse Self-Assessment 

Treating a problem is hard if you do not realise it exists. Our self-assessment tool can help you decide if you have an issue and need professional support.

The quiz consists of carefully crafted questions from experts, giving you a better understanding of your patterns of using cocaine and its effects on your physical and mental health and the people around you.

We value your privacy, and all results are anonymous and confidential.

Prevent Overdose with Cocaine Addiction Treatment

The longer and heavier you use cocaine, the more the risk of an overdose increases.

Don’t wait until it is too late. Seek help right now and prevent overdose with appropriate treatment for cocaine addiction.

If you are looking for a way to start healing, begin with a confidential self-assessment to understand the degree of your addiction, if you have one, and determine if professional help is necessary.

At Smarmore Castle, we provide the necessary tools to help you overcome your addiction and support healthy brain function without cocaine.

We also offer assistance in making lifestyle changes that promote sobriety while addressing factors contributing to addiction.

The Recovery Journey at Smarmore

Your recovery journey starts with a thorough medical evaluation to assess your physical and mental health and the severity of your cocaine addiction.

After your assessment, you will be supported through a detox programme to get you comfortably and safely through cocaine withdrawal. Drug treatment, in the form of therapy to help you recover from your addiction, starts after detox, once you have flushed the cocaine from your system.

The different therapies available at Smarmore Castle will help you understand what caused your addiction, how to deal with cravings and equip you with tools for creating a life without drugs in the future.

Therapy will also address any mental health or family issues contributing to addiction.

Recovering from drug addiction often requires reconnecting with lost hopes and purpose in life. We offer a programme of complementary therapies to help you explore ways to bring joy and fulfilment back into your life without the damaging hold of addiction.

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How Is Cocaine Overdose Treated?

There is no cure for a cocaine overdose, but specialists can help you recover with treatments that target the organs and systems in your body that cocaine overdose affects the most.

They may give you medication to support your heart, which experiences the greatest damage due to cocaine use and will monitor your vital signs constantly.

The effects of the overdose will not go away overnight. You will need medical support, supervision and guidance to give you the best recovery outcomes. 


Cocaine overdoses are dangerous and life-threatening. It is essential to be mindful of how much of the substance you take.

Although being careful reduces the risk of overdosing on cocaine, it does not eliminate it.

If you are afraid of overdosing on cocaine, perhaps it’s time to let professionals help you and start treatment.


What Are the Immediate Dangers of a Cocaine Overdose?

The immediate danger of cocaine overdose is suffering from heart failure or cardiac arrest, or an accident caused by cognitive impairment and paranoia.

What Should I Do if Someone Has Overdosed on Cocaine?

If someone has a cocaine overdose, stay with them to help them cope and call an ambulance immediately.

Can Someone Die from a Cocaine Overdose?

Yes, it is possible to die from a cocaine overdose, especially if you mix it with other substances. 

What Are the Long-Term Effects of a Cocaine Overdose?

Cocaine overdose may cause a stroke and irreversible brain damage.


  1. Marzuk, P. M., Tardiff, K., Leon, A. C., Hirsch, C., Portera, L., Iqbal, M. I., Nock, M. K., & Hartwell, N. (1998). Ambient temperature and mortality from unintentional cocaine overdose. JAMA, 279(22), 1795. https://doi.org/10.1001/jama.279.22.1795
  2. Tseng, C. C., Derlet, R. W., & Albertson, T. E. (1993). Acute cocaine toxicity: The effect of agents in non-seizure-induced death. Pharmacology, Biochemistry and Behavior, 46(1), 61–65. https://doi.org/10.1016/0091-3057(93)90317-m
  3. Treweek, J. B., & Janda, K. D. (2012). An antidote for acute cocaine toxicity. Molecular Pharmaceutics, 9(4), 969–978. https://doi.org/10.1021/mp200588v

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