How to Tell If Someone Is on Cocaine

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Cocaine is a powerful drug that can lead to dependency, overdose, and death. Because people feel an intense high immediately, it creates a desire to have more. In 2020, 5.2 million people aged 12 and older reported using cocaine in the past 12 months.

With cocaine increasingly becoming a problem among young adults, it is essential to understand the signs, symptoms, and effects of cocaine use. Guardian Recovery will describe the signs of addiction and how you or someone you love can seek treatment.

If you or someone you love has a cocaine use disorder, Guardian Recovery is available to help. We are dedicated to providing the most comprehensive and individualized medically monitored detox program. To learn more about our programs, contact us today.

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Signs of Cocaine Abuse & Addiction

You may not notice the signs of cocaine use if someone tries to hide their drug use from you. However, there are physical signs to look for as well as behavioral and emotional indicators shown by the person using cocaine. Cocaine is a substance that immediately produces a high and changes the brain of the cocaine user. In this article, Guardian Recovery will explore specific signs and behaviors to look for if you are concerned a person you love is using cocaine.

Physical Signs of Cocaine Use:

  • Dilated pupils.
  • Runny nose.
  • Nosebleeds.
  • Sudden changes in eating or sleeping.
  • Weight loss.
  • Mood swings.
  • Talkative habits.
  • White residue on hands, nose, and mouth.
  • Burn marks on hands and lips.
  • A decline in attention paid to personal hygiene.

Psychological Signs of Cocaine Use

Because cocaine impacts brain function and chemical reactions, there are psychological symptoms of cocaine use. Psychiatric symptoms include agitation, paranoia, hallucinations, delusions, violence, and suicidal and homicidal ideation. Additionally, if a person is already diagnosed with a comorbid mental health disorder, cocaine can exacerbate the symptoms of the co-occurring mood disorder.

Research has found paranoia in 68-84% of patients using cocaine. 55% of people were found to have engaged in violent behaviors, and homicide occurred in 31% of patients who used cocaine. Suicide has appeared in 18-22% of cases. Finally, many people diagnosed with a comorbid psychological disorder were found to have cocaine dependence.

Emotional & Mood Effects

Cocaine produces an immediate high. However, it only lasts 15-30 minutes. This leads to frequent use and can unintentionally lead to an overdose and a sudden low in behaviors as one person is coming off the high. When a person starts to come down from a high, they may experience withdrawal symptoms quickly.

This experience of coming down from a cocaine high is called a cocaine crash. Here are the common symptoms one may experience when they have hit a cocaine crash.

Symptoms of a cocaine crash include: 

  • Agitation.
  • Irritability.
  • Restlessness.
  • Increased blood pressure.
  • Increased body temperature.
  • Intense cravings.
  • Mood swings.
  • Exhaustion.
  • Depression.
  • Suicidal thoughts.
  • Increased appetite.

There can be severe consequences if continued cocaine use occurs or if a person attempts to detox without medical assistance. If you need help detoxing cocaine from your body, Guardian Recovery can help.

Early Signs of Use

You may not be able to recognize the signs or symptoms of cocaine use immediately. However, trust your instincts if something appears wrong or you are concerned about a person’s behavior change. For most people using cocaine, you will notice secrecy, periods away from friends and family, erratic and emotional behavior, and perhaps they appear on edge, talkative, or easily agitated. A high person will be very social and excitable, but remember, this intensity will only last approximately 30 minutes before hitting a crash. If you start noticing behavior that seems different or out of the norm, you may need to seek additional help for your loved one.

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Physical Signs & Indications

As previously mentioned, you will notice physical changes in a person’s appearance when using cocaine. Immediate effects of cocaine include dilated pupils, runny nose, lack of eating and sleeping, and talkative, hyper behavior. Over time you may notice weight loss, lack of hygiene, and more profound psychiatric symptoms, including aggression or suicidal thoughts.

The long-term effects of chronic cocaine use can be severe. Adverse effects include anxiety, panic attacks, reduced blood flow to the gastrointestinal tract, significant weight loss, malnourishment, permanent damage to the heart and cardiovascular system, increased risk of stroke, permanent damage to the nasal passageways, and a sharp decline in cognitive functioning.

Changes in Weight

In addition to cocaine suppressing one’s appetite, research has indicated that chronic cocaine use has profound metabolic changes, reducing the body’s ability to store fat. The University of Cambridge found that people who regularly used cocaine also engaged in a high-fat diet and lost weight during cocaine use. However, this becomes especially problematic because when cocaine use stops, people gain a significant amount of weight, a stressful side effect that may interfere with a person’s ability to maintain sobriety.

Dilated Pupils

Cocaine dilates the pupils, and people who use cocaine may be described as having “cocaine eyes” because of the appearance of the pupils after taking cocaine. While some common drugs make pupils appear smaller,  cocaine makes pupils appear larger.

When the pupils dilate, they become sensitive to light. Therefore, wearing sunglasses when it isn’t bright can indicate cocaine use. Apart from pupil enlargement and sensitivity to light, the eyes may also seem bloodshot or red.


Nosebleeds occur with cocaine use due to the chemicals of cocaine and cutting agents irritating the membranes of the nose and drying the nasal passage out. In addition, cocaine causes the blood vessels to constrict, and when the effects of cocaine wear off, the blood vessels enlarge and then burst to cause a nosebleed. Not only does cocaine put a person at risk for nosebleeds, but it can lead to serious consequences such as permanent damage to the nose.

Behavioral Signs of Cocaine Use

Other behavioral signs include frequent legal trouble, stealing money or possessions, lying or secrecy, financial problems, impulsive or risky behavior, staying up all night, or increased irritability and aggression. People questioned about drug use may deny or lie about using drugs. They may act like it’s not a problem or will stop soon.

Helping Someone That Uses Cocaine

What do you do when someone you love is using cocaine and doesn’t want help?

Here are some helpful tips when you have a loved one who refuses to recognize they have a substance use disorder. Understand more about the problem, what you can do to take care of yourself, and how to communicate your feelings effectively to prevent conflict or rupture of the relationship.

Educate Yourself

Educating yourself on substance use can increase addiction awareness, find ways to communicate effectively, and understand the cycle of change so that you feel prepared to support your loved one through this process. Being informed on addiction can help us remain empathetic and compassionate, two necessary components in helping someone in their journey toward recovery.

Remain Compassionate and Empathetic

If you’ve never struggled with an addiction, this may be very difficult for you to do. You may have thought, “Why can’t you just stop?” However, some strategies can help you learn how to show compassion and empathy even if you have never experienced an addiction yourself.

Ways to Practice Compassion and Empathy:

  • Practice self-compassion.
  • Understand that many addictions happen because of trauma.
  • Put yourself in their shoes and how it feels to be them.
  • Imagine if this were a child feeling this way. Would you remain critical? How do you feel about the child? What does that child need?

Remember to Care For Yourself First

If you’re not prioritizing your health and well-being, you will most likely be unsuccessful in helping your loved ones. Take care of yourself before you can care for others. One meaningful way to care for yourself is by setting boundaries. It can be emotionally overwhelming and traumatic to love someone with a substance use disorder.

Giving yourself space and time away can help. Seek therapy for yourself. You can work with someone to help you cope with stress or join a support group. Recognize that there is only so much you can do. Ultimately, it’s up to your loved one to agree to treatment and do the work. Focus on what you have control over and what you need for peace.

What To Avoid When Talking to a Loved One About Cocaine Use

In addition to understanding what one should say or do to help a loved one seek treatment, here are some tips on what not to do. These actions will further strain the relationship, keep your loved one stuck in the cycle of addiction, increase risks of aggression or violence, and make your loved one less likely to seek help.

What Not to Do When Talking to Loved One with SUD:

  • Do not lecture.
  • Avoid blaming or making accusations.
  • Do not argue with your loved one.

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At Guardian Recovery, we remain dedicated to providing our clients with a comprehensive program of cocaine detox — one that focuses on much more than physical stabilization. In addition to emphasizing physical recovery, we tackle mental, emotional, and spiritual well-being. While we prioritize a safe and pain-free cocaine withdrawal, we offer individualgroup, and family therapy sessions, case management services, relapse prevention training, and aftercare planning.

Contact us today if you or your loved one is ready to begin an entirely new way of life and commit to long-term recovery. As soon as you call, we start developing a plan of action that begins with an initial pre-assessment. This assessment helps us determine which level of care is the most appropriate for each unique case. We identify potential coverage options if our medically monitored detox program is a good fit. We work closely with most major regional and national insurance providers. Contact us today for a free, no-obligation insurance benefit check.


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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

Written by:

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Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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