Cocaine is a well-known illicit drug with very potent stimulant properties. The drug can cause numerous dangerous and pronounced effects all through the user’s body and brain. It is typically found as a powder, which is taken through oral ingestion, injection, smoking, or snorting. The rock form of the drug, also referred to as crack cocaine, is mostly smoked. Most cocaine users can spiral into an escalating and dangerous pattern of cocaine abuse since the effects occur quite rapidly leading to an energetic and euphoric high. The user will also become hypersensitive to any outside stimuli while on the drug. Overdose is one of the most immediate dangers associated with cocaine use. Over 5500 people died in 2014 alone due to cocaine overdose, which is why it is essential to know the signs and symptoms of the same.
The National Institute on Drug Abuse or NIDA defines cocaine overdose as a condition that results from a person taking too much of the drug for it to get to toxic levels within the system leading to a serious bodily reaction. Cocaine can essentially poison the user’s system and the levels considered toxic do not seem to be determined entirely by the dosage. Studies show of cases in which users overdosed from taking a few hundred milligrams while others were able to take several grams of the drug without experiencing an overdose. This implies that the overdose toxicity may heavily depend on the specific user and his or her susceptibility to the drug’s toxins.
The drug’s potency also varies significantly considering the street version of cocaine is usually mixed with other substances or drugs to maximize dealers’ profits. This also means the potency of the same amount of cocaine from two different sources could differ significantly.
Some time back, specifically in the early 1980s, cocaine was merely considered a drug that brought about pleasant short-term effects for users and not necessarily harmful. However, it reached a point where overdoses became more frequent and more people became aware that the drug had the potential to be very dangerous to users.
Causes of Cocaine Overdose Among Users
There are various causes for cocaine overdose but by far the biggest cause would be compulsive use, which involves the user getting a strong urge to take more cocaine than they need to and use the drug for longer periods than they need to. Such compulsions may result in poisoning or toxicity mostly during binge sessions, which are common practice among cocaine users. During binges, the user will take the drug in back-to-back doses such that the drug cannot be metabolized sufficiently by the body causing the cocaine to accumulate to deadly and toxic bodily levels. These binges can go on for days which ends up sabotaging the user’s psychological and physical stability. There will be serious alterations within the brain in addition to the interruption of the user’s basic needs for things like hydration, food, and sleep. The method being used to take cocaine may cause some variations in the overdose potential but all methods are still capable of causing serious and fatal overdoses. These methods include intranasal use, injection, and smoking.
When someone overdoses on cocaine, their central nervous system becomes overstimulated such that the primary life systems also speed up and the body is unable to keep up. Once this happens, temperature rate, heart rate, breathing rate, and blood pressure all increase. A sudden and dangerous overdose reaction can happen within minutes or immediately after use. Generally, the faster the body absorbs cocaine, the higher the risk of an overdose.
Some people with untreated, partially treated, or co-occurring psychiatric conditions usually try to self-medicate by using cocaine heavily. Other people suffering from PTSD and chronic depression have reported experiencing relief from their symptoms following cocaine use. In other cases, patients with schizophrenia have also reported experiencing relief from their symptoms and alleviation of side effects brought about by their anti-psychotic medication. All these users have a high risk of overdosing from cocaine.
The body will gain tolerance to cocaine as it does with other addictive drugs so that the user will have an increasing urge to use more cocaine in terms of frequency and amount to get the intoxication effects they want. This physical tolerance for the drug will continue to escalate with increased use of the drug.
Risk Factors
Anyone can get a cocaine overdose regardless of whether it is a regular abuser or a novice user. Taking too much of any substance can cause dire consequences and as obvious as it may seem any form of cocaine use is a huge risk factor for an overdose. For this reason, the best way to avoid a cocaine overdose is to cease usage of the drug altogether.
Another significant risk factor is the combination of cocaine with other drugs or substances during use. In fact, combining cocaine with other drugs increases this risk exponentially. The two drugs that are most frequently used with cocaine are heroin and alcohol. We know that cocaine enhances the CNS activity while heroin and alcohol both depress the Central Nervous System. Combining all these drugs will plunge the user’s body into a dangerous rollercoaster. The stimulating effects brought on by cocaine may be hidden or appear diminished when the drug is used in combination with depressant or sedating drugs such as heroin and alcohol. This may cause the user to overindulge in cocaine to experience the desired euphoric effects to the point where it reaches toxic levels in the blood. Unfortunately, the individual may not realize this until it is too late and this is usually what leads to elevated risk of cocaine overdose in such multiple drug combinations.
Most people often call cocaine a “party drug”, which is why it is often used with alcohol. There are reports of approximately 40% of people dependent on cocaine using alcohol regularly. This combination is especially dangerous and it gives off a powerful toxin within the body referred to as cocaethylene, which takes a very long time to be eliminated from the body in comparison to cocaine. This toxin can amplify cardiotoxic effects in the body by speeding up the user’s heart rate thus increasing cocaine’s concentration within the bloodstream. Cocaethylene has been found responsible for multiple cases involving users’ sudden death or heart-related injuries. As much as cocaine is potent, cocaethylene has been reported more likely to lead to sudden death by up to 25 times in comparison to the drug.
Another dangerous drug combination is that of heroin and cocaine and it can very easily become fatal when taken in a practice that is commonly known as speedballing. Both heroin and cocaine have potent yet opposing effects on the body and this can make each drug’s individual effects on the body appear less intense. Cocaine will speed up the body systems while heroin, being a depressant, slows down the body. As the body fights between these two states, brain damage, organ damage, coma, or seizures could occur. This, in turn, can make the user take unpredictable doses or very high doses, which will increase the risk of a lethal overdose.
Effects of Cocaine Overdose on the Body
The effects that result from cocaine use are the product of the drug’s interaction with different processes within the body. People who survive an overdose might have temporary damage that can be taken care of relatively quickly thanks to hasty treatment. Regardless, the user may experience permanent damage to the intestines, heart, liver, lungs, brain, and heart.
Heart
A cocaine overdose will affect the heart massively as the user can experience severe chest pressure or chest pain when there is constriction of the coronary arteries, which are responsible for feeding blood to the heart. This is the point at which the heart is being deprived of its oxygen and blood supply and enters into a state of crisis. During this state, it will go into overdrive and this can eventually result in a heart attack if not a stroke at the very least, regardless of how healthy the person is. During a cocaine overdose, the heart rate and blood pressure will also spike dangerously and this may cause heart failure. If even without the stimulant use, the person still has heart problems or high blood pressure, then there is an even higher risk of death from a stroke or a heart attack. It should also be known that an overdose can leave the user prone to irregular heart rhythms which can possibly cause death.
Lungs
A cocaine overdose may also lead to acute bronchospasm and other serious problems of the lungs such as lung collapse, which is also known as pneumothorax.
Other users, specifically those who inject cocaine into their systems, are at a higher risk of developing a blood clot or thrombus within the lungs.
Users who smoke the drug are more likely to get permanent lung damage.
Other Organs
A cocaine overdose can also damage other organs in the body including the following:
- The eyes: microvascular infarcts, retinal vessel spasms, alterations in visual acuity, and pupil dilation which may cause the latter all of which can cause possible vision loss
- Bones and muscle can become damaged from dangerous metabolic imbalances following a cocaine overdose
- The kidneys and intestines: metabolic acidosis caused by excessive production of acid may occur. An inadequate blood supply caused when the blood vessels become narrower can lead to stomach damage and perforated ulcers. There is also the possibility of acute renal failure in addition to damage to the other organs.
- The Nose- In some situations, restriction of the flow of blood to the nasal area will lead to perforation of the partition separating both nostrils also known as the septum. Once the septum has a hole it is never going to heal without any medical intervention. Cocaine overdose and heavy cocaine use can also affect the nose’s function and appearance severely particularly for users who snort the drug.
- The Central Nervous System and the Brain can become damaged following an overdose through intracranial bleeding, headaches, coma, and even seizures.
Effects of Cocaine Overdose on the CNS and the Brain
We have seen before that convulsions and seizures are frequent occurrences among users experiencing a cocaine overdose. This is because the brain is extremely sensitive to the drug when it reaches toxic levels. The user can also experience a lethal hemorrhagic stroke or aneurysm when the blood vessels situated within the brain rupture as a systemic cardiovascular aftermath of the overdose within the skull. Additionally, there is an increase in the neurotransmission of catecholamines to dangerous levels and during this period, they user might experience significant miscommunication among nerve cells. This may lead the user to experience unmanageable muscle movements including chattering of the teeth, grinding of the jaws, and shaking.
The person’s arms and legs might also feel weak and shaky not to mention the increased activity of the muscles can also cause a high fever when the body temperatures are raised to dangerous levels. The overtaxed muscles can eventually seize up such that the user might be unable to even call out for assistance.
If you are able to imagine yourself in such a position whereby your body is going through the above-mentioned changes and you are powerless to do anything against it, then you have just gotten a look at the horrible experience overdose survivors had to go through.
Long-Term Effects
People who have experienced a cocaine overdose and lived to tell the tale come out of it changed not only mentally but also physically in terms of health. These people may have gotten serious damage to some of their primary organs including the kidneys, brain, lungs, liver, and the heart. This excessive damage may also happen to the reproductive organs and the intestines. Pregnant women who used cocaine and experienced an overdose may also cause damage to the developing fetus.
A cocaine overdose can cause mental trauma to the user, which in turn, can affect how this person feels and thinks even after quitting the drug successfully. They can also suffer from delusions, tremors, panic attacks, paranoia, and psychosis.
What to do In Case of a Cocaine Overdose
In the event of a cocaine overdose, it is vital that you call for medical assistance immediately. To increase the chances for survival and reduce the risk of any permanent damage occurring to the major organs, you must not waste any time. Additionally, if a cocaine overdose is left untreated, then the situation can become deadly. In addition, one should never attempt to take matters into their own hands in such a scenario, which is why it is best to leave it to a medical professional. The individual should not try to drive himself or herself to the hospital and should not hesitate to look for treatment.
Other ways to help an overdose victim in the moment include:
- Reassuring the person
- Loosening any tight clothing the person is wearing
- Check the person’s blood pressure, and monitor breathing rates and pulse if possible
- If you find there is no pulse or no signs of breathing, call 911 immediately and begin CPR after doing so.
- In case the user is experiencing a seizure, anyone present in the room should try to move him or her away from objects that could cause injury due to the body movement. Turn him or her to the side to make breathing a bit easier and keep reassuring them using a calm voice.
- Avoid trying to hold him or her in a specific place or offering the person water or food
- A helpful way to reduce the person’s body temperature is to apply a cold compress.
Treatment
Once the person gets to the hospital, the medical staff in the emergency room will do the following to assess the situation and treat the patient
- Tests will be conducted to check for cocaine levels and that of its metabolite chemicals within the user’s system. This information is used in conjunction with any information provided by the user or loved ones. These tests are also conducted to check if there are any other drugs present in the user’s system. Blood and urine analyses will test for complete blood count, blood acidity levels, cardiac enzymes, liver, and kidney function.
- Medication is given to the victim. Treatment for cocaine overdose makes use of drugs to deal with various possible complications that may occur. A sedative or benzodiazepine such as Lorazepam can be administered to the patient intravenously if there is a need to manage the state of hyper excitement that occurs during a cocaine overdose.
- The next step includes harm prevention. In certain cases, mechanical ventilation can be employed to prevent further drug-induced paralysis and physiological damage. This can also prevent individuals who are severely agitated from harming themselves any further. In the event that the victim’s high blood pressure is unresponsive to benzodiazepines, the physician can administer and IV nitrate such as nitroprusside
- Cooling the body: In order to manage dangerously elevated body temperatures, which is a characteristic of cocaine overdose, sedation, IV saline, and ice packs are used
- Evaluation of the victim’s heart condition: cocaine abuse often brings on chest pain and if it is present at the time, this will call for a comprehensive cardiac evaluation. Diagnostics such as echocardiography, electrocardiogram, cardiac enzymes, and chest x-rays will be helpful in ruling out any heart damage
- A Psychiatric evaluation: Before the individual can leave the emergency room, their physician can ask for a psychiatric evaluation for the patient to determine whether further treatment and diagnosis are necessary. A social worker can also be present to discuss treatment options for the patient after discharge from the hospital
Recovery
After immediate treatment, one can survive a cocaine overdose. However, the fact that the person overdosed on cocaine in the first place is a strong sign that he or she might have a problem with substance abuse. It is imperative that he or she avoids the consequences associated with long-term cocaine dependence or prevents another overdose altogether. This is why it is good to look for treatment at any recovery center. After recovering from a cocaine overdose, the person needs to avoid a similar situation again because another overdose could put immense stress on the vital organs. This could leave him or her susceptible to further damage and trauma in the future. As mentioned before, cocaine is highly addictive and this can be easier said than done to someone who has already developed tolerance and dependence on the drug.
In certain situations, individuals who use multiple drugs, cocaine included, might be dealing with mental health problems in addition. If the person wants to succeed on the journey towards sobriety, these other conditions need to be assessed and treated. Depending on what the user needs in terms of treatment, one can either look for addiction treatment via outpatient or residential settings.
- Residential or inpatient programs often range from 3-6 weeks if not more and they will provide intensive treatment for the user. Most of these programs make use of the 12-step method of addiction treatment not to mention they provide holistic treatment, therapy, detox and they plan for follow-up care
- Outpatient programs for addiction treatment may be the next step for users following discharge from residential treatment programs or they can be the primary means of treatment for the user based on the circumstances. Most outpatient-treatment programs focus on how to prevent relapse and they range from intensive day treatment to drug education. Some of these recovering addicts will need to be monitored regularly to help them be accountable and to assess for any setbacks to their recovery.
- 12-step recovery programs for example Cocaine Anonymous, will provide their members with a structured recovery program in addition to peer support. This program requires the recovering addict to complete 12 series of steps towards successful recovery.
The most important thing to prioritize after experiencing a cocaine overdose is the prevention of relapse or the reoccurrence of another overdose and this can only be achieved by seeking treatment and assistance.