Cocaine Overdose

Cocaine is a powerful central nervous system stimulant. This article addresses signs of cocaine overdose, treatments for it, and how you can help someone if you are present during such an overdose.

How Does Cocaine Overdose Happen?

Cocaine overdoses can either be purposeful or unintentional.  If an addict intentionally overdoses on cocaine, he or she may either be trying to get a better high or may be attempting suicide (often in combination with other substances).  Unintentional overdoses can occur when a recovering cocaine addict relapses; with the passage of time, less cocaine is needed to produce the high yet the recovering addict may return to their old (usually much higher) dose thereby leading to the overdose.  Others may accidentally overdose when using cocaine to self-treat feelings of anxiety or depression, believing that “a little bit more” will make them feel better but not realizing just how much they have taken. Overdoses of cocaine and other illegal drugs also occur among “body packers;” these individuals – either voluntarily or as a result of threats or other forms of coercion – carry packets of illegal drugs in their bodies to smuggle them.  If one of these packets breaks, an overdose can easily result.

Cocaine Overdose Signs and Symptoms

• dehydration
• high body temperature (over 106 F), sometimes accompanied by agitation, shivering, and muscle rigidity
• convulsions
• irregular heart rhythms
• high blood pressure

How to Help Someone Who Has Overdosed on Cocaine

• A cocaine overdose should be treated by medical professionals.  Although cocaine is an illegal substance, the possible repercussions of not getting help could be much worse.  Stay calm and call for help.
• Depending on the person’s state, you can call the National Poison Control Center (1-800-222-1222), a local urgent care center, or 9-1-1.   The Poison Control Center offers information for both non-emergent and emergent situations.  Any emergency response personnel will want to know the amount of cocaine that was used; whether any other substances were also used; the person’s weight, age, and condition (e.g., do they respond to you?); and the length of time that has passed since cocaine administration.
• Try to keep the person cool by turning on your air conditioner or fanning him or her.
• Have the person sit or lie down in a safe area so that they will not be injured if they should have a seizure.  If the person has a seizure, make sure that they are able to breathe after the seizure has ended (read more about seizure first aid). 

Treatment of a Cocaine Overdose in an Emergency Department

When a patient is suspected of having a high (toxic) level of cocaine in his or her system, the physicians will often treat the symptoms that are present.  Should the person have a high fever, an ice bath may be used to rapidly cool their bodies to avoid damage to any organs.  If the fever is causing symptoms like rigid muscles, agitation, or shivering, the physician may order mechanical ventilation and sedation.  Dehydration is often treated with a sterile saline solution.  Benzodiazepines (e.g., diazepam, midazolam, or lorazepam) may treat seizures, hypertension, or agitation; propofol may also be used for extreme agitation, but is usually considered a secondary option because of the risk of respiratory depression.  Cardiac monitoring will also occur and interventions (like defibrillation) will be done if necessary.  If the person’s cocaine overdose was the result of body packing, surgery or bowel irrigation may be needed.  Because cocaine is often administered in conjunction with opiates, naloxone may be used.