Cocaine has both a physical and psychological effect on anyone who uses this substance, as it can change the way your mind and bodywork.
Many people are aware of the common side effects of using cocaine including euphoria, confidence and a faster heart rate, but cocaine-induced psychosis and paranoia are not talked about as frequently as these more well-known symptoms.
When someone takes too much cocaine at once, mixes cocaine with other substances or attempts to withdraw from cocaine without medical supervision, they may experience cocaine-induced psychosis or paranoia. [1]
Psychosis causes the sufferer to view the world and their immediate environment in a different way. This is often in the form of hallucinations which may be visual, auditory or tactile.
They may see and hear things that aren’t there, or believe that bugs or other creatures are crawling over their skin. It can be a terrifying experience and many people are even traumatised by the effects of cocaine-induced psychosis.
Another common effect of cocaine-induced psychosis is paranoid delusions, in which the sufferer will hold certain beliefs that may be irrational, even when presented with evidence to the contrary. [2]
They may believe that they are in a relationship with a celebrity or that they are famous, and some people even believe that they are suffering from a terminal disease. Others may believe that they are being targeted, and this type of cocaine-induced paranoia is explained in further detail below.
Some people who are suffering from this condition may end up stalking others as they mistakenly believe they are in a relationship with them,
Cocaine-induced psychosis is usually temporary, but the effects of this condition can follow you throughout the rest of your life.
Some people commit violent crimes against others when suffering from cocaine-induced psychosis, and there have even been cases in which people have committed murder.
Another risk is the increased likelihood of the sufferer experiencing urges to self-harm, and they may even become suicidal.
One of the main symptoms of cocaine-induced psychosis is extreme paranoia, and this is commonly reported by frequent cocaine users.
People suffering from paranoia often believe that they are under threat, even when there is little or no evidence to support this belief.
They may believe that other people are thinking about, talking about or plotting against them. Even a stranger in the street may suddenly become a potential threat, as cocaine-induced paranoia can make you believe that you are the centre of unwanted attention.
As a result, it can be difficult to form and maintain friendships and relationships when you are suffering from cocaine-induced paranoia.
Some people who experience cocaine-induced paranoia may become violent and aggressive towards other people, believing that they have sinister motives or are dangerous in some way.
Thankfully, this condition is usually temporary. If you stop using cocaine your symptoms should dissipate within a few days or weeks, although in severe cases you may require additional help and support.
It may be difficult to recognise when you or someone else is suffering from cocaine-induced psychosis, as the symptoms can appear gradually.
Most people are unlikely to develop cocaine-induced psychosis when they first begin using cocaine unless they have a co-occurring mental health disorder.
As the frequency and dosage of this substance is increased over time along with dependency, symptoms may begin to manifest and can quickly worsen.
Some people liken the symptoms of cocaine-induced psychosis to schizophrenia and bipolar disorder, and some studies state that over 50% of people who have used cocaine have experienced this condition to some extent.
Common signs and symptoms of cocaine psychosis may include:
It’s important to remember that anyone can develop cocaine-induced psychosis, regardless of whether they suffer from a co-occurring mental health disorder.
Most of us experience feelings of paranoia at certain times during our lives, and it’s normal to occasionally worry that other people are talking about you or watching you too closely.
However, cocaine-induced paranoia is a more serious condition that can leave sufferers feeling alone, unsafe and frightened for as long as they continue to take cocaine. It can also worsen over time as their dependency on cocaine grows.
The belief that they are being targeted can begin to dominate their life, and some people begin to feel so overwhelmed that they consider taking their own life as a way to escape from the perceived threat.
As the thoughts and beliefs that accompany cocaine-induced paranoia can feel all too real, it can be difficult to recognise when you are suffering from this condition.
It is often not until concerned friends or family members get involved that the true extent of the paranoia is revealed.
However, there are a number of symptoms that can indicate the presence of cocaine-induced paranoia.
Common signs and symptoms of cocaine paranoia include:
As with cocaine psychosis, it is possible to develop cocaine-induced paranoia without the presence of a co-occurring mental health disorder.
The primary function of cocaine is to encourage the brain to produce large amounts of dopamine while simultaneously preventing this excess dopamine from being recycled back into the brain.
This results in a large flood of dopamine that does not immediately dissipate, which is what causes the much-coveted sensation of being euphoric and invincible.
Studies have indicated that too much dopamine can cause psychosis, which is why it is so common in long-term cocaine users. They may have spent months or even years building up an excess of dopamine in the brain, making them extremely likely to develop cocaine-induced psychosis and paranoia. [3]
Other research has pointed to brain-derived neurotrophic factor (BDNF) as a potential cause. BDNF is a brain chemical that has been found to be extremely low in people who suffer from cocaine-induced psychosis and paranoia.
However, more research is needed to determine a clear link between the two.
As explained above, research appears to have found a link between cocaine-induced psychosis and the way dopamine levels are affected.
Dopamine levels can be affected by many risk factors, with any combination of the below risk factors increasing the chances of developing cocaine-induced psychosis.
Common risk factors that can cause cocaine-induced psychosis include:
In general, people who use cocaine more frequently and at higher dosages are more likely to develop cocaine-induced psychosis and paranoia. The chances are increased further if they have a personal or family history of mental health conditions.
Depending on the individual person, cocaine-induced psychosis can last between two hours and several weeks.
If you are suffering from cocaine-induced psychosis and paranoia and you continue to use cocaine, your condition will likely worsen. The only way to stop this condition from occurring is to completely stop your cocaine use with the help of medical professionals.
Some people find that it can take years to completely recover from cocaine-induced psychosis and paranoia, particularly if the cocaine addiction was severe.
During the months and even years after stopping cocaine use, you may still experience bouts of paranoia as your brain attempts to adapt and recover.
Cocaine-induced psychosis and paranoia can wreak havoc on your life and may have serious long-term consequences.
Psychosis is an extremely dangerous condition, as it can make you vulnerable to injury and even cause you to become a danger to others.
Some of the most common dangers of cocaine-induced psychosis and paranoia are listed below.
People who are suffering from cocaine-induced psychosis and paranoia often view other people as a threat, and they may pre-emptively attack others as they believe they are defending themselves.
This can injure or even kill innocent people, and the sufferer may face jail time for their actions.
It’s common to feel extremely confused when suffering from cocaine-induced psychosis, and this can lead to poor judgement and potentially dangerous situations.
They may leave their homes at night in a vulnerable and confused state, drive without being in full control of their actions or attempt to care for children which can have serious consequences.
The stress and worry of believing that other people are conspiring against them, or from seeing and hearing things that don’t exist, can cause many people to become overwhelmed.
This can lead to a higher rate of self-harm and suicidal thoughts, and some people may become so consumed with fear that they end up taking their own life.
It can be extremely scary when you notice the effects of cocaine psychosis and paranoia in yourself or a friend.
Once you understand what is happening and which actions to take, you will be able to deal with the situation more effectively and prevent further danger from occurring.
The first step is to establish whether the condition is drug-induced or simply the result of a mental health condition. If you or the other person have been taking cocaine on a regular basis, the symptoms are likely to be a sign of cocaine psychosis.
Ensure that you get the affected person to a safe place, and contact emergency services if you believe that you or anyone else may be in danger.
It’s important to let the medical team know which substances you or the other person have taken, even if they are illegal. They are more concerned with saving lives than arresting patients for drug possession.
Once the immediate danger has passed, it is recommended that the affected person enter a treatment programme focused on recovering from a cocaine dependency.
As cocaine psychosis and paranoia can have dangerous consequences, the safest and most effective form of treatment is to enter an inpatient rehabilitation centre.
This will allow you to stop taking cocaine in a controlled environment, with 24/7 medical monitoring and supervision.
As cocaine is not physically addictive, it is usually safe to avoid the tapering method and simply cut out this substance entirely.
However, if cocaine-induced psychosis and paranoia are present then this could lead to severe anxiety and depression as the brain and body attempt to adjust to this new chemical imbalance.
As long as patients are properly supervised by medical professionals, cocaine withdrawal is generally a very safe process.
You may also be prescribed certain medications to help you through withdrawal, such as antidepressants and other mood stabilisers.
Counselling and therapy can be extremely effective tools to help someone recover from a cocaine dependency and reduce the effects of psychosis and paranoia, and patients will be offered a range of therapy treatments including cognitive behavioural therapy (CBT), dialectical behaviour therapy (DBT) and motivational interviewing.
During therapy sessions, you will examine the behaviours and experiences behind your cocaine use with an experienced and empathetic counsellor.
They will arm you with the tools and techniques required to manage triggers and resist cravings while rebuilding your life outside of rehab.
Many rehab centres offer a complimentary 12-month aftercare programme for former patients, giving you an anchor and consistent reminder of your ongoing treatment during the months after rehab.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181074/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6386431/
[3] https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0106111
Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field. His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline. You can connect with Boris online at LinkedIn or X.com.
