Cocaine has become an increasingly popular drug in nightclubs and even offices across the UK.
People take it for its stimulant or ‘upper’ effects, but it does have a downside. After the euphoria of coke wears off, psychological distress can set in, leading to depression, anxiety and paranoia.
Cocaine paranoia is really common, affecting up to three-quarters of people who use the drug. It can be unsettling, and you could experience it during the high, during the comedown, or while in withdrawal.
Along with paranoia, cocaine can trigger several psychiatric conditions and symptoms like violent behaviour, suicidal or homicidal thoughts, delusions, and hallucinations. [1]
Paranoia brought on by cocaine happens when your brain becomes more aware of negative things, or interprets something harmless as a threat. Paranoia can feel like you’re being harmed, while there’s no evidence or little evidence that you are.
Mild cocaine paranoia symptoms:
Mild paranoid thoughts are temporary. You may only notice them when you’re in a stressful situation. They may give you anxiety, but they don’t stop you from functioning in daily life.
Severe cocaine paranoia symptoms:
Severe paranoid thoughts are intense, fixed beliefs that last over a month. The delusions feel completely real and can’t be reasoned against. Severe delusions can be an indicator of cocaine psychosis.
Cocaine is a stimulant that floods the brain with dopamine. While this is a ‘feel-good’ chemical for our brains, an overload can cause normal signals to be misinterpreted as threatening or more meaningful than they really are.
Cocaine stimulates the sympathetic nervous system. This can activate our ‘fight or flight’ response, putting us on edge and making us feel hypervigilant towards anything we may feel is threatening or negative. This is called stimulant-induced paranoia.
Cocaine suppresses the need for sleep and causes a ‘crash’ when it wears off. This can cause cocaine paranoia symptoms by increasing anxiety and stress, and impairing cognitive function.
The drug also impairs judgement and creates an altered sense of reality, which reduces our ability to assess whether our experiences are true to life.
There’s no safe limit of cocaine. Any amount could trigger paranoia. However, the more you take and the more frequently you use cocaine, the more likely you are to feel paranoid while high, and to have lingering paranoia afterwards.
During cocaine withdrawal, it’s common to experience anxiety, depression, hostility and paranoia. Cocaine withdrawal paranoia is caused by lowered levels of norepinephrine and serotonin neurotransmitters.
It can be tempting during the crash or withdrawal to take more cocaine to ease these withdrawal symptoms, but this creates a vicious cycle leading to a high tolerance and eventually, dependence.
Cocaine paranoia symptoms may last for a few hours or days after you stop taking the drug. During binges, paranoia can become more intense and last for days or even weeks. Some people with stimulant-induced mental health disorders may require long-term treatment to feel better.
You’re more likely to experience cocaine-induced paranoia if you take a high dose, if you’ve been using cocaine for a long time, or if you smoke or inject it.
People with mental health disorders, or a family history of mental health disorders are more at risk. Your chances are also higher if you mix drugs, and you often sleep poorly.
Cocaine and paranoia can be a dangerous mix. If you feel threatened, you can be more likely to:
Dangerous cocaine-induced behaviour requires medical intervention.
When treating cocaine-induced paranoia, it’s important to tackle the problem at the root – cocaine use. You will need to stop using cocaine, and seek support for dependence.
This could be either through charity-funded or NHS treatment services, or privately through an inpatient cocaine rehab.
Through inpatient rehab, you’ll be given 24/7 support and a thorough treatment plan:
It’s always best to seek help for drug-related issues as soon as possible, as they can worsen with time. If you or someone you know are experiencing severe paranoia alongside cocaine use, or cocaine paranoia symptoms that last more than a few days, it’s important to get support to prevent serious harm.
Loss of control over cocaine use is a symptom of addiction, which needs to be treated.
Persistent cocaine paranoia is a red flag that your use may be out of control. The earlier you get help for cocaine addiction, the easier it will be to successfully recover.
Book an appointment with your GP who will signpost you to NHS and charity-funded cocaine recovery services in your area.
Rehab 4 Addiction can offer confidential advice and referrals to top inpatient rehabs across the UK. Call 0800 140 4690 (or +44 345 222 3508 from outside the UK).
Below, we outline some FAQs around this important topic:
Yes, even if you only take cocaine once, you may still feel paranoid while high, during the comedown or afterwards. Although, the more you take cocaine or the higher the dose you take, the higher your chances are of experiencing cocaine paranoia.
Yes, cocaine paranoia should go away within a few days of stopping cocaine. If you’re still experiencing paranoia after a week, you may need to seek help, as cocaine can trigger or exacerbate mental health problems like anxiety.
Yes, paranoia can become part of a permanent condition, especially if you’re taking cocaine frequently. People with underlying mental health conditions or predispositions are more likely to be triggered by cocaine and develop long-lasting symptoms.
Paranoia is a common symptom of cocaine addiction. While many other things can cause paranoia like isolation, trauma or stress, you are more likely to have paranoid thoughts if you’re using cocaine.
Yes, therapy can help cocaine paranoia symptoms, but only if you quit. Therapy can then begin to heal your brain from cocaine-induced hypervigilance, dopamine overload and fight-or-flight response.
[] https://pmc.ncbi.nlm.nih.gov/articles/PMC181074/
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.
