The effects of cocaine vary depending on the intake method and dose. A single dose of cocaine can cause hypersensitivity, alertness, or paranoia. It may be fatal if people overdose or mix the drug with other substances.

Cocaine is a central nervous system stimulant that temporarily increases dopamine in the brain. Dopamine is a chemical messenger that forms part of the reward system.

The sustained increase of dopamine results in feelings of well-being and euphoria, a key part of how cocaine addiction can develop.

However, a single dose of cocaine may also cause adverse side effects, such as paranoia, irritability, and difficulty performing straightforward tasks.

This article explains what may happen after a single dose of cocaine, including the risks of death and addiction and what to do if an overdose occurs.

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Cocaine can affect judgment, which can result in high risk or dangerous behaviors. However, experiences may vary since cocaine can affect each person differently.

A 2021 animal study on mice suggests that even a single, small dose may lead to structural changes and tissue damage in the brain.

According to a 2016 research report by the National Institute on Drug Abuse (NIDA), factors that can influence the safety and effects of cocaine include the following:

  • the method of intake
  • whether the cocaine is cut or mixed with other substances
  • mixing cocaine with other drugs or alcohol
  • dose size

Can cocaine cause death after one use?

Cocaine can cause death after one use if an overdose occurs. Mixing cocaine with other substances, such as heroin or alcohol, can also be life threatening.

According to the Centers for Disease Control and Prevention (CDC), 1 in 5 fatal overdoses involved cocaine in 2019.

A cocaine overdose can cause severe, potentially fatal health problems and other serious effects, including:

After taking cocaine, people may experience its effects immediately. The effects may last for a few minutes or up to an hour. They may vary from person to person.

The short-term effects of cocaine use may include:

Cocaine may increase the speed some people can do straightforward physical or mental tasks, while others may experience the opposite.

Effects may also depend on the dose people take. For example, large doses of cocaine may cause unpredictable or violent behavior.

Cocaine has a high potential for addiction. However, a 2018 review suggests that environmental and genetic factors may affect a person’s risk of developing a cocaine addiction.

Review authors suggest that environmental risk factors for substance misuse in general include:

  • parental use of cocaine
  • drug availability
  • childhood abuse
  • parental attitudes toward drug use
  • household and peer drug use
  • lack of participation in social activities

Review authors suggest that genetics is a significant risk factor for addiction in every major class of addictive drugs and is one of the main risk factors for cocaine addiction.

How quickly an addiction develops may also depend on the form of the drug. Crack cocaine, processed from cocaine hydrochloride, may cause addiction within 2–3 weeks of using. In some cases, addiction may develop after the first use.

Risks of prolonged use

According to the NIDA, prolonged use of cocaine can cause various health problems, depending on how people take cocaine:

  • Snorting cocaine: This intake method may cause nosebleeds, frequent runny nose, loss of smell, and difficulty swallowing.
  • Smoking cocaine: Smoking cocaine may lead to a cough, asthma, respiratory distress, and a higher risk of respiratory infections, such as pneumonia.
  • Injecting cocaine: This intake method may cause scarring, skin or soft tissue infections, collapsed veins, and a higher risk of bloodborne diseases, such as HIV and hepatitis C.
  • Taking orally: Taking cocaine orally may lead to severe bowel decay due to impaired blood flow.

Another potential risk of long-term cocaine use is malnourishment because cocaine is an appetite suppressant. Other long-term risks include severe paranoia, hallucinations, and movement disorders, such as Parkinson’s disease.

If people think someone is overdosing on cocaine, they should call 911 or seek medical help immediately. Symptoms of a cocaine overdose may include:

  • nausea and vomiting
  • severe anxiety or panic
  • chest pain
  • irregular breathing
  • tremors
  • hallucinations
  • paranoia
  • severe agitation or restlessness
  • seizures
  • stroke

If a person has concerns about cocaine use or addiction, they can speak with a healthcare professional.

A trusted healthcare professional can suggest local support groups and offer further resources to help a person overcome addiction.

Seeking help for addiction may seem daunting or even scary, but several organizations can provide support. If you believe that you or someone close to you is showing signs of addiction, you can contact the following organizations for immediate help and advice:

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Getting help for a child

If people have concerns that their child is using cocaine, Partnership to End Addiction suggests the following advice:

  • Choose a time and place with no distractions or interruptions to have a safe, open conversation.
  • Make sure the child is sober before talking with them.
  • Stay calm and talk from a place of love and support.
  • Talk honestly about any personal drug use and explain the risks of substance use. Be clear that it is not safe for them to be using illegal drugs or misusing prescription drugs.
  • Listen to how the child feels. Try to see their point of view, and avoid getting defensive or overreacting.
  • Let the child know you have concerns about their safety and well-being, which is why the conversation is happening.
  • Decide together on the next steps forward.
  • Continue to check in with the child and follow up on their progress.

SAMHSA offers a family resource page for substance use disorders and a helpline to call. People can also find treatment facilities on

Taking cocaine once may cause short-term effects, such as euphoria, hypersensitivity, and paranoia.

It is also possible to overdose with the first use of cocaine, which can be life threatening. Cocaine has a high potential for addiction. In some cases, addiction may develop after short-term use.

If people have concerns about cocaine use in themselves or others, they can contact a healthcare professional, substance use disorder helpline, or support group.