Quick summary
Cocaine is a powerfully addictive stimulant, and there is no FDA-approved medication to treat cocaine use disorder. Behavioral therapies, especially contingency management, have the strongest evidence. Cocaine is often contaminated with fentanyl, so naloxone and emergency care matter. Call 911 for chest pain or overdose.
Cocaine is a powerfully addictive stimulant made from the leaves of the coca plant. It is usually snorted, smoked, or injected, and it can reach the brain within seconds when smoked or injected. The intense high is followed by a crash, and the cycle of use and crash is part of why cocaine use disorder can take hold quickly.
What cocaine does
The DEA classifies cocaine as a Schedule II controlled substance, meaning it has a high potential for abuse and a limited accepted medical use. As a street drug it appears as a white powder or as crack, the rock form that is smoked.
NIDA describes serious medical complications from cocaine use, including cocaine use disorder and overdose. Cocaine raises heart rate, blood pressure, and body temperature, and it can cause irregular heart rhythms, heart attack, stroke, and seizures. Chronic snorting can damage the nasal passages.
A separate risk now travels with cocaine. NIDA reports that adulteration of cocaine with highly potent fentanyl and related substances is a major contributor to rising drug overdose deaths. People often do not know fentanyl is present, which is why naloxone and emergency care belong in any safety plan.
The crash and the cravings
Stopping cocaine brings a withdrawal period often called the crash. NIDA describes symptoms such as fatigue, sleep problems, increased appetite, and intense cravings. This crash is usually not medically dangerous the way alcohol or benzodiazepine withdrawal can be, but it is a high-risk period for relapse.
Depression during the crash can be severe and has been linked to suicide risk. Anyone with intense low mood or thoughts of self-harm should reach out. Call or text 988 for crisis support, and call 911 if someone is a danger to themselves or others.
Treatment that works
There is no FDA-approved medication to treat cocaine use disorder, though researchers are studying several possibilities. That makes behavioral therapy the backbone of treatment:
- Contingency management uses tangible rewards, such as vouchers or prizes, for confirmed drug-free test results. NIDA calls it a particularly promising strategy for stimulant use disorders, including cocaine.
- Cognitive behavioral therapy helps people identify and change the situations and thought patterns that lead to use.
- The Matrix Model is a structured outpatient program developed for stimulant dependence that combines therapy, family education, and drug testing.
Because there is no medication to anchor treatment the way buprenorphine does for opioids, consistency and program intensity matter. Outpatient programs with frequent contact tend to work better than brief interventions for many people.
Getting help
Use SAMHSA's FindTreatment.gov locator to search for care by ZIP code or service type, or call the SAMHSA National Helpline at 1-800-662-HELP (4357), free, confidential, and open 24/7.
Call or text (800) 653-9376 or use the form below to talk through options.
Calling is free; the referral service is paid for by treatment providers. In a medical emergency, call 911. For a mental health crisis, call or text 988.
Last updated: Sun Oct 04 2026 00:00:00 GMT+0000 (Coordinated Universal Time)
Frequently asked questions
Is there a medication to treat cocaine addiction?
No. NIDA states that there are currently no FDA-approved medications to treat cocaine use disorder, though researchers are studying several targets. Treatment relies on behavioral therapies.
What is contingency management?
It is a behavioral therapy that gives tangible rewards, such as vouchers or prizes, for confirmed drug-free test results. NIDA calls contingency management a particularly promising strategy for stimulant use disorders, including cocaine.
Is cocaine withdrawal dangerous?
The cocaine crash is usually not medically dangerous the way alcohol or benzodiazepine withdrawal can be. It brings fatigue, sleep problems, increased appetite, and strong cravings. Depression during this period can be severe and is linked to suicide risk, so support matters.
Why is fentanyl a concern with cocaine?
NIDA notes that adulteration of cocaine with highly potent fentanyl is a major contributor to rising overdose deaths. A person may not know it is present. Naloxone reverses opioid overdose and should be available.
What should I do in an emergency?
Call 911 for chest pain, seizure, severe agitation, or a suspected overdose. For a mental health or substance use crisis, call or text 988.