Cocaine use can come with a range of harms if taken in high doses and on a regular basis, or by people with pre-existing problems or susceptibilities (e.g., heart conditions that people may or may not be aware of).

Regular use of cocaine may eventually cause:

• Insomnia and exhaustion
• Depression
• Anxiety, paranoia and psychosis
• Sexual dysfunction
• High blood pressure and irregular heartbeat
• Cardiovascular (heart) disease
• Stroke
• Liver, kidney and lung problems
• Cognitive impairments, such as loss in attention, memory, and impulsivity control.

Snorting cocaine regularly can also cause:

• Runny nose and nose bleeds
• Long term damage to the nasal cavity and sinuses
• Damage to the teeth and gums.

Symptoms of cocaine ‘overdose’ include:

• Nausea and vomiting
• Chest pain
• Heart failure
• Seizures
• Stroke
• Kidney failure
• Liver damage
• Panic
• Extreme anxiety, agitation and paranoia
• Hallucinations.

Mixing cocaine with other drugs, including over the counter or prescription medications, or alcohol can be dangerous and fatal. Polydrug use increases the risk of drug toxicity, which can lead to unpredictable adverse effects, severe negative health and mental health outcomes, and even death.

There is a recognised psychostimulant withdrawal syndrome. The prominent symptoms include:

• Depression
• Anxiety and agitation
• Fatigue
• Insomnia
• Craving for cocaine.

The acute phase of withdrawal peaks within the first 24 hours after taking the drug but with heavier use and severe dependency, these symptoms intensify and may last longer.

Death due to cocaine use is mainly due to heart attacks, seizures or stroke. Cocaine causes damage to the heart, which increases the risk of death.

Between 2003 and 2022, the rate of drug overdose deaths involving cocaine increased, on average, by 11% per year to reach a historical high of 0.39 deaths per 100,000 people in 2020 and stabilising thereafter.

In 2022, there were 68 drug overdose deaths involving cocaine recorded in Australia. Most of these deaths occurred among males in the 25-34-year age group, with 91% of these (61 deaths) deemed unintentional.

A study conducted by the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney found that more widespread use of cocaine resulted in a large increase in deaths, particularly among people with no history of substance use problems.

Repeated use of cocaine can be associated with mental health problems, including:

• Depression
• Anxiety, paranoia and panic attacks
• Cocaine psychosis, with symptoms such as delusions, hallucinations, and aggressive behaviour.

Treatment for cocaine dependence includes inpatient rehabilitation programs, outpatient therapy, support groups, or individual therapy such as cognitive behavioural therapy.

According to the Australian Institute of Health and Welfare’s National Drug Strategy Household Survey (NDSHS), in 2022-23, 4.5% of Australians over the age of 14 had used cocaine in the previous 12 months, which equates to 1 million people.

Furthermore, 13.5% of the population aged over 14 reported lifetime use of cocaine in 2022-23, which equates to 2.9 million people.

Recent cocaine use is most common among those aged 18 to 24, and 25 to 34. While men have typically been more likely to use cocaine than women, this gap has narrowed.

The 2022-23 NDSHS showed that women aged 18 to 24 were just as likely to have used cocaine in the last 12 months as men.

The Illicit Drug Reporting System (IDRS) is an Australian monitoring system run by the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney that identifies emerging trends of local and national concern in illicit drug markets.

The Ecstasy and Related Drugs Reporting System (EDRS) is an Australian monitoring system run by NDARC that identifies emerging trends of local and national interest in ecstasy and related drug use, markets and harms.

The Pocket Guide to Drugs and Health is a publication authored by experts from NDARC that provides information for health professionals on the impact of drug use.

The Australian Institute of Health and Welfare collects information on alcohol and tobacco consumption, and illicit drug use among the general population in Australia.

The Australian Bureau of Statistics is Australia’s national statistical agency, providing official statistics on a range of economic, social, population and environmental matters of importance to Australia.

Alcohol and Drug Foundation (2024). Cocaine. Retrieved from: adf.org.au/drug-facts/cocaine/

Australian Institute of Health and Welfare (2024). National Drug Strategy Household Survey 2022–2023. AIHW, Australian Government. Retrieved from: aihw.gov.au/reports/illicit-use-of-drugs/national-drug-strategy-household-survey/contents/about

Chrzanowska A., Man N., Sutherland R., et al (2024). Trends in overdose and other drug-induced deaths in Australia, 2003-2022. Sydney: National Drug and Alcohol Research Centre, UNSW Sydney. Retrieved from: unsw.edu.au/research/ndarc/resources/trends-drug-induced-deaths-australia-2003-2022

Darke, S., Lappin, J., & Farrell, M. (2024). The Clinician’s Guide to Illicit Drugs and Health (Revised Edition). London: Silverback Publishing.

Darke, S., Duflou, J., Peacock, A., et al (2022). “Rates, characteristics and toxicology of cocaine-related deaths in Australia, 2000–2021.” Addiction, vol. 118, no. 2, pp. 297-306. Retrieved from: doi.org/10.1111/add.16055

Headspace (2024). What is Cocaine and the Effects on Mental Health? Retrieved from: headspace.org.au/young-people/understanding-cocaine-for-young-people/