Cocaine intoxication

  • Definition
    • Cocaine is an illegal stimulant drug that affects your central nervous system. It comes from the Erythroxylum coca plant, which is found in many parts of the world. It produces a sense of extreme joy by causing the brain to release higher than normal amounts of some biochemicals. However, cocaine's effects on other parts of the body can be very serious, or even deadly.

      See also:

  • Alternative Names
    • Intoxication - cocaine

  • Causes
    • Cocaine intoxication may be caused by:

      • Taking too much cocaine, or too concentrated a form of cocaine
      • Using cocaine when the weather is hot, which leads to more harm and side effects because of dehydration
      • Using cocaine with certain other drugs
      • Severe intoxication and death can occur in "drug mules" or "body packers." These are people who swallow packets of cocaine on purpose as a way to transport the drug.
  • Symptoms
    • Symptoms of cocaine intoxication include:

      • Anxiety and agitation
      • Chest pain or pressure
      • Enlarged pupils
      • Feeling of being "high" (euphoria)
      • Increased heart rate and blood pressure

      With higher doses, sweating, tremors, confusion, hyperactivity and muscle damage, seriously elevated body temperature, kidney damage, seizures, stroke, irregular heartbeats and sudden death can occur. Psychosis (losing touch with reality, having a severe change in personality) and showing signs of mental illnesses such as depression, manic depression, and schizophrenia can also occur. These symptoms may also occur with any use of cocaine.

      Cocaine is often cut (mixed) with other substances, which can cause additional symptoms.

  • Exams and Tests
    • Tests may include:

      • Blood chemistries and liver function tests, such as CHEM-20
      • Cardiac enzymes (to look for evidence of heart damage or heart attack)
      • CBC (complete blood count, measures red and white blood cells, and platelets)
      • Chest x-ray
      • CT (computerized tomography) scan (a type of imaging) of the head, if head injury is suspected
      • EKG (electrocardiogram, to measure electrical activity in the heart)
      • Toxicology (poison and drug) screening
      • Urinalysis
  • Treatment
    • The health care provider will measure and monitor the person's vital signs, including temperature, pulse, breathing rate, and blood pressure.

      Symptoms will be treated as appropriate. The person may receive:

      • Breathing support, including oxygen, a tube down the throat, and ventilator (breathing machine)
      • IV fluids (fluids through a vein)
      • Medicines to treat symptoms such as pain, anxiety, agitation, nausea, seizures, and high blood pressure
      • Other medicines or treatments for heart, brain, muscle, and kidney complications

      Long-term treatment requires drug counseling in combination with medical therapy.

  • Outlook (Prognosis)
    • The outlook depends on the amount of cocaine used and what organs are affected. Permanent damage may occur, which may cause:

      • Seizures, stroke, and paralysis
      • Chronic anxiety and psychosis (severe mental disorders)
      • Decreased mental functioning
      • Heart irregularities and decreased heart function
      • Kidney failure requiring dialysis (kidney machine)
      • Destruction of muscles, which can lead to amputation
  • References
    • Perrone J, Hoffman RS. Cocaine, amphetamines, caffeine, and nicotine. In: Tintinalli JE, Kelen GD, Stapczynski JS, Ma OJ, Cline DM, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, NY: McGraw-Hill; 2004:chap 168.

      Rao RB, Hoffman RS. Cocaine and Other Sympathomimetics. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 154.

      Shih RD, Hollander JE. Cocaine. In: Wolfson AB, Hendey GW, Ling LJ, et al, eds. Harwood-Nuss' Clinical Practice of Emergency Medicine. 5th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2009:chap 329.

      Zimmerman JL. Cocaine intoxication. Crit Care Clin. 2012;28(4):517-26.