Medically Reviewed By

Brittany Kowalski, LCSW, ACS, CCS

Clinical Director, Speranza Behavioral Health · Last clinically reviewed June 2026

Cocaine Addiction: Signs, Effects, and Treatment Options in New Jersey

Cocaine addiction doesn't get the same media attention as the opioid crisis, but it remains a significant and growing problem in New Jersey and across the nation. In recent years, the situation has been made exponentially more dangerous by cocaine increasingly being laced with fentanyl — unbeknownst to users — creating overdose deaths among people who believed they were using cocaine only.

Understanding cocaine addiction, its signs, its effects, and how it's treated is essential information for anyone in South Jersey struggling with stimulant use or concerned about someone they love.

What Is Cocaine Addiction?

Cocaine is a powerful central nervous system stimulant derived from coca leaves. It produces its effects primarily by blocking the reuptake of dopamine in the brain's reward circuits — causing dopamine to flood the synapse and producing an intense but short-lived euphoria (15–30 minutes for snorted cocaine; 5–10 minutes for smoked crack cocaine).

This brief, intense high followed by a rapid crash creates a powerful binge pattern: users often compulsively use cocaine in rapid successive doses (a "run") trying to maintain the high and avoid the crash. This pattern is the hallmark of stimulant addiction.

Cocaine does not produce the physical dependence (tolerance and withdrawal) that characterizes opioid or alcohol addiction — there are no seizures during cocaine withdrawal. But this doesn't mean cocaine addiction is less serious. Its psychological dependence is among the most powerful in all of substance use — the compulsive drive to use, the craving, the inability to stop despite severe consequences.

Signs of Cocaine Addiction

Physical Signs During Use

• Dilated pupils
• Elevated heart rate, blood pressure, and body temperature
• Runny nose, frequent sniffling, or nasal damage (snorted cocaine)
• Reduced appetite and weight loss
• Restlessness and hyperactivity
• Jaw clenching, teeth grinding
• Talkativeness and grandiosity

Signs Between Use (The Crash)

• Profound fatigue and exhaustion after a binge
• Depression, emptiness, and anhedonia
• Intense irritability and agitation
• Hypersomnia (sleeping excessively after a run)
• Powerful cravings for more cocaine
• Anxiety and paranoia in heavy users

Behavioral Signs of Cocaine Addiction

• Using cocaine in binges that last hours or days
• Financial problems disproportionate to income (cocaine is expensive)
• Disappearing for extended periods (particularly on weekends)
• Extreme secrecy about activities and whereabouts
• Declining performance at work or school
• Legal problems — DUIs, possession charges, erratic behavior
• Relationship breakdown due to lying, financial harm, or behavioral unpredictability

Health Effects of Cocaine

Cardiovascular Risks

Cocaine is among the most cardiotoxic substances of abuse. It can cause:

• Heart attack (even in young, otherwise healthy users)
• Aortic dissection
• Dangerous arrhythmias
• Stroke
• Sudden cardiac death

These risks are present even with single-use and increase dramatically with chronic use.

Neurological Effects

• Cocaine depletes dopamine systems over time, producing prolonged anhedonia (inability to feel pleasure) during abstinence
• Cognitive impairment: attention, memory, and decision-making are all affected by chronic use
• Paranoia and psychosis in heavy users (cocaine-induced psychosis)
• Anxiety disorders — cocaine chronically disrupts the brain's stress response systems

Nasal Damage (Intranasal Use)

Repeated snorting destroys the delicate mucosal tissue of the nasal passages, septum, and sinuses, leading to chronic inflammation, infection, nasal perforation, and in severe cases, structural collapse.

Cocaine and Fentanyl: A Deadly Combination

As noted above, fentanyl is increasingly found in cocaine sold in New Jersey and nationally. This is frequently unknown to the buyer. Users who don't have opioid tolerance and unknowingly consume fentanyl-laced cocaine are at extreme risk of fatal overdose.

Always carry Narcan. It's available over the counter at NJ pharmacies. If someone using cocaine shows signs of overdose (unresponsive, slow/stopped breathing), administer Narcan and call 911 immediately — NJ's Good Samaritan Law protects callers from prosecution.

Cocaine Addiction Treatment in New Jersey

There is currently no FDA-approved medication specifically for cocaine use disorder (unlike opioids and alcohol). This makes behavioral treatment the cornerstone of cocaine addiction recovery.

At Speranza Behavioral Health in Woodbury, NJ, cocaine addiction treatment in our PHP and IOP programs includes:

• CBT for Stimulant Use Disorder — identifying triggers, cognitive restructuring of permission-giving beliefs, building coping skills for the crash and cravings
• Contingency Management — a behavioral intervention with the strongest evidence base for stimulant use disorder; provides positive reinforcement for cocaine-negative urine screens
• DBT — emotion regulation and distress tolerance skills address the emotional states that trigger cocaine use
• Psychiatric evaluation — Co-occurring ADHD, depression, bipolar disorder, and anxiety frequently underlie stimulant use disorder and require concurrent treatment
• Dual diagnosis treatment — Most people with cocaine addiction have a co-occurring mental health condition. Learn about dual diagnosis →

Get Help for Cocaine Addiction in South Jersey

Speranza Behavioral Health provides evidence-based cocaine addiction treatment in Woodbury, NJ — serving all of South Jersey. Most insurance accepted.

Call (866) 814-0126 for a free, same-day confidential assessment.

Related Reading:

• Fentanyl Addiction: Signs and Treatment in NJ
• What Is Dual Diagnosis?
• The 5 Stages of Addiction Recovery

About the Author

Brittany Kowalski

Brittany Kowalski is a licensed clinical social worker (LCSW) and behavioral health advocate at Speranza Behavioral Health in Woodbury, NJ. With over a decade of experience in addiction recovery and mental health treatment, she specializes in dual diagnosis care, trauma-informed therapy, and evidence-based outpatient programs serving South Jersey communities.