How to Tell If Someone Is Addicted to Cocaine or Crack

Cocaine and crack are powerful stimulant drugs. They speed up the brain and body, increase energy, and can cause a short, intense “high” (National Institute on Drug Abuse [NIDA], 2024; U.S. Drug Enforcement Administration [DEA], 2024).

But they can also:

• Change the brain

• Damage the heart and blood vessels

• Lead to addiction and overdose

  
  

This article explains:

• What cocaine and crack are

• How addiction shows up in behavior, body, and life

• What you can do if you’re worried about yourself or someone you love

  
  

What Are Cocaine and Crack?

Cocaine is a stimulant made from the leaves of the coca plant. It usually looks like a white powder. People may (NIDA, 2024; DEA, 2024):

• Snort it through the nose

• Rub it on their gums

• Dissolve and inject it into a vein

  
  

Crack cocaine (or “crack”) is a form of cocaine that has been processed into small rocks or crystals that are usually smoked (DEA, 2024; NIDA, 2024).

Both cocaine and crack:

• Act very quickly in the brain

• Are highly addictive

• Can lead to cocaine use disorder, which is a type of stimulant use disorder (American Psychiatric Association, 2013; Substance Abuse and Mental Health Services Administration [SAMHSA], 2024)

  
  

Drug Use vs Addiction

Trying cocaine once or a few times is not the same as having an addiction.

Doctors use the term “substance use disorder” or “cocaine use disorder” when a person (American Psychiatric Association, 2013; Verywell Mind, 2025):

• Can’t cut down or stop, even when they want to

• Keeps using even when it causes serious problems

• Spends a lot of time getting, using, or recovering from the drug

• Develops tolerance (needing more for the same effect)

• Has withdrawal symptoms when they stop

  
  

The more of these signs someone has, and the more their life is affected, the more likely it is a moderate or severe addiction (American Psychiatric Association, 2013; SAMHSA, 2024; MentalHealth.com, 2022).

Signs Someone May Be Addicted to Cocaine or Crack

You usually can’t tell for sure just by looking at someone once. But when many signs show up together over time, cocaine or crack addiction may be present.

1. Changes in Behavior

Look for pattern changes, such as (NIDA, 2024; American Addiction Centers, 2023; Addiction Center, 2024):

• Sudden bursts of energy, talkativeness, or confidence, sometimes feeling “on top of the world”

• Staying up very late or going for long periods with little sleep

• Being restless, pacing, fidgeting, or unable to sit still

• Leaving suddenly or disappearing for hours with unclear explanations

• Taking more risks: driving fast, unsafe sex, gambling, or hanging with new risky crowds

• Lying about where they’ve been or how they spent money

• Using the drug in dangerous situations (driving, caring for kids, at work)

  
  

Over time, the person may seem to care more about getting and using cocaine or crack than about anything else.

2. Changes in Work, School, or Home Life

Addiction often shows in daily responsibilities (SAMHSA, 2024; American Psychiatric Association, 2013):

• Missing work or school, or performance dropping

• Not paying bills, rent, or child support on time

• Ignoring basic household tasks and personal responsibilities

• Relationship problems: more arguments, broken trust, or isolation

• Legal trouble, such as arrests related to drugs or money

  
  

When cocaine or crack use keeps happening despite clear damage in these areas, that’s a major warning sign of addiction.

3. Physical Signs

Some possible physical clues of frequent cocaine or crack use include (NIDA, 2024; DEA, 2024; SAMHSA, 2024):

• Dilated pupils (big, wide pupils)

• Runny or bloody nose, frequent sniffing (for people who snort cocaine)

• Nosebleeds and nasal irritation over time

• Very fast heart rate, palpitations, or chest pain

• Weight loss and poor appetite

• Jaw clenching, teeth grinding, muscle twitches

• Sweating, feeling hot, or body temperature changes

  
  

People who smoke crack may have:

• Burns or dark marks on lips or fingers

• Chronic cough, breathing issues, or chest discomfort (DEA, 2024; NIDA, 2024)

  
  

Remember: none of these signs alone prove someone is using cocaine, but together they can raise concern.

4. Mood and Mental Health Changes

Cocaine and crack can strongly affect mood and thinking, especially with repeated use (NIDA, 2024; SAMHSA, 2024; MentalHealth.com, 2022):

During or right after using, a person may seem:

• Very happy or excited

• Over-confident or “invincible”

• Very talkative, with racing thoughts

  
  

As the drug wears off, they may:

• Crash – feel tired, sad, or irritable

• Have strong cravings for more

• Feel anxious, paranoid, or like people are watching them

• Hear or see things that aren’t there (hallucinations) in more severe cases

  
  

Over time, heavy cocaine or crack use is linked with depression, anxiety, paranoia, and difficulty feeling pleasure without the drug (NIDA, 2024; SAMHSA, 2024).

Health Risks of Cocaine and Crack

Cocaine and crack affect the heart, blood vessels, brain, and more. Serious risks include (NIDA, 2024; DEA, 2024; Centers for Disease Control and Prevention [CDC], 2024):

• Heart attack, even in younger people

• Stroke

• Dangerous blood pressure spikes and irregular heart rhythms

• Seizures

• Nasal and sinus damage from snorting

• Breathing problems and lung damage from smoking crack

• Higher risk of infections like HIV or hepatitis if injecting or sharing equipment

  
  

Long-term use can also lead to serious mental health issues, including paranoia and severe mood problems (NIDA, 2024; SAMHSA, 2024).

Overdose and Fentanyl Risk

Cocaine and crack can cause overdose—the body is overwhelmed and cannot cope. Signs may include (NIDA, 2024; CDC, 2024; DEA, 2024):

• Extremely high blood pressure or heart rate

• Severe chest pain

• Trouble breathing

• Seizures

• Sudden collapse, stroke, or heart attack

  
  

In recent years, cocaine and crack have sometimes been mixed with fentanyl or other dangerous opioids—often without the user knowing (NIDA, 2024; CDC, 2024; DEA, 2024).

This greatly increases the risk of:

• Opioid overdose

• Stopped breathing

• Death

  
  

Emergency data show that overdose deaths involving stimulants like cocaine have risen over the past decade, even as overall overdose deaths have recently started to decline (CDC, 2024; CDC, 2025).

What You Can Do If You’re Worried

If You’re Worried About Yourself

If you’re reading this and thinking, “This sounds like me,” that is a brave first step.

You can:

• Talk to a doctor, nurse, or mental health professional and say:

  “I’m using cocaine/crack and I can’t control it. I want help to stop.”

• Contact SAMHSA’s national helpline (in the U.S.) or local addiction services for confidential guidance and treatment options (SAMHSA, 2024; SAMHSA TIP 33, 2024).

  
  

Treatment can include:

• Counseling and behavioral therapies (like cognitive-behavioral therapy and contingency management)

• Support groups and peer support

• Help with mental health issues like depression or anxiety

• Case management, housing, and job support in some programs (SAMHSA TIP 33, 2024; NIDA, 2024)

  
  

There is no shame in having a cocaine use disorder. Addiction is now recognized as a chronic, treatable brain disorder, not a moral failure (NIDA, 2024; SAMHSA, 2024).

If You’re Worried About Someone Else

Try to:

• Pick a calm time to talk

• Avoid accusing language

• Use “I” statements, such as:

“I care about you. I’ve noticed you’re up late, losing weight, and seem really different lately. I’m worried you might be using something like cocaine and that it’s hurting you. Can we talk about it?”

You can also:

• Offer to help them make an appointment

• Go with them to see a provider or counselor

• Share information from NIDA, SAMHSA, or DEA so they see this is a real health issue, not just your opinion

  
  

If they are in immediate danger—having chest pain, trouble breathing, seizures, or they collapse—call 911 right away.

Tee Shirt: Education You Can Wear (Cocaine/Crack Awareness Tee)

Talking about cocaine and crack can be hard. Many families and communities struggle in silence with shame and fear.

That’s why NurseMob’s Cocaine/Crack Awareness Tee is designed as more than clothing—it’s education you can wear.

This tee can highlight key ideas like:

• “Cocaine and crack are addictive stimulants—not party toys.”

• “Addiction looks like cravings, crashes, missed responsibilities—not just using ‘a lot.’”

• “Addiction is a treatable brain disorder. Help is available.”(NIDA, 2024; SAMHSA, 2024; American Psychiatric Association, 2013)

  
  

When someone wears this shirt at:

• A health fair or community event

• A clinic, recovery group, or outreach program

• School, college, church, or just out in public

  
  

it can:

• Start conversations like:

  “What does your shirt mean about cocaine being a brain disease?”

• Help people understand that cocaine/crack addiction has real signs, not just stereotypes

• Encourage someone to rethink “party drug” talk and see cocaine as a serious health risk

• Remind people that treatment and recovery are possible, and they are not alone

  
  

The more of these tees out in the world, the more people:

• See accurate information about cocaine and crack

• Recognize warning signs in themselves or loved ones

• Are nudged toward support instead of silence

  
  

You can find this cocaine/crack awareness tee (and other substance use education designs) in the NurseMob shop, created by a nurse to blend real health education, harm reduction, and advocacy.

Cocaine/Crack User

From$18.00

Buy Now

Key References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.

Addiction Center. (2024). Crack cocaine symptoms and warning signs. 

American Addiction Centers. (2023). Cocaine addiction: Signs & symptoms of cocaine use. 

Centers for Disease Control and Prevention. (2024). Stimulants and overdose and Drug overdose deaths in the United States, 2003–2023 (Data Brief 522).

Drug Enforcement Administration. (2024). Drugs of Abuse: A DEA Resource Guide and Cocaine: 2024 drug fact sheet.

MentalHealth.com. (2022). Cocaine use disorder: Definition, symptoms, and causes.

National Institute on Drug Abuse. (2024). Cocaine drug facts and Cocaine (PDF fact sheet).

Substance Abuse and Mental Health Services Administration. (2024). Substance use disorder (overview).

Substance Abuse and Mental Health Services Administration. (2024). Treatment for Stimulant Use Disorders (TIP 33).

Verywell Mind. (2025). DSM-5 criteria for substance use disorders.