Cocaine Dosage Guide

Cocaine overdose is a medical emergency that can be rapidly fatal. The primary life-threatening complications are cardiovascular: cocaine can cause myocardial infarction (heart attack), stroke, aortic dissection, and fatal cardiac arrhythmias. These events can occur even in young, apparently healthy individuals, and even at doses the person has previously tolerated. Community reports emphasize that cocaine-related cardiac events are unpredictable and can occur without warning, even in individuals who have used similar doses many times before. Signs of cocaine overdose include: severe chest pain (potential heart attack), irregular or very rapid heartbeat, difficulty breathing, extreme agitation or panic, seizures, extremely high body temperature (hyperthermia), confusion or delirium, bluish skin (cyanosis), and loss of consciousness. A heart attack can present as crushing chest pain radiating to the arm or jaw, shortness of breath, and nausea. Call emergency services (911) immediately for any of these symptoms. While waiting: keep the person calm and still (physical exertion increases cardiac risk). If the person is seizing, protect their head and do not put anything in their mouth. If unconscious and not breathing, begin CPR. If the person is overheating, apply cool water. Do not attempt to treat cocaine overdose with depressant drugs or other home remedies. In an emergency department, benzodiazepines are first-line treatment for cocaine-related agitation and can reduce cardiovascular strain by lowering sympathetic activity. Beta-blockers are generally avoided due to risk of unopposed alpha-adrenergic stimulation, which could worsen hypertension and coronary vasoconstriction. Nitroglycerin may be used for cocaine-associated chest pain. Good Samaritan laws apply in most jurisdictions. Community discussions emphasize that chest pain during or after cocaine use should always be taken seriously, as cocaine-related cardiac events are the leading cause of cocaine-related death. Individuals who experience even brief chest pain during cocaine use are advised to seek medical evaluation, as the risk of a subsequent cardiac event may be elevated for hours after use.