Cocaine-Induced Psychosis: Causes, Symptoms, And Treatment

Cocaine-induced psychosis (CIP) is an undesirable short-term side effect of cocaine use. The hallucinations and delusions that accompany CIP can cause erratic and even dangerous behavior and indicate an emergency situation that requires immediate care.

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Cocaine-induced psychosis is the most troubling short-term side effect of cocaine use. Studies indicate that 55% of cocaine users have experienced cocaine-induced psychosis.

What Is Cocaine-Induced Psychosis?

Cocaine-induced psychosis is a condition where the person loses contact with reality as a result of cocaine use.

Paranoia, hallucinations, delusions, and erratic or violent behavior are common symptoms.

Causes Of Cocaine-Induced Psychosis

Cocaine-induced psychosis can technically be caused by any amount of cocaine. However, the exact cause of CIP is unknown.

Your sex, body mass index (BMI), and concurrent mental illnesses are all contributing factors.

You are also more likely to experience CIP if you use larger doses or have been using cocaine for an extended period of time.

Excess Release Of Dopamine

The pleasurable feelings associated with cocaine are caused by the release of dopamine. Under normal circumstances, the release is mild enough to make you feel energetic and confident.

However, it is also possible for cocaine to cause an excessive release of dopamine. In excess, dopamine may cause aggression, hallucinations, and other psychiatric abnormalities.

Low Levels Of Brain-Derived Neurotrophic Factor (BDNF)

Brain-derived neurotrophic factor is integral to neuroprotection, synapse regulation, learning, and memory.
Significantly decreased levels of BDNF have long been associated with active schizophrenia and other forms of psychosis.

Recent research built on these associations found that people under the influence of cocaine also show decreased BDNF levels.

Prior to an episode of cocaine-induced psychosis, their BDNF levels often drop a further 50%.

Symptoms Of Cocaine-Induced Psychosis

Cocaine-induced psychosis shares many features with acute paranoid schizophrenia. However, CIP is more likely to produce some symptoms of psychosis over others.

Auditory Hallucinations

Auditory hallucinations are used to describe anything you hear that isn’t real. Both people who experience CIP and people with acute paranoid schizophrenia are likely to experience command hallucinations.

These hallucinations are voices that tell you to take some kind of action.

People experiencing cocaine-induced psychosis are less likely to hear voices encouraging them to hurt themselves or others, but the effects are entirely unpredictable.

Visual Hallucinations

Visual hallucinations are associated with many types of substance abuse. They are also common in people experiencing cocaine-induced psychosis.

A visual hallucination is a trick of the brain. You see something. It seems so real, but it’s not. If you’re experiencing CIP you may see shadows, flashing lights, or unexplained movement.

Tactile Hallucinations

One of the scariest and most common symptoms of cocaine-induced psychosis is visual as well as tactile. With CIP, you may hallucinate that there are bugs crawling over or under your skin.

This is a deeply upsetting hallucination in practically all cases and may result in accidental self-harm.

Paranoid Delusions

Paranoid delusions are a common side effect of drug use. Cocaine users experiencing cocaine-induced paranoia are likely to believe that individuals or groups are conspiring against them.

Similar trends are regularly witnessed in people with schizophrenia. The difference is that people experiencing CIP are not likely to have identity delusions, possession delusions, or Capgras syndrome.

Risk Factors For Developing Cocaine-Induced Psychosis

There are many risk factors that may affect how likely you are to experience cocaine-induced psychosis. Some are biological and others are experiential.


Biological men are significantly more likely than biological women to experience cocaine-induced psychosis.

Currently, the disparity is not fully understood, but it is clear that men are more susceptible to CIP. This trend does not necessarily hold true for other forms of substance use.

Age Of First Cocaine Use

There’s a direct correlation between your age when you first used cocaine and your risk of experiencing cocaine-induced psychosis.

People who began using cocaine at a young age are far more susceptible.

Body Weight

If you have a lower body mass index (BMI), you are also more prone to cocaine-induced psychosis.

It is unclear whether a lower BMI actively increases the risk of CIP or whether a higher BMI actively decreases the risk of CIP.

Method Of Cocaine Abuse

Snorting cocaine is far less likely to result in a psychotic episode. The delivery method is delayed and less potent, making adverse side effects somewhat less likely.

Smoking crack cocaine or injecting cocaine greatly increases your risk of experiencing cocaine-induced psychosis. Both delivery methods result in an almost instantaneous and very intense high.

Due to the intensity of the high, smoking and injecting are more likely to cause an excessive release of dopamine.

Co-Occurring Mental Health Disorders

Drug abuse is known to aggravate existing mental illness. Cocaine is no different.

Any mental health disorder, including depression, anxiety, bipolar disorder, and schizophrenia increases your risk of experiencing cocaine-induced psychosis.

Amount And Duration Of Cocaine Use

Taking a large amount of cocaine significantly increases your risk of experiencing adverse side effects.

You will develop a tolerance for dopamine over time, but that doesn’t decrease your risk.

You are actually more likely to experience cocaine-induced psychosis if you have been using cocaine for a longer period of time.

Treatment For Cocaine-Induced Psychosis

Cocaine-induced psychosis is a severe short-term side effect of cocaine use. It may not happen every time you use cocaine, but the risk of a potentially dangerous episode will only increase with time.

If you or a loved one are demonstrating symptoms consistent with CIP, you are in an emergency situation.

Get to the nearest emergency room, and tell the staff everything you can about symptoms and what drugs or alcohol were used.

Restraints may be needed while an antipsychotic is administered. These steps are necessary to ensure your well-being.

Treatment Programs For Cocaine Abuse

Drug addiction can have serious, life-long consequences and not just for you. During an episode of cocaine-induced psychosis, you are an active threat to yourself and others.

Fortunately, there are treatment programs designed to help you make sure you never hurt yourself or another person.

With medically assisted cocaine detox and comprehensive options for inpatient and outpatient behavioral therapy, the right treatment program will help you to start off fresh.

Find Addiction Treatment Services At Bedrock Recovery Center

Bedrock Recovery Center is here to help. We understand how difficult it can be to make a major change. That’s why we have a facility that is designed to make it as painless as possible for you.

If you’re ready to stop putting yourself at risk, call us today.

  1. National Library of Medicine
  2. National Library of Medicine
  3. National Library of Medicine: PubMed
  4. National Library of Medicine: PubMed
  5. National Library of Medicine: PubMed
  6. National Library of Medicine: PubMed

Written by Bedrock Recovery Center Editorial Team

© 2023 Bedrock Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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