Why Does Cocaine Cause Rhabdomyolysis?

Dr. Langdon M.D.

Medically Reviewed By: Kimberly Langdon M.D.


Rhabdomyolysis is a serious medical condition caused by a breakdown of muscle tissue and muscle death (necrosis).

This is dangerous largely because this can result in the release of certain proteins into the blood, which is capable of causing severe kidney damage and death.

Common causes of rhabdomyolysis include:

  • overexertion
  • severe dehydration
  • heat exposure
  • direct or indirect muscle injury
  • physical trauma (e.g. severe burn)
  • use of certain medications
  • alcohol or drug abuse

Chronic use of cocaine, for example, can contribute to the development of this condition, which can lead to permanent disability or death.

How Does Cocaine Cause Rhabdomyolysis?

Cocaine is a drug that has been associated with rhabdomyolysis, as well as conditions with similar symptoms, like myocardial infarction (MI).

While the exact cause of this condition from cocaine use is unclear, researchers have developed several theories for how this might occur.

Effects Of Cocaine Use On The Blood Vessels

Cocaine use can cause a narrowing of blood vessels in the body (vasoconstriction), which can disrupt the normal flow of oxygen to skin, muscle, and organ tissue.

Without enough oxygen, muscle tissue can begin to disintegrate and can die off, and therefore lead to complications associated with rhabdomyolysis.

Learn more about the effects of cocaine use.

Other Effects Of Cocaine

Some researchers also believe that cocaine can have direct toxic effects on myocytes (muscle cells), and may cause tissue ischemia.

Cocaine-induced seizures and other complications of cocaine intoxication may also have effects on muscle tissue — and thereby become a risk factor for this condition.

Can Other Drugs Cause Rhabdomyolysis?

Yes. According to the Cleveland Clinic, excessive use of heroin, LSD, and alcohol abuse have also been associated with a dangerous breakdown in muscle tissue.

Other risk factors include:

  • taking certain supplements (i.e. ephedra, creatine)
  • taking certain medications (antidepressants, antiviral medication, anti-psychotics)
  • excessive consumption of caffeine and other stimulants
  • long period of inactivity (e.g. being in a coma)
  • having muscular dystrophy
  • certain genetic disorders

What Are The Dangers Of Cocaine-Associated Rhabdomyolysis?

When the skeletal muscles deteriorate, they release proteins like myoglobin and creatine into the blood. This can be toxic for the kidneys in large quantities.

Without medical intervention, this can lead to:

Cocaine-associated rhabdomyolysis has also been linked to hyperthermia, hyperactivity, and can be deadly without medical and behavioral health intervention.

How Common Is Rhabdomyolysis?

According to the Cleveland Clinic, this condition is relatively rare.

It’s diagnosed in about 26,000 people in the United States each year. However, it is known to be more common among those who use cocaine. 

According to a study published in the Journal of Family Medicine and Disease Prevention, an estimated 24 percent of those who use cocaine develop this condition.

Signs And Symptoms Of Rhabdomyolysis

Cocaine-induced rhabdomyolysis can be identified by certain physical symptoms, which are used to help diagnose and treat the condition.

Common signs include:

  • dark urine that is red, brown, or tea-colored
  • muscle swelling
  • weak or tender muscles
  • severe muscle cramps
  • severe muscle pain (myalgia)
  • unusual fatigue

According to the Centers for Disease Control and Prevention (CDC), symptoms can develop any time after an injury to the muscles occurs. 

Diagnosing Cocaine-Induced Rhabdomyolysis

Having symptoms alone will not be able to determine whether you have acute rhabdomyolysis. Typically, a diagnosis is made through a blood test.

A healthcare provider will specifically look for:

  • elevated myoglobin levels
  • elevated creatinine kinase/creatine phosphokinase (CPK)

A urine test can identify myoglobin levels, but it is not considered an accurate way to test for rhabdomyolysis, due to the fact that myoglobin leaves the body quickly.

Therefore, repeated CK/CPK tests are considered the most effective way to detect and diagnose this condition.

Unlike myoglobin, high CK/CPK levels can remain in the blood for days. Your medical history may also be considered.

Treatment For Cocaine-Induced Rhabdomyolysis

Recommended treatment for this condition will depend on the severity of the case, and other factors relating to your health.

If the condition is caught early, a treatment plan will likely involve:

Severe cases of rhabdomyolysis may require inpatient care within a medical center, as well as other medical treatments.

A treatment plan for severe rhabdomyolysis may require:

  • intravenous (IV) fluids
  • consistent medical monitoring 
  • physical therapy
  • dialysis (for very severe cases)

The severity of this condition can be determined through repeated blood tests, as well as an electrocardiogram (EKG) and other diagnostic mechanisms.

For those who have developed this condition through illicit drug use, stopping your drug use will be an essential part of your treatment plan to prevent further complications.

Get Help For Cocaine Abuse And Addiction

Cocaine is a highly addictive and dangerous drug that can cause serious health consequences and negatively affect your overall quality of life over time.

If you are concerned about the consequences of your or a loved one’s cocaine use, call our helpline today to learn about cocaine addiction treatment options at Bedrock Recovery Center.

  1. American Heart Association Journal — Management of Cocaine-Associated Chest Pain and Myocardial Infarction https://www.ahajournals.org/doi/full/10.1161/CIRCULATIONAHA.107.188950
  2. Centers for Disease Control and Prevention (CDC): National Institute for Occupational Safety and Health (NIOSH) — Rhabdomyolysis https://www.cdc.gov/niosh/topics/rhabdo/default.html
  3. Cleveland Clinic — Rhabdomyolysis: Symptoms, Treatment https://my.clevelandclinic.org/health/diseases/21184-rhabdomyolysis
  4. Journal of Family Medicine and Disease Prevention — Acute Rhabdomyolysis and Acute Cocaine Intoxication https://clinmedjournals.org/articles/jfmdp/journal-of-family-medicine-and-disease-prevention-jfmdp-2-024.pdf
  5. Toxicology Communications — The association between cocaine use detected on drug screening and rhabdomyolysis https://doi.org/10.1080/24734306.2020.1752536

Written by Bedrock Recovery Center Editorial Team

© 2024 Bedrock Recovery Center | All Rights Reserved

* This page does not provide medical advice.

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