Two Things That Need Emergency Care
Chest pain. NIDA states cocaine has significant and well-recognized toxic effects on the heart and cardiovascular system, and that chest pain which feels like a heart attack is common and sends many people who use cocaine to the emergency room.1 Do not wait it out and do not assume it is anxiety. Call 911.
The crash. MedlinePlus, writing about cocaine withdrawal, notes there is a risk of suicide or overdose.2 If the days after stopping bring thoughts of ending your life, call or text 988. That is what it is for, and using it is not an overreaction.
Sol is an outpatient program and does not provide detox or emergency care. In a medical emergency, call 911.
Clinically reviewed by Tania Acevedo, MA, LPCC, Founder and Chief Clinical Officer
What Cocaine Is and How It Takes Hold
NIDA describes cocaine as an addictive stimulant drug made from the leaves of the coca plant, and as a Schedule II drug, meaning it has high potential for misuse but can be administered by a doctor for medical uses such as local anesthesia for some eye, ear and throat surgeries.1 It works by binding to the dopamine transporter and blocking the removal of dopamine from the synapse.1 Sol treats cocaine use disorder in Riverside through three substance use levels of care: High-Intensity IOP, IOP and OP.
NIDA describes how the hold forms: circuits involved in stress become increasingly sensitive, leading to increased displeasure and negative moods when not taking the drug, which are signs of withdrawal.1 That is the mechanism behind the thing most women describe first, which is that everything without it feels flat.
Key Takeaways
- There are currently no medications approved by the FDA to treat cocaine use disorder.1
- NIDA names contingency management as a behavioral therapy that shows positive results in people with cocaine use disorders, and calls CBT another effective approach.1
- MedlinePlus states cocaine withdrawal may not be as dangerous as withdrawal from alcohol, while noting there is a risk of suicide or overdose.2
- NIDA states cocaine has significant and well-recognized toxic effects on the heart and cardiovascular system.1
- Cocaine-involved overdose deaths fell 26.7% between 2023 and 2024.3
Show all 5 takeaways
What Cocaine Does to the Body
This is the part of the topic that gets the least attention and deserves the most. NIDA states plainly that cocaine has significant and well-recognized toxic effects on the heart and cardiovascular system.1
The most frequent effects NIDA names are cardiovascular, including disturbances in heart rhythm and heart attacks; neurological, including headaches, seizures, strokes and coma; and gastrointestinal, including abdominal pain and nausea.1
Beyond the acute events, NIDA reports that cocaine use is linked with increased risk of stroke, inflammation of the heart muscle, deterioration of the heart’s ability to contract, and aortic ruptures.1
And the everyday version: chest pain that feels like a heart attack is common, and sends many people who use cocaine to the emergency room.1 Women who have had that experience once often decide it was nothing. It is worth taking seriously each time.
What Stopping Is Actually Like
MedlinePlus states that withdrawal from cocaine may not be as dangerous as withdrawal from alcohol, while adding that withdrawal from any chronic substance use can be very serious and that there is a risk of suicide or overdose.2
The symptoms MedlinePlus lists are agitation and restless behavior, depressed mood, fatigue, a general feeling of discomfort, increased appetite, vivid and unpleasant dreams, and slowing of activity.2
Notice what is not on that list. No seizures, no medical emergency of the kind alcohol and benzodiazepine withdrawal produce. What is on it is a depression severe enough that MedlinePlus raises suicide risk in the same paragraph.
And it does not end in a week. MedlinePlus states the craving and depression can last for months after stopping long-term heavy use.2 Knowing about that longer stretch ahead of time can help it feel less discouraging if it comes.
Fentanyl and the Stimulant Supply
This deserves care, because the evidence is more nuanced than many headlines suggest.
What is verified: CDC found that among overdose deaths involving stimulants between January 2021 and June 2024, 79.1% of cocaine-involved deaths also involved opioids.4 NIDA states that adulteration of cocaine with highly potent fentanyl and related substances is a major contributor to rising drug overdose deaths, and that the combination of cocaine with heroin or fentanyl is very dangerous.1
What is not verified: that most cocaine is laced. In the same CDC analysis, drug-checking programs rarely detected opioids in recent stimulant products, which led CDC to conclude that people who died of overdoses involving both stimulants and opioids had intentionally used separate stimulant and opioid products.4
So both things matter. Most cocaine-involved overdose deaths do involve an opioid, and that is not the same as most cocaine containing fentanyl. Naloxone is still worth having, because if an opioid is involved it will work.
Read about fentanyl.
What Actually Treats This
Start with what does not exist, because it is the first question. NIDA states that there are currently no medications approved by the US Food and Drug Administration to treat cocaine use disorder.1
What does have evidence behind it is behavioral. NIDA names contingency management as a form of behavioral therapy that shows positive results in people with cocaine use disorders, and describes cognitive behavioral therapy as another effective approach.1
In the research, contingency management offers small, tangible incentives for staying in treatment and for negative drug tests.
What Sol does provide is CBT, group and individual therapy, and treatment for what is underneath the use. Medication management is available for co-occurring conditions, which is a different thing from a medication for cocaine use disorder.
Along the way, women are recognized for milestones like steady attendance with a charm for a bracelet. It is a small, warm way to mark progress, separate from the treatment itself.
Almost nobody uses cocaine for no reason. For many of the women here it was managing exhaustion, depression, or a life that required more than one person could deliver. See depression, dual diagnosis or ADHD.
See our therapy approaches or read about CBT.
What Is Different for Women
NIDA’s research on sex differences in stimulant use is mixed, so here is the full picture.
On vulnerability, NIDA states that research in both humans and animals suggests women may be more vulnerable to the reinforcing effects of stimulants, with estrogen possibly being one factor, and that in animal studies females are quicker to start taking cocaine and take it in larger amounts than males.5 Note that the “quicker to start” finding is from animal studies.
On the heart, NIDA states women may also be more sensitive than men to cocaine’s effects on the heart and blood vessels.5 Given everything in the section above, that is the finding worth carrying.
On the brain, NIDA reports the opposite direction. Female and male cocaine users show similar deficits in learning, concentration and academic achievement even when women had been using it longer, and female users are less likely than male users to show abnormalities of blood flow in the brain’s frontal regions, which NIDA suggests may indicate a sex-related mechanism protecting women from some of cocaine’s detrimental effects on the brain.5
On progression, NIDA states that women often have a shorter history of using substances including cocaine, yet typically enter treatment with more severe medical, behavioral, psychological and social problems, because women show a quicker progression from first using the substance to developing dependence.6
The practical takeaway is a gentle one. A shorter history is not a reason to wait, even though it is often the reason a woman talks herself out of calling.
If You Are Pregnant
NIDA states that cocaine use during pregnancy is associated with migraines and seizures, premature membrane rupture, and separation of the placental lining from the uterus prior to delivery.1
It also notes that pregnancy brings normal cardiovascular changes which cocaine use intensifies, sometimes leading to serious problems with high blood pressure, spontaneous miscarriage, preterm labor and difficult delivery, and that babies exposed to cocaine during pregnancy are often prematurely delivered, have low birth weights and smaller head circumferences, and are shorter in length.1
NIDA’s conclusion is the one that matters here: people who use cocaine and are pregnant must receive appropriate medical and psychological care, including addiction treatment, to reduce these risks.1 The answer is treatment, not shame, and telling someone is the step that gets you there.
What Is Actually Happening Nationally
CDC data shows cocaine-involved overdose deaths are falling.
| Measure | Figure | Period |
|---|---|---|
| Cocaine-involved overdose death rate | Down 26.7%, from 8.6 to 6.3 per 100,000 | 2023 to 20243 |
| Cocaine-involved overdose deaths | 21,945, down from 29,449 | 2024 against 20233 |
| Share of stimulant-involved deaths co-involving opioids | 79.1% of cocaine-involved deaths | Jan 2021 to Jun 20244 |
| US drug overdose deaths, estimated | 69,973, down almost 14%. Third consecutive annual decline. | Calendar year 20257 |
CDC reported that cocaine and psychostimulant deaths decreased again in 2025 but did not publish a drug-specific 2025 figure. The 2024 numbers above are the most recent drug-specific data available.
How Much Treatment
Typically suits
What the week holds
Read more
High-Intensity IOPMost intensive substance use level
Typically suits
The first weeks, when mood is at its lowest
What the week holds
Sol’s most intensive substance use level, with days structured like PHP: Monday to Friday, 9:00 AM to 1:30 PM
Read more
IOPIntensive outpatient
Typically suits
The common fit: real treatment alongside work or family
What the week holds
Three days a week, you choose which three, counseling plus group
Read more
OPOutpatient
Typically suits
Protecting a recovery that is holding
What the week holds
Ongoing support and relapse prevention
Read more
If home is part of what makes this hard, our supportive housing affiliate has an all-female home about ten minutes from our treatment center. It is run by a separate organization, and admissions can tell you more.
Starting Treatment
1
Call or Send Your Insurance Details
Admissions answers 24 hours a day, seven days a week.
2
Assessment
A clinician looks at how much and how long, what else is going on, and what the days after stopping have been like before.
3
Verify Your Insurance
We contact your plan confidentially and explain what we learn.
4
Start Date
Set around what your week can hold.
If you have had chest pain while using, say so on that first call. It changes what gets checked and when.
In crisis right now? Call or text 988.
The flatness after stopping is not proof that you need it. It is a common part of withdrawal, and you do not have to face it alone.
Frequently Asked Questions
Our admissions line is answered 24 hours a day, 7 days a week at (951) 972-5085.
Is There a Medication for Cocaine Addiction?
No. NIDA states there are currently no medications approved by the FDA to treat cocaine use disorder. What has evidence behind it is behavioral: NIDA names contingency management as showing positive results and cognitive behavioral therapy as another effective approach.
Is Cocaine Withdrawal Dangerous?
MedlinePlus states that withdrawal from cocaine may not be as dangerous as withdrawal from alcohol, while adding that withdrawal from any chronic substance use can be very serious and there is a risk of suicide or overdose. It is not a medical emergency in the way alcohol or benzodiazepine withdrawal can be. The depression is the risk.
How Long Does Cocaine Withdrawal Last?
MedlinePlus lists the symptoms without giving an acute timeline, and states that the craving and depression can last for months after stopping long-term heavy use. Timing varies from woman to woman, so a clinician is the best guide for your situation.
Is Cocaine Bad for Your Heart?
Yes, and NIDA is unusually direct about it. Cocaine has significant and well-recognized toxic effects on the heart and cardiovascular system, including disturbances in heart rhythm and heart attacks, and NIDA notes chest pain that feels like a heart attack is common. Cocaine use is also linked with increased risk of stroke.
Is Cocaine Laced With Fentanyl?
Some of it is, and the picture is more complicated than the headline. CDC found 79.1% of cocaine-involved overdose deaths between January 2021 and June 2024 also involved opioids, but also that drug-checking programs rarely detected opioids in recent stimulant products, and concluded people were more often using separate stimulant and opioid products. Naloxone is still worth having.
Does Cocaine Affect Women Differently?
NIDA’s findings cut both ways. Women may be more vulnerable to the reinforcing effects of stimulants and may be more sensitive to cocaine’s effects on the heart and blood vessels. On the brain, female users show similar cognitive deficits to men and are less likely to show frontal blood flow abnormalities, which NIDA suggests may be protective.
Can I Be Treated for Cocaine Use While Pregnant?
Yes, and NIDA states that people who use cocaine and are pregnant must receive appropriate medical and psychological care including addiction treatment, to reduce the risks. Telling someone is the step that gets you there.
Does Insurance Cover Cocaine Treatment?
Every plan is different, so the quickest way to know is to verify your insurance. Sol accepts most major insurance plans, and benefits are confirmed individually before admission. Sol can often work with HMO policies through a single case agreement. Sol does not accept Medi-Cal, Medicaid, Medicare, Molina, IEHP, Kaiser, TRICARE or TriWest.
Show all 8 questions
A Shorter History Is Not a Reason to Wait
NIDA’s finding is that women tend to arrive at treatment with a shorter history and a more severe picture. Reaching out earlier can make the path gentler.
4175 Brockton Avenue, Riverside, CA 92501
Confidential, and nobody is going to ask you to promise anything on the phone.
Sources7
- 1.National Institute on Drug Abuse. Cocaine. https://nida.nih.gov/research-topics/cocaine
- 2.MedlinePlus, National Library of Medicine. Cocaine withdrawal. https://medlineplus.gov/ency/article/000947.htm
- 3.Centers for Disease Control and Prevention, National Center for Health Statistics. Drug Overdose Deaths in the United States, 2023-2024, NCHS Data Brief No. 549, January 2026. https://www.cdc.gov/nchs/products/databriefs/db549.htm
- 4.Centers for Disease Control and Prevention. Drug Overdose Deaths Involving Stimulants, United States, January 2018-June 2024. MMWR 2025;74. https://www.cdc.gov/mmwr/volumes/74/wr/mm7432a1.htm
- 5.National Institute on Drug Abuse. Substance Use in Women Research Report: Sex Differences in Substance Use. https://nida.nih.gov/publications/research-reports/substance-use-in-women/sex-differences-in-substance-use
- 6.National Institute on Drug Abuse. Substance Use in Women Research Report: Sex Differences in Substance Use Disorder Treatment. https://nida.nih.gov/publications/research-reports/substance-use-in-women/sex-differences-in-substance-use-disorder-treatment
- 7.Centers for Disease Control and Prevention, National Center for Health Statistics. U.S. Overdose Deaths Decrease for Third Consecutive Year in 2025, May 13, 2026. https://www.cdc.gov/nchs/pressroom/releases/20260513.html
Medical Disclaimer
This page is educational and is not medical advice. Cocaine use disorder can only be diagnosed by a qualified clinician. Chest pain, seizures, severe confusion or loss of consciousness need emergency care, not a website. Sol Women’s Treatment is certified by DHCS for outpatient and intensive outpatient services (330246AP) and licensed by CDSS (facility 331881576), and does not provide detox, inpatient or residential care. No two women respond identically and nothing here promises a result. In a medical emergency call 911. If you are in crisis, call or text 988.