Cocaine is a powerful, highly addictive stimulant derived from the coca plant that rapidly affects the central nervous system. It triggers a massive surge of dopamine, creating an intense, short-lived feeling of euphoria and heightened energy. For those concerned about a friend or family member, observing objective signs is the first step toward seeking help. These indicators fall into categories of immediate physical changes, acute shifts in behavior, and cumulative effects from sustained use.
Immediate Physical Indicators
The initial effects of cocaine intoxication manifest as distinct physiological changes. One of the most noticeable signs is the extreme dilation of the pupils (mydriasis), which makes the eyes appear unusually dark and wide. This occurs alongside an increased sensitivity to light, sound, and touch.
Cocaine acts as a vasoconstrictor and stimulant, causing the cardiovascular system to accelerate rapidly. A person actively using the drug will experience tachycardia (a rapid heart rate) and elevated blood pressure. This physiological stress may also lead to nonintentional tremors, often seen as slight twitching in small muscles, particularly in the face and fingers. The drug also interferes with temperature regulation, leading to an elevated body temperature and frequent excessive sweating.
Acute Behavioral and Emotional Changes
The stimulant effects cause immediate, temporary shifts in a person’s mood and activity level. Users often display intense euphoria and a sense of grandiosity, accompanied by inexhaustible energy and a lack of fatigue. This heightened state is frequently characterized by logorrhea, or excessive talkativeness, often expressed as rapid, pressured speech that jumps from topic to topic.
During the high, the person may become restless, agitated, and hyperactive, exhibiting wired behavior. As the short-lived effects of the drug fade, this energized state quickly transitions into a “crash,” marked by irritability, anxiety, and sharp mood swings. A particularly concerning symptom of acute intoxication is the onset of paranoia, which can range from mild suspiciousness to severe delusion or cocaine-induced psychosis.
Signs of Chronic or Sustained Use
Long-term cocaine use leaves behind distinct physical and lifestyle markers. The stimulant effect suppresses appetite, resulting in noticeable weight loss or malnutrition over time. Frequent snorting of cocaine causes significant damage to the nasal passages because the drug constricts blood vessels, cutting off blood supply to the tissue.
This damage commonly leads to chronic nosebleeds, a persistent runny nose, and a loss of the sense of smell. In heavy users, the lack of blood flow can erode the cartilage, potentially resulting in a perforated septum (a hole in the wall dividing the nostrils) or nasal collapse. On a behavioral level, the need to maintain an expensive habit leads to sudden, unexplained financial instability, manifesting as selling possessions or accumulating debt. The psychological consequences of dependence also become apparent, with users neglecting personal hygiene and responsibilities at work or school. When the drug is absent, the brain’s depletion of dopamine can lead to a severe emotional low, causing depression, anxiety, and an inability to feel pleasure (anhedonia).
Next Steps and Seeking Assistance
Identifying these signs means the next step is to approach the person with genuine concern, rather than confrontation or judgment. It is helpful to choose a private, calm setting and avoid discussing the issue while the person is actively under the influence. Use “I” statements to describe specific behaviors you have observed, focusing on how these changes have made you feel.
The goal of this conversation is not to diagnose or treat, but to encourage the person to seek professional assistance. Addiction is a medical condition, and effective treatment requires the expertise of medical professionals or addiction specialists. You can offer to help them find resources, such as national helplines, support groups, or a qualified mental health provider. This shifts the focus from accusation to practical support.