Cocaine is a potent central nervous system stimulant that rapidly triggers physiological and psychological effects. The drug works by preventing the reabsorption of dopamine, leading to an intense but brief rush of euphoria and energy. Visible changes in a person’s appearance, demeanor, and long-term physical health can offer distinct indicators of its use.
Immediate Physical Indicators of Use
The acute effects of cocaine intoxication manifest almost immediately in involuntary physical responses. One primary visual sign is mydriasis, or the noticeable dilation of the pupils, which often appear significantly larger and may not contract properly in bright light. This is a direct result of the sympathetic nervous system being overstimulated.
The body displays signs of increased metabolic activity, including elevated heart rate and blood pressure, which can sometimes cause a flushed or noticeably pale complexion. The stimulant effect increases core body temperature, often resulting in profuse sweating. Fine muscle tremors or twitching, particularly in the hands, face, or jaw, may also be visible.
Observable Behavioral Changes
Intoxication dramatically alters a person’s demeanor, leading to visible changes in communication and movement. The person often exhibits pronounced hyperactivity and restlessness, appearing unable to sit still or focus. This excessive energy translates into constant fidgeting, rapid shifts in posture, and a general air of agitation.
Communication is frequently characterized by rapid, pressured speech, where the person talks excessively and jumps quickly between topics. Accompanying this is often an inflated sense of self-importance or grandiosity, making the individual appear overly confident or excitable. High-dose use can trigger acute paranoia, causing the person to become visibly suspicious, constantly scanning their surroundings, or exhibiting erratic behavior.
Signs of Chronic Use and Physical Deterioration
Repeated, long-term cocaine use causes severe physical deterioration. Chronic appetite suppression and high metabolic demands frequently lead to severe, unexplained weight loss, resulting in a gaunt or malnourished appearance.
The repetitive snorting of cocaine damages nasal tissues, leading to a chronically runny nose, frequent nosebleeds, and persistent sniffing. In advanced cases, this damage can result in the perforation or visible collapse of the nasal septum, altering the nose’s structure.
Long-term users may also display signs of bruxism, or teeth grinding, which is an involuntary side effect of chronic stimulation that causes severe dental wear and decay. If the drug is injected, visible track marks—small scars, scabs, or bruises—may be present along veins, most commonly on the arms or legs.
The Appearance During the “Crash”
The “crash” is a distinct post-intoxication phase that occurs as the drug’s effects wear off. The most striking visual element is profound physical and mental exhaustion, where the person appears extremely fatigued and lethargic. This state is the opposite of the high, marked by heavy-lidded eyes, a slow gait, and an overall look of sickness.
The intense euphoria is replaced by a severe mood crash, often manifesting as visible depression, irritability, and anxiety. This emotional depletion can cause the person to withdraw, displaying fearful body language, such as slouching or avoiding eye contact.