Cocaine is well known for producing desirable effects like elevated mood and energy. But it can also create paranoia or delusions.

Cocaine, also colloquially known as crack, coke, or blow, is a stimulant drug that causes increased energy and euphoria, among other effects.

Cocaine is classified as a Schedule II drug in the United States. This means that although it has an accepted medical use, it also has a high potential for misuse and the risk of dependence.

Generally, the immediate effects of cocaine are short-lived and tend to last anywhere from 10 minutes up to 3 hours, depending on how the drug is administered. But both short-term and long-term cocaine use can also cause lasting cognitive effects, including symptoms like paranoia and even cocaine-induced psychosis.

Keep reading to learn everything you need to know about the risk of paranoia and psychosis from cocaine use. We’ll also discuss how to recognize and treat the symptoms of cocaine-induced psychosis and how to get support if cocaine use is affecting your life.

Cocaine is a stimulant drug, which means that it increases the activity of the central nervous system.

When someone uses cocaine, they may notice drastic short-term effects. But cocaine doesn’t just cause feelings like increased euphoria and energy. Many cocaine users also report experiencing symptoms like anxiety, panic attacks, and paranoia.

In some people, cocaine use can even lead to episodes of psychosis, which can cause symptoms like paranoia, hallucinations, and delusions. In fact, early research found that anywhere from 68–84% of people who used cocaine reported experiencing paranoia as a side effect.

In a 2021 research review, researchers explored the prevalence of cocaine-induced psychosis in people who currently or previously used cocaine.

Results of the analysis found that the presence of cocaine-induced psychosis was 50.2% in current cocaine users and 55.6% in lifetime cocaine users. However, the authors note that the pool of participants was on the smaller side.

Another review from 2021 that analyzed research on substance-induced psychosis also found similar reports of cocaine-induced psychosis in the studies they reviewed.

For example, one study included in the review found that 90% of participants reported experiencing paranoid delusions after cocaine use. And another study showed that almost 54% of participants who used cocaine reported psychotic symptoms, especially paranoia and suspiciousness.

We know this experience is shared by the majority of people that use cocaine — but what exactly causes some people to have paranoia or psychosis when using cocaine?

Well, health experts aren’t entirely sure ― but it’s most likely due to several factors, such as age, dosage, preparation, and other underlying mental health conditions, such as personality disorders.

Can you prevent cocaine paranoia?

Research suggests that underlying factors or conditions may increase the risk of developing cocaine-induced psychosis.

In one study from 2013, for example, researchers found that antisocial personality disorder and a history of cannabis dependence were both associated with an increased risk of cocaine-induced psychosis. And a 2014 study found a relationship between neuroticism personality traits and the risk of psychosis in people with cocaine dependence.

At the end of the day, cocaine use is likely to cause harm and there is no way to know whether someone will develop paranoia, psychosis, or other symptoms or side effects after using the drug.

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When people use cocaine for the first time, they often do so at smaller doses, so the side effects don’t tend to be severe. At smaller doses, side effects like anxiety and paranoia may only stick around for a short time until the drug wears off.

But people who use cocaine more frequently and at higher doses are more likely to experience these types of symptoms more severely.

In fact, they’re also at a higher risk of experiencing full-blown episodes of psychosis.

Psychosis can cause people to experience a break from reality and act in ways that they aren’t aware of. In some cases, this can lead them to engage in behaviors that place themselves or those around them in danger.

If you or someone you love is experiencing symptoms like paranoia, hallucinations, or delusions after using cocaine, it’s important to reach out for professional help.

If you’ve noticed that cocaine use is negatively affecting your life, there are resources available to help you navigate through treatment and recovery.

Here are a few to get you started:

It can sometimes be difficult for people living with substance use disorder to take that first step toward recovery. But you’re not alone, and there is support available.

And even if you’re not yet ready to reach out to any of the resources above, sometimes just starting a conversation with a loved one or healthcare professional you trust can make all the difference.

Cocaine is a stimulant that can have both short-term and long-term cognitive effects, including symptoms like paranoia and psychosis.

Many people who use cocaine report experiencing paranoia, with a significant percentage also reporting having episodes of cocaine-induced psychosis.

If you or someone close to you is living with cocaine use disorder or any other substance use disorder, support and treatment are available.