Cocaine and Anxiety
Cocaine addiction and anxiety are common co-occurring disorders. Learn more in this article.What is Cocaine?
Cocaine and anxiety are common co-occurring disorders in addiction treatment. Cocaine is one of the most popular controlled substances in the world. It is derived from the cocoa plant and has been used as a drug for thousands of years. Modern technology has taken over the production of cocaine to either increase its purity or cut it down into a more unrefined form called crack.1
This article will examine the link between cocaine and anxiety and treatment for cocaine and anxiety. Treating cocaine and anxiety may require professional addiction treatment.
Crack vs. Coke
The main difference between crack and cocaine are the impurities that are mixed with it. Pure powder cocaine is known as coke and is developed using chemical processes to refine the coca leaf into a product that is easily snorted or injected. The whiter the cocaine the purer it is.
On the other hand, crack is cocaine that is mixed with binding agents such as baking powder and then cooked. The reason why this is done is to lower the temperature at which it can be burned. Lower temperatures mean that the drug can be more easily smoked in a pipe since crack has about half the temperature required to burn than cocaine. Additionally, cocaine that is smoked usually takes effect within seconds while cocaine might take between five to ten minutes.
Can Cocaine Cause Anxiety?
Cocaine, like most other narcotics, has a strong correlation between drug use and mental health disorders. This relationship is known as comorbidity. Cocaine is no exception to this comorbidity dilemma.
Essentially, comorbidity is the diagnosis of one illness with the existing presence of other illnesses at the same time. In this case, it would be the diagnosis of drug addiction along with anxiety. Multiple studies from around the world have linked cocaine and anxiety.2
Brain Chemistry of Cocaine and Anxiety
Cocaine works chemically by binding the dopamine receptors inside the brain. When dopamine is released, it produces an intense yet fleeting sensation of euphoria that temporarily alleviates feelings of pain or depression. Additionally, cocaine is a complicated chemical substance and also affects other neurotransmitters inside the brain including those related to serotonin production.
While releasing serotonin might temporarily alleviate feelings of anxiety, prolonged cocaine use deplete the overall levels of serotonin in the brain. This causes even more anxiety since serotonin is the main chemical in the brain that regulates feelings of happiness.
The Physical Effects of Cocaine and Anxiety
The physical effects of cocaine also produce anxiety symptoms. As tolerance develops, larger amounts of cocaine are needed to obtain the previous high. As higher levels of cocaine are needed, the body’s dependency increases which in turn causes intense withdrawal symptoms.
Withdrawal symptoms for cocaine can include paranoia, difficulty sleeping, weight loss, irritability, sweating, vomiting, and many others. While this isn’t a direct link between cocaine and anxiety, these symptoms can make anyone feel anxious to avoid them. Additionally, some of these symptoms such as insomnia can increase anxiety.3
Why Might a Person Turn to Cocaine When Anxious?
People that attempt to self-medicate with cocaine seek the nearly instantaneous relief the drug offers. Because it is so quick-acting, it has been known to be abused in social situations where people might not be comfortable.
Self-medication for mental health issues can lead to issues with cocaine and anxiety. Self-medication is one of the most common reasons people turn to this drug to address their untreated mental health problems. While there are a variety of factors that cause people to do this, some of the most common include lack of access to health care in low-income populations as well as social stigma regarding seeing a mental health professional.
Can You Become Addicted to Cocaine?
Cocaine is an incredibly addictive stimulant. One of the main reasons is because of its instant reward system. When cocaine is used, the drug can take effect immediately depending on the method taken. As cocaine use increases, the time that it takes for the dopamine levels to be absorbed by the body decreases. This in turn makes the high less in duration, which typically results in increased use.4
Additionally, prolonged cocaine use makes the brain produce less and less serotonin over time. Therefore, after using the substance for a while, people may use cocaine to feel better since their bodies become incapable of doing so without assistance from the substance.
In summary, cocaine use puts people addicted to it down a vicious cycle of feeling down without having the drug and feeling good when they have it. Yet, these moments of happiness becoming increasingly fleeting as the addiction grows and forces the body to rely on the drug to help regulate itself.

Treatment for Cocaine and Anxiety
Unfortunately, compared to other drugs, there does not exist a current medication to ease cravings. However, there are a variety of therapy techniques that have proven to be effective in stopping cocaine use and preventing relapse.
One of the best techniques for treating cocaine and anxiety is contingency management. Contingency management attempts to take back control of the reward system. Instead of rewarding with the drug, those in recovery are awarded other incentives such as tickets to movies, dinners to restaurants, gym memberships, or even cash, and a variety of other positive coping mechanisms.
The goal of this type of therapy is to rewire the reward system that cocaine has damaged. By reinforcing positive rewards to rebuild dopamine levels, it’s possible to essentially rewire the brains to associate the reward with positive attributes and not drug use. The therapy has shown to be beneficial not only for initially weaning off cocaine use but also to encourage continued treatment and therapy past initial detoxification.
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