What is Cocaine Psychosis?

Last Updated: November 1, 2023

As many may know, cocaine is a very dangerous drug with a high potential for abuse. Along with dependency and overdose, cocaine psychosis can also occur to a person who uses the drug. What is cocaine psychosis? Cocaine psychosis refers to a variety of symptoms that an individual may experience while in a cocaine-induced psychotic state, including paranoia, hallucinations and delusions. There are many signs and symptoms of cocaine-induced psychosis and several important risk factors that influence cocaine-induced psychosis.


Symptoms of Cocaine-Induced Psychosis

What are the main symptoms of psychosis? Cocaine-induced psychotic symptoms may consist of paranoia, hallucinations, and/or delusions.


Is paranoia a symptom of psychosis? Actually, paranoia and suspiciousness are the first signs of entering a psychotic state. Cocaine users who experience paranoia while intoxicated have a higher risk for the development of psychosis than cocaine users who do not experience paranoia.


A hallucination is a sensory experience in which a person can see, hear, smell, taste, or feel something that is not there. For example, someone on cocaine might hallucinate that they can see people that are not there. These hallucinations are a symptom that results from an imbalance of dopamine in the brain. So, can cocaine cause hallucinations? In short, yes! It all comes down to how cocaine influences dopamine systems within the brain.


Delusions are a symptom closely linked to hallucinations but are a little different. A delusion is a false belief that persists in spite of evidence to the contrary. Delusions are usually linked to identity, possessions, feelings of grandiosity, or the feeling that people are imposters. Delusions can also result from dopamine imbalance, and thus are at risk of occurring if a person uses cocaine.

Risk Factors of Cocaine-Induced Psychosis

Cocaine can influence psychological processes and induce psychosis because of how it affects a chemical in the brain called dopamine. Dopamine is an important neurotransmitter that plays a large and complex role in motivated behaviors, reward, and movement. It is also the brain’s chemical transmitter that is most commonly associated with drug use and addiction. But what are some of the other risk factors for cocaine-induced psychosis?

  • Frequency of use: Frequency of use is one of the biggest risk factors for cocaine-induced psychosis. The more that a person uses cocaine, the more they are putting themselves at risk for entering a psychotic state. A higher frequency of cocaine use alters the brain’s dopamine system more dramatically, which can lead to cocaine-induced psychosis.
  • Dosage: Dosage can also play a modulatory role in cocaine-induced psychosis. The more cocaine that a person uses, the more they are putting themselves at risk for cocaine-induced psychosis.
  • Body mass index: Research has also linked body mass index to cocaine-induced psychosis. People addicted to cocaine who were prone to cocaine-induced psychosis had a lower body mass index than cocaine addicts who were resistant to psychosis.
  • Age: Age can also be a risk factor for cocaine-induced psychosis. Adolescents and teenagers are at increased risk for cocaine addiction because they are more likely to engage in risky behaviors or try to self medicate through the use of cocaine.
  • Co-occurring disorders: The presence of a mental health diagnosis alongside substance abuse, also known as co-occurring disorders, is a serious risk factor for cocaine-induced psychosis. Many disorders, such as major depressive disorder and antisocial personality disorder, can co-occur alongside cocaine use. In particular, attention-deficit and hyperactivity disorder (ADHD) has been linked to cocaine-induced psychosis. Interestingly, dopamine is also a key player in ADHD, further implicating the actions of cocaine on dopamine systems in cocaine-induced psychosis. Finally, the personality trait of neuroticism has also been linked to both cocaine-induced psychosis and several mental health disorders.

Treating Cocaine-Related Psychosis

What is the treatment for psychosis, particularly cocaine-related psychosis? Treatments can range from behavioral-based therapies to medication-assisted therapies. However, each person will need an individualized treatment strategy to best meet their specific needs.

Medication-Assisted Therapies

Medications such as antipsychotics, antidepressants, or anti-anxiety drugs are sometimes used to reduce psychotic symptoms present in cocaine users.

The type of therapy an individual will benefit most from will differ from person to person, as each person is unique in terms of their specific mental health and substance abuse diagnosis. If you or someone you love is suffering from cocaine-induced psychosis, you are not alone and help is available. Contact us today at Orlando Recovery Center to learn more about our personalized and confidential services.


Roncero, Carlos; et al. “Risk factors for cocaine-induced psychos[…]e-dependent patients.” European Psychiatry, 2013. Accessed October 9, 2019.

Roncero, Carlos; et al. “Prevalence and risk factors of psychotic[…]e dependent patients.” Actas espanolas de psiquiatria, 2012. Accessed October 9, 2019.

Roncero, Carlos; et al. “Neuroticism associated with cocaine-indu[…] observational study.” PloS one, 2014. Accessed October 9, 2019.

Hansell, N. K.; et al. “Genetic co-morbidity between neuroticism[…]nd young adult twins.” Psychological medicine, 2012. Accessed October 9, 2019.

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