Cocaine Psychosis: What It Is & How Long It Lasts

When it comes to hallucinations, it’s all in the mind.

People who experience them may see, hear, smell, or feel things. Sometimes they’re caused by fevers or mental disorders such as schizophrenia, but hallucinations can also be brought on by drug use.

Does Cocaine Cause Hallucinations?

Cocaine is best known as a stimulant — an illegal one, at that — that gives its users energy and alertness.

People either snort it or rub it on their gums. They also may mix it with water and inject it. Cocaine that has been heated to turn into rock crystals — aka crack — is smoked.

Users mention the bliss of that initial rush right after using cocaine. They feel confident and focused. Some say it helps block out troubling feelings.

The problem with cocaine and other stimulants is that what goes up must come down. And coming down from cocaine is no walk in the park.

Current and former users on sites such as Quora discuss how amazing they feel after using cocaine. For a while. Once it wears off, they feel awful. There’s a good reason they call it crashing.

Users tend to experience powerful cravings once the drug exits their system, as well as numerous negative feelings and sensations:

  • Fatigue
  • Anxiety
  • Irritability
  • Sleepiness
  • Agitation
  • Suspicion
  • Paranoia

Many of the above are also the symptoms of cocaine withdrawal. A lot of people, as they quit the stimulant, say they experience vivid nightmares, and tend to feel fearful, uncomfortable, and depressed.

Typically if a person feels those psychological lows and feels more than a little under the weather after trying to quit, those are signs that they’re addicted. Such come down symptoms are huge reasons why people continue to use; to them, it’s better than going without.

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Cocaine-Induced Psychosis

Does cocaine make you hallucinate? Does cocaine make you paranoid?

It definitely can make a mess of one’s mind.

One potential result from cocaine abuse is transient (short-term) psychosis. Some medical professionals liken it to a “mini schizophrenia.”

Symptoms include suspicion, paranoia, hallucinations and other behaviors. Some studies have found as many as 86% of people with  cocaine use disorder experience psychosis.

Drug-induced psychosis can hinge on a number of factors, including:

  • Quantity of cocaine consumed
  • How long it’s been abused
  • If there is a dependence on the substance
  • How it’s taken (intranasal use seems more likely to bring on this state)
  • If there are co-occurring mental disorders (antisocial personality disorder seems to be a risk factor)
  • The weight and gender of the user
  • Genetics
  • Other drug interactions

It should be noted that not all users experience psychosis, either, but many do.

There does appear to be a link between those who rank as highly neurotic (subject to frequently changing emotions, anxiety, tense moods, depression, anger, guilt, and being withdrawn) and cocaine-addicted patients with psychotic symptoms.

In a comparison study, paranoid schizophrenics and cocaine abusers experienced bouts of delusions and hallucinations, including command hallucinations. As the name indicates, command hallucinations are voices that instruct people to do things.

The schizophrenic group in the study heard more violent commands, ordering them to attack or even kill others. The cocaine abusers experienced more visual hallucinations, including seeing shadows, flashing lights, objects moving, and bugs crawling on their arms.

Paranoid schizophrenics might report other delusions, such as not being able to tell what is real. Cocaine abusers appear to be less likely to experience those delusions.

Cocaine Use on the Rise

Does cocaine cause paranoia? Can cocaine cause hallucinations? For both questions, the answer is yes.

The problem is likely to grow. Cocaine-linked deaths are on the rise. More people are dying from overdoses, and cocaine is connected. Routine drug screenings performed from 2013 to 2019 found cocaine use was up by 21%.

Since cocaine use is on the rise, so is the risk of overdose. If users survive and opt to continue with the habit, they risk the long-term damage that cocaine and other stimulants can inflict on a person. It can lead to anything from the loss of smell to major paranoia.

Excess use also alters how the brain functions. Too much cocaine can overload the brain with dopamine and produce seizures and other neurological problems.


  • – Hallucinations
  • – Cocaine Withdrawal
  • – Mind Matters: The Body’s Response to Cocaine
  • – Is Acute and Transient Psychotic Disorder (ATPD) Mini Schizophrenia? The Evidence from Phenomenology and Epidemiology
  • – An International Perspective and Review of Cocaine-Induced Psychosis: A Call to Action
  • – Neuroticism Associated with Cocaine-Induced Psychosis in Cocaine-Dependent Patients: A Cross-Sectional Observational Study
  • – Neuroticism
  • – Delusions and Hallucinations of Cocaine Abusers and Paranoid Schizophrenics: A Comparative Study
  • – The Rise in Meth and Cocaine Overdoses, Explained
  • – Does Using Cocaine Kill Brain Cells?

Medical disclaimer:

Sunshine Behavioral Health strives to help people who are facing substance abuse, addiction, mental health disorders, or a combination of these conditions. It does this by providing compassionate care and evidence-based content that addresses health, treatment, and recovery.

Licensed medical professionals review material we publish on our site. The material is not a substitute for qualified medical diagnoses, treatment, or advice. It should not be used to replace the suggestions of your personal physician or other health care professionals.

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