Cocaine and Anxiety: The Connection

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People who struggle with addictions frequently also have co-occurring mental health concerns. In some cases, the mental illness precedes the addiction, while in other cases, the compulsive substance use leads to the onset of the mental health disorder. In today’s post, we explore the potential links between anxiety and cocaine addiction.

Does Cocaine Use Cause Anxiety?

When a person uses cocaine, the stimulating effect that this drug has on their central nervous system can lead to anxiety-like symptoms such as elevated heart rate, excessive perspiration, irritability, and loss of appetite. Are these merely temporary feelings that will subside once the effects of the drug wear off, or can cocaine actually cause a person to develop anxiety?

Several research efforts into the relationship between anxiety and cocaine have found that using this drug can, indeed, put a person at risk for various forms of anxiety. Examples of these findings include the following:

  • A 2017 book titled The Neuroscience of Cocaine reported that “chronic cocaine [use] is known to result in a high prevalence of anxiety disorders.”
  • An August 1999 article in The Primary Care Companion to the Journal of Clinical Psychiatry noted that both cocaine abuse and cocaine withdrawal can cause anxiety.
  • A March 1989 report in the American Journal of Epidemiology cited a strong connection between cocaine abuse and panic attacks. Panic disorder is one of several anxiety disorders in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 

How Do You Know if You’re Experiencing Anxiety After Using Cocaine?

If you develop the following types of symptoms after using cocaine, you may be experiencing drug-induced anxiety:

  • Sense of impending doom
  • Heart palpitations
  • Difficulty focusing and concentrating
  • Irritability and restlessness
  • Dizziness or lightheadedness
  • Tremors or shakiness
  • Heavy sweating
  • Difficulty catching your breath


The association between anxiety and cocaine can also include panic attacks. If you have a cocaine-induced panic attack, you may experience the following:

  • Chest pain
  • Sense of being smothered or choked
  • Depersonalization (feeling of being detached from your thoughts and emotions)
  • Derealization (sense that you are removed from your environment, as if your surroundings were suddenly drained of all color or otherwise distorted
  • Fear of imminent death 

What to Do if You Have Anxiety After Using Cocaine

If you have been experiencing anxiety after using cocaine, you should take two immediate steps:

  • Stop using cocaine
  • Consult with a qualified mental health professional


Of course, if you have become addicted to cocaine, ending your use of this substance may not be a simple matter – but it is essential. 

The simultaneous presence of both a substance use disorder (addiction) and a mental health concern such as anxiety is known as dual diagnosis. When you have a dual diagnosis, it’s important to comprehensive care that addresses the full scope of your needs. Trying to treat either cocaine addiction or anxiety without addressing the other concern is unlikely to result in a sustainable positive outcome.

Please understand that admitting that you need help with anxiety and cocaine abuse isn’t a sign of failure. Instead, it is evidence that you want to live a healthier life, and you’re willing to take whatever steps are necessary to achieve that goal. Demonstrating this level of strength and hope can put you on the path toward a much more satisfying future.

Is There Treatment for Both Cocaine Abuse and Anxiety?

The combined impact of compulsive cocaine abuse and untreated anxiety can be catastrophic. Thankfully, both of these conditions are treatable.

Anxiety disorders are typically treated with a combination of medication and therapy. 

Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are common first-line medication choices for people who have been struggling with anxiety. 

  • The category of SSRIs includes Paxil (paroxetine), Zoloft (sertraline), Prozac (fluoxetine), and escitalopram (Lexapro).
  • Frequently prescribed SNRIs include Effexor (venlafaxine), Cymbalta (duloxetine), and Pristiq (desvenlafaxine). 


The therapeutic component of treatment for anxiety can help people learn to manage symptoms that aren’t alleviated by medication alone. 

  • Cognitive behavioral therapy (CBT) can be extremely beneficial for people who have anxiety. This form of therapy is based on the belief that negative automatic thoughts about yourself, the world, and your future are root causes of psychological distress.
  • Dialectical behavior therapy (DBT) can also be a valuable component of anxiety treatment. DBT helps people develop skills in areas such as mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness.


CBT and DBT are also often incorporated into treatment for people who have become addicted to cocaine. 

If a person isn’t able to get through withdrawal on their own, they may need to begin cocaine addiction treatment in a detoxification, or detox, program. This is a short-term program where they can receive therapeutic and medical support to keep them safe and ease their discomfort as they rid their body of cocaine.  

After completing detox, a patient can transfer directly into one of the following programs:


These programs may include several types of therapy along with educational sessions. These services can help patients develop the skills they will need to resist relapse and build a healthier future, free from the chains of compulsive cocaine abuse.

Remember: There is no single path that’s right for everyone who has been living with an addiction to cocaine and anxiety. What’s most important is finding a provider whose services and approach to treatment align with your needs, goals, and preferences.

Contact Our Dual Diagnosis Treatment Center in Southern California 

When you’re trapped in the darkness of active cocaine addiction and untreated anxiety, it can feel like there’s no escape. Please know that this is far from the truth. When you get the right type and level of care, you can learn to manage your symptoms, regain control of your behaviors, and live a much healthier and more satisfying life.

Renewal Health Group is a trusted source of quality care for adults whose lives have been disrupted by addictions and co-occurring mental health concerns. Our dual diagnosis treatment center in Southern California is a safe and welcoming environment. Here, you can receive focused care from a team of highly skilled professionals. We’ll help you build new skills, gain valuable knowledge, and make essential lifestyle changes, so that you can achieve the promising future you deserve.

To learn more or to schedule a free assessment, please visit our Contact page or call us today.   

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