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Cocaine Use Disorder in Children



  • Cocaine use disorder is a pattern of using cocaine that lead to serious personal, family, and health problems.
  • For any treatment to be successful, your child must want to stop using cocaine. If your child wants to quit, get help from your healthcare provider.
  • Self-help groups such as Cocaine Anonymous, support groups, and therapy may be helpful.


What is cocaine use disorder?

Cocaine is made from the leaves of the coca plant that grows in South America. It is a type of drug called a stimulant, which means it increases alertness and energy. Cocaine can be inhaled through the nose in powder form, which is called snorting, injected into a vein, or smoked. Crack, a less expensive form of cocaine that is smoked, has made cocaine use a widespread problem.

Cocaine use disorder is a pattern of using cocaine that leads to serious personal, family, and health problems. The more of these statements that apply to your child, the more severe the cocaine use disorder.

  1. Your child uses more or uses cocaine for longer than planned.
  2. Your child wants to cut down or quit but is not able to do so.
  3. Your child spends a lot of time and energy getting drugs, using drugs, and getting over the effects.
  4. Your child craves cocaine so much that your child has trouble thinking about anything else.
  5. Your child has problems at work, school, or at home.
  6. Your child has relationship problems because your child doesn’t keep promises or argues or gets violent with other people.
  7. Your child stops doing things that used to matter, such as sports, hobbies, or spending time with family members and friends, because of the cocaine use.
  8. Your child uses cocaine even when it is dangerous such as while driving or operating machinery.
  9. Your child keeps using cocaine even though your child knows that it is hurting his or her physical or mental health.
  10. Your child needs to use more of the drug or use it more often to get the same effects. This is called tolerance.
  11. Your child has withdrawal symptoms when your child stops using.

Cocaine use disorder may also be called drug or substance dependence or addiction.

What is the cause?

The cause of cocaine use disorder is not known. The brain makes chemicals that affect thoughts, emotions, and actions. Cocaine changes the balance of these chemicals in your child’s brain. When your child uses cocaine regularly, the brain starts to get used to it. As a result, your child doesn't feel good unless using cocaine. When your child stops using cocaine suddenly, the balance of chemicals in the brain changes, which causes the symptoms of withdrawal.

Your child has a higher risk of becoming dependent on drugs if your child:

  • Has a family history of drug or alcohol use disorder
  • Has used alcohol or drugs in the past
  • Is easily frustrated, has trouble dealing with stress, or feels like he or she isn’t good enough
  • Is regularly around people who use alcohol or drugs
  • Has a mental health problem
  • Has constant pain

What are the signs of cocaine use disorder?

The symptoms of cocaine use disorder depend on how much and how often your child uses cocaine. The symptoms can be mild to severe such as:

  • Being overexcited or nervous
  • Being irritable and having angry outbursts
  • Having a runny nose, bloody nose, hoarseness, and reduced sense of smell
  • Having belly pain, nausea or vomiting, or loss of appetite
  • Talking and thinking fast, which is called speeding
  • Having a fast heartbeat or sweating
  • Having large dilated pupils
  • Seeing, hearing, or feeling something that is not there
  • Thinking that others are out to get him or her when they are not

If your child snorts cocaine, your child may have:

  • Sores or broken skin in or around the nose
  • Nosebleeds
  • A constant runny nose
  • Reduced sense of smell

If your child smokes cocaine, your child may have symptoms of a lung infection such as a cough or mucus in his lungs.

Your child may also have symptoms of new or worse health problems caused by cocaine use. Health problems caused by cocaine include.

  • Eating and sleeping disorders
  • Chest pain and fast heartbeat
  • High body temperature and blood pressure
  • Heart attack and cardiac arrest (the heart suddenly stops beating)
  • Kidney failure
  • Seizures
  • Trouble breathing or stopping breathing
  • Stroke

The symptoms of cocaine withdrawal can be mild to severe. Your child may have some of these symptoms when your child stops taking cocaine:

  • Nervousness and restlessness
  • Irritability
  • Feeling tired or weak
  • Depression and thoughts of suicide
  • Increased appetite
  • Cravings for cocaine
  • Sleep problems and bad dreams

The feelings that your child gets from cocaine only last a short time. This causes your child to crave more cocaine to get the feelings back. Your child may binge, which means your child take large amounts of cocaine for several days. The binge is followed be a crash, where your child feels sad and depressed. Then your child starts all over again. This pattern of cocaine use can lead to an overdose. A cocaine overdose can be life threatening.

Pregnant people using cocaine are at high risk of having a miscarriage, premature delivery, or low birth weight baby. Babies born to mothers who use cocaine are addicted at birth. The babies have to go through the painful process of withdrawal.

How is it diagnosed?

Your child’s healthcare provider will ask how much and how often your child uses cocaine. Your child needs to be honest about any drug use. Your provider needs this information to give your child the right treatment. Your child’s provider will also ask about your child’s symptoms and medical history and give your child a physical exam. Your child may have blood or urine tests.

How is it treated?

Cocaine use disorder can be treated. For any treatment to be successful, your child must want to stop using cocaine. When your child stops using cocaine, your child’s healthcare provider may prescribe medicine to help get through withdrawal symptoms. Your child should not use alcohol and other drugs to reduce withdrawal symptoms.

If your child wants to quit, get help.

Self-help groups such as Cocaine Anonymous, support groups, and therapy may be helpful. Kinds of therapy may include:

  • Cognitive behavior therapy (CBT) is a good way to help your child identify and change views your child has of self, the world, and the future. CBT can make your child aware of unhealthy ways of thinking. It can also help your child learn new thought and behavior patterns even after your child stops going to therapy. It can help your child learn to manage stress and improve self-esteem.
  • Family therapy. Often people with substance use disorders don’t realize they have a problem or aren’t ready to accept treatment. This leaves loved ones frustrated and confused. Family therapy treats all members of the family rather than working with one person alone. It helps the whole family understand each other better and make changes.
  • Substance use disorder treatment programs. Your child’s healthcare providers and counselors will work with you to develop a treatment program. Your child may be able to go to therapy a few times a week (outpatient therapy). Or your child may need treatment in a hospital or rehab center. Your child may need to stay there for several weeks or may be able to go to a clinic or hospital each day.

Recovery is a long-term process. Many people with substance use disorders try to quit more than once before they finally succeed. Don't give up. Your child can quit and quit for good. Get help and try again. Follow-up treatment is important so that your child doesn’t go back to using drugs.

If your child has overdosed or is having severe withdrawal symptoms, your child will need to be treated in a hospital. Your child will also be treated for any health problems such as a heart attack or stroke, or other life-threatening problems.

How can I help prevent cocaine use and dependence?

You can help prevent cocaine use and dependence if you:

  • Talk to your child about the risks of smoking, using e-cigarettes, drinking alcohol, and using drugs. Teach in a way that fits your child's age and ability to understand.
    • If you are watching TV with your 6-year-old and cocaine is mentioned on a program, you can ask if your child knows what cocaine is. If your child has more questions, answer them. If not, let it go. Short, simple comments, that are repeated often, will get the message across.
    • For your 12-year-old, you might explain what cocaine and crack look like, the different names for cocaine, and how using cocaine will change his or her brain and body. Repeat the message. Talk to your child about drugs whenever you can.
  • Listen to your child's feelings and concerns, so that they feel comfortable talking with you.
  • Make your family position on drugs clear. Explain that in your family, you don't use drugs and the children are not allowed to drink alcohol. Set a good example. Your child is much more likely to use drugs if you use drugs, even if you tell them not to.
  • Talk about what makes a good friend. Peer pressure is a big part of why kids get involved with drugs and alcohol. Help your child understand that friends who pressure them to drink or use drugs aren't friends at all. Get to know your child’s friends. Role-play ways for your child to say no to drugs:
    • Say, “no, thanks” and walk away.
    • Suggest something else to do such as playing a video game.
    • Use humor such as "No thanks. If I want to fry my brain, I'll get a skillet."
  • Build self-esteem. Children who feel good about themselves are much less likely to turn to drugs. Offer lots of praise for a job well done. If you need to criticize or discipline your child, talk about the action, not the child. For example, instead of telling your child that he or she should know better, try explaining that the action may not be safe. Set aside time every day to talk, play a game, or take a walk with each of your children.
  • Get your child and your whole family involved with healthy activities such as sports, music, arts, or clubs through school or your community.

People and resources in your community that can help include your healthcare providers, therapists, support groups, mental health centers, and alcohol or substance use disorder treatment programs.

For more information, contact:

Developed by Change Healthcare.
Pediatric Advisor 2022.1 published by Change Healthcare.
Last modified: 2021-06-25
Last reviewed: 2018-04-02
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2022 Change Healthcare LLC and/or one of its subsidiaries
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