You came to the emergency department because of harmful effects of cocaine
Your heart, blood pressure, and nervous system were affected
You have been treated and your condition has stabilized
Return to the emergency department immediately if you experience
Chest pain, pressure, or tightness
Palpitations or feeling your heart racing or skipping beats
Shortness of breath or difficulty breathing
Severe headache, especially if sudden and worst of your life
Weakness, numbness, or paralysis of face, arm, or leg
Difficulty speaking or understanding speech
Seizures or convulsions
Fever or feeling extremely hot
Dark or tea-colored urine
Severe abdominal pain
Feeling faint or loss of consciousness
Important information about cocaine and your health
Cocaine use causes serious and life-threatening heart and brain problems
Effects can be worsened and prolonged by alcohol consumed with cocaine
Fentanyl is commonly mixed into cocaine without your knowledge and is fatal
Each episode of cocaine use increases your risk of heart attack and stroke
Medications and follow-up
Take all medications prescribed exactly as directed
Follow up with your family doctor or specialist as scheduled
Contact your doctor if new or worsening symptoms develop before your appointment
Resources and support
Addiction medicine referral has been arranged or is recommended
Call the SAMHSA National Helpline: 1-800-662-4357 (free and confidential)
Narcan (naloxone) provided if opioid co-ingestion or contamination risk identified
Do not drive or operate machinery for 24 hours
References
Guidelines and key sources
American Heart Association guidelines
Lavonas EJ, et al. 2023 AHA Focused Update on Management of Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning. Circulation. 2023
Primary guideline for cocaine toxicity management including benzodiazepines, sodium bicarbonate, lipid emulsion
Cao D, et al. Part 10: Adult and Pediatric Special Circumstances of Resuscitation. 2025 AHA Guidelines for CPR and ECC. Circulation. 2025
Updated resuscitation protocols for toxicological cardiac arrest
Gulati M, et al. 2021 AHA/ACC Guideline for Evaluation and Diagnosis of Chest Pain. J Am Coll Cardiol. 2021
Evidence-based approach to cocaine-associated chest pain evaluation
Cardiovascular toxicity references
Havakuk O, Rezkalla SH, Kloner RA. The Cardiovascular Effects of Cocaine. JACC. 2017
Comprehensive review of cocaine cardiovascular mechanisms and management
Lucyk SN. Acute Cardiovascular Toxicity of Cocaine. Can J Cardiol. 2022
Canadian perspective on acute cocaine cardiovascular management
Lange RA, Hillis LD. Cardiovascular Complications of Cocaine Use. NEJM. 2001
Landmark review of cocaine cardiovascular pathophysiology
Pharmacology and toxicology
Roque Bravo R, et al. Cocaine: An Updated Overview on Chemistry, Detection, Biokinetics, and Pharmacotoxicological Aspects. Toxins. 2022
Pharmacokinetics, metabolism, and pharmacodynamics
Riezzo I, et al. Side Effects of Cocaine Abuse: Multiorgan Toxicity and Pathological Consequences. Curr Med Chem. 2012
Systemic toxicity mechanisms across organ systems
Zimmerman JL. Cocaine Intoxication. Crit Care Clin. 2012
Critical care management of severe cocaine toxicity
Body packing references
von Fabeck K, et al. Body Packers and Body Stuffers: Cocaine Intoxications Reported to French Poison Centers (2020-2024). Clin Toxicol. 2025
Traub SJ, Hoffman RS, Nelson LS. Body Packing: The Internal Concealment of Illicit Drugs. NEJM. 2003
Heymann-Maier L, et al. Emergency Department Management of Body Packers and Body Stuffers. Swiss Med Wkly. 2017
Addiction medicine guidelines
The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder. J Addict Med. 2024
Evidence-based recommendations for stimulant use disorder treatment
Batki SL, et al. Management of Stimulant Use Disorder. American Academy of Addiction Psychiatry. 2023
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.