Substance guides

Signs of cocaine use: What to look for in someone you love

Published February 15, 2026 · 7 min read · Updated April 2026

Reviewed for accuracy by licensed clinical professionals. Editorial process.

Cocaine use produces distinctive physical and behavioral changes that, when understood, can help you identify a problem in someone you care about. No single sign is conclusive, but clusters of these indicators together — especially with sudden onset — are cause for concern.

Physical signs

Dilated pupils (even in well-lit environments). Runny nose, frequent sniffling, or nosebleeds (from snorting). Powder residue around the nostrils. Rapid speech and heightened energy followed by crashes. Decreased appetite and unexplained weight loss. Increased heart rate and elevated blood pressure. Sweating, even in cool environments. Jaw clenching, teeth grinding (bruxism). Tremors or involuntary muscle movements. Burn marks on lips or fingers (from smoking crack).

Behavioral signs

Periods of intense energy, talkativeness, and confidence alternating with depression and lethargy (the crash). Staying up for unusually long periods followed by extended sleep. Increased impulsivity and risk-taking. Financial problems (cocaine is expensive — a daily habit can cost $100-$300+). Secretiveness about whereabouts and activities. Social circle changes — new friends, avoiding old ones. Paranoia or suspiciousness. Grandiosity and inflated self-importance during use. Loss of interest in activities, responsibilities, and relationships.

Environmental signs

Small bags with white powder residue. Rolled-up bills or cut straws. Small mirrors or flat surfaces with scratch marks. Razor blades. Small spoons. Glass pipes (for crack). Credit cards with powder residue on edges. Unexplained financial withdrawals.

When short-term use becomes a pattern

Cocaine does not produce the same physical dependence as opioids or alcohol, but psychological addiction develops rapidly. The cycle of euphoria and crash creates a powerful drive to use again. If you are noticing these signs repeatedly — not just once after a party — the pattern has likely progressed beyond experimentation. Read our guide to cocaine and alcohol for the specific dangers of combined use.

Find a location near you

Shelby County Treatment Center

Alabaster, AL

Call 205-216-0200

Lighthouse of Tallapoosa County Inc

Alexander City, AL

Call 256-234-4894

South Central Alabama MHC

Andalusia, AL

Call 334-428-5050

Anniston Fellowship House Inc

Anniston, AL

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Authoritative sources

This article references guidelines from: NIDA · SAMHSA · CDC · FDA · ASAM

Frequently asked questions

How can you tell if someone is using cocaine?

Look for clusters of signs: dilated pupils, rapid speech, decreased appetite, frequent sniffling/nosebleeds, financial problems, secretiveness, and alternating periods of high energy and crashes.

What does someone look like on cocaine?

During use: dilated pupils, increased energy and talkativeness, confidence, sweating, jaw clenching. During the crash: fatigue, depression, irritability, increased appetite, excessive sleep.

Is cocaine use a one-time thing or a pattern?

While some people use cocaine occasionally without developing addiction, the drug creates strong psychological dependence. Regular use — even 'weekend only' — frequently escalates over time.

Disclaimer: Informational only. Not medical advice. SAMHSA: 1-800-662-4357.