How Long Does Cocaine Stay In Your System?

Cocaine is a substance with very high abuse potential. It is a recreational drug but is still considered a schedule II controlled substance. This means it needs a physician order to be taken legally. It can at times be prescribed in weaning doses during rehabilitation but other than that it has no medical use.  It contains stimulant, narcotic and depressant substances. (4)

How long does Cocaine stay in your system?

The parent drug is difficult to track in drug screens. It can only be noted within hours of ingestion. For this reason, the metabolites are what is tested for and can be noted for a few days. (4)

How long does Cocaine stay in your blood?

Cocaine metabolites are not present until they are in the urine. Cocaine levels in the blood can only be detected for a few hours because its half-life is 30-40 minutes. Urine tests are much more useful than blood testing.

How long does Cocaine stay in your urine?

For recreational users, cocaine metabolite benzoylecgonine will show up in a urine drug test for two to three days. If cocaine use is more chronic or very heavy benzoylecgonine can be found for almost 22 days after stopping. (5)

How long does Cocaine stay in your saliva?

The parent drug as well as the metabolite benzoylecgonine shows a spike and then a rapid decline after use. The parent drug can be detected for about five hours after use in the saliva. The metabolite can be detected for about 7 hours after use. (2)

How long does Cocaine stay in your hair?

Can be noted during a 90 day period but does not appear in the hair for 4-5 days after use. (11)

How is Cocaine metabolized?

  • Cocaine is broken down in the liver into ecgonine methyl ester and benzoylecgonine.
  • Metabolites are excreted in the urine through 2-3 days. (5)

Effects of Cocaine

Can cause issues in the following body systems:


  • Chest pain
  • Hypertension
  • Myocardial ischemia or infarction (Stroke)
  • Nose bleeds
  • Dysrhythmias
  • Tachycardia’s
  • Ventricular fibrillation
  • High-output heart failure.


  • New onset of seizures
  • Intracranial hemorrhage


  • Dyspnea
  • A cough with black sputum
  • New-onset asthma
  • Hemoptysis (bleeding)
  • Hypersensitivity pneumonitis (Crack lung)- specifically after smoking.
  • Foreign body aspiration
  • Airway burns
  • Respiratory arrest
  • Pneumothorax
  • Pneumomediastinum
  • Pulmonary edema
  • Wheezing due to constriction of the airway.
  • Nasal septum perforation

Psychiatric illness

Emotional effects can be agitation, distractibility, paranoia, depression, and distorted perception.  These things can increase chances of injury, violence, or suicide.

It represents itself by showing high pulse rate and blood pressure with cool or clammy skin.
Due to the cardiac issues such as vascular spasms users could have secondary complications such as:

  • Blindness
  • The death of tissue in the limbs (arms and legs)
  • Tissue death in the intestines
  • blindness
  • Real infarction.

Gastric issues:

  • Hyperactive bowel causing vomiting and diarrhea
  • Mesenteric ischemia

Phases of the cocaine toxicity– The high is noted in three phases. During these phases, a user may feel the following effects.  This list does not cover all symptoms a user might feel.

  • Phase I – includes a headache, bruxism, nausea with vomiting, dizziness, increased rate of breathing, tics, pseudo-hallucinations, euphoria, garrulous talk, apprehensions, and restlessness.
  • Phase II – generalized seizures, decreased responsiveness to all stimuli, increased deep tendon reflexes, high blood pressure and pulse rate, fast breathing, and possible hyperthermia.
  • Phase III -Coma, fixed and dilated pupils, paralysis, cardiorespiratory failure, pulmonary edema, agonal respirations (3,5,6)

Considerations for  Cocaine withdrawal

  • A user who quiets cocaine may feel the following symptoms within hours of their last dosage:
  • Vivid unpleasant dreams
  • Fatigue
  • Increased appetite
  • Psychomotor retardation
  • Agitation (5)

If you know someone who is stopping cocaine use you can consider some of the following precautions.

  • Decrease stimulation such as loud noises and frequent touching because the user will have an increased sensory sensitivity.
  • Avoid direct eye contact and approaching the user from behind because they will have an increased sense of paranoia.
  • Keep the ABC´s in mind. (Airway, Breathing, Cardiac)
  • Hydrate with a lot of fluids to prevent dehydration and to help flush the system.
  • If the user has insomnia they can seek medical assistance and receive medication.
  • If the user is at risk of harming themselves or someone else you may need to initiate restraint.
  • Reassure the user that these feelings will pass. (4)

Cocaine Addiction

  1. Nonpharmacological treatment for abuse is available when sought out. (4)
  2. Abuse of Cocaine as an official diagnosis is classified as the following:
  • Stimulant users disorder
  • Stimulant intoxication
  • Stimulant withdrawal

The diagnosis is made when looking at some of the following symptoms:

  • Cravings for more of the drug
  • Inability to control use of the drug
  • Use of drug even when it begins to interfere with activities of daily living.
  • The increase of the amount of drug used and frequency.
  • Spending most of their time or resources in order to consume.
  • Tolerance development.  (5)

Cocaine Drug Test

All testing should follow these three protocols:

  • Collection procedures with strict protocols
  • Testing procedures correctly followed
  • Randomly drawn labs

Urinal Drug Test

  • An important aspect of urine testing is regulation of temperature.
  • Collections usually are witnessed
  • Digital temperature checks are done directly after collection. (1,3)

Blood Test for Cocaine

  • As stated above this test is only useful shortly after use of cocaine. When admitted to the hospital other blood tests will be done to verify cardiac harm.
  • Must be done in a laboratory setting.

Cocaine Hair Test

  • This method is used often because it is harder to tamper with hair follicle testing than with urine testing.
  • Standard screening covers almost 90 days.
  • It takes at least 4-5 days for cocaine use to be present in the hair. (11)



Published on by under Addiction and Withdrawals.
Article was last reviewed on August 16th, 2016.

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