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Watching ‘Cocaine Bear’? Here are the 5 effects of cocaine toxicity in humans

Before you watch the film inspired on true events learn how cocaine toxicity really presents in humans


Cocaine toxicity refers to the harmful effects that can occur when someone uses too much cocaine. It can lead to a range of symptoms, some of which can be life-threatening.

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In 1985, a drug runner’s plane crashed, and a black bear went on a rampage after ingesting missing cocaine. With the release of “Cocaine Bear,” the film inspired by these events, let’s review the symptoms of cocaine toxicity and what EMS needs to know to treat patients with these symptoms.

Cocaine is a highly addictive stimulant drug that is extracted from the coca plant. It is often used illicitly for its euphoric effects, which include heightened alertness, increased energy and feelings of pleasure. Unfortunately, cocaine use can also have serious negative consequences, including cocaine toxicity.

Cocaine toxicity refers to the harmful effects that can occur when someone uses too much cocaine. It can lead to a range of symptoms, some of which can be life-threatening.

Learn how cocaine toxicity presents in patients and what providers need to know about cocaine toxicity.

Symptoms of Cocaine Toxicity

The symptoms of cocaine toxicity can vary depending on the amount of cocaine consumed, the purity of the drug, and the individual’s tolerance level. Some of the most common symptoms of cocaine toxicity include:

1. Cardiovascular effects. Cocaine use can cause an increased heart rate, which can lead to heart palpitations, chest pain and even heart attacks. It can also cause blood pressure to rise, which can lead to stroke.

2. Respiratory effects. Cocaine use can cause shortness of breath, wheezing and respiratory failure.

3. Gastrointestinal effects. Cocaine use can cause abdominal pain, nausea and vomiting.

4. Neurological effects. Cocaine use can cause seizures, headaches and dizziness. It can also cause a loss of consciousness.

5. Psychological effects. Cocaine use can cause anxiety, paranoia and agitation. It can also cause hallucinations and delusions.

3 stages of cocaine toxicity

According to the National Institute of Health, there are three stages of cocaine toxicity that individuals can present with.

Stage 1

  • Central nervous system. Headache, nausea, mydriasis, vertigo, twitching, pseudohallucinations and pre-convulsive movements

  • Vascular. Increased BP, ectopic beats

  • Pulmonary. Tachypnea

  • Skin. Hyperthermia

  • Psychiatric. Paranoia, euphoria, confusion, aggression, agitation, emotional lability, restlessness

Stage 2

  • Central nervous system. Encephalopathy, seizures, increased deep tendon reflexes, incontinence

  • Cardiac. Hypertension, arrhythmias, peripheral cyanosis

  • Pulmonary. Tachypnea, gasping, apnea, irregular breathing

  • Skin. Hyperthermia

Stage 3

  • Central nervous system. Areflexia, coma, fixed and dilated pupils, loss of vital functions

  • Cardiac. Hypotension, ventricular fibrillation, cardiac arrest

  • Pulmonary. Apnea, respiratory failure, cyanosis, agonal breathing

Complications of cocaine toxicity

The complications of cocaine toxicity can range from mild to severe. In some cases, it can be life-threatening. Some of the potential outcomes of cocaine toxicity include:

  • Cardiac arrest. Cocaine use can cause the heart to stop beating, which can be fatal
  • Seizures. Cocaine use can cause seizures, which can also be life-threatening
  • Respiratory failure. Cocaine use can cause the lungs to fail, which can be fatal
  • Stroke. Cocaine use can cause a stroke, which can lead to permanent brain damage or death
  • Organ damage. Cocaine use can cause damage to the liver, kidneys, and other organs

It is important to note that the risk of these outcomes increases with the amount of cocaine consumed and the frequency of use. Using cocaine in combination with other drugs or alcohol can also increase the risk of negative outcomes.

EMS treatment of cocaine toxicity

The treatment for cocaine toxicity depends on the severity of the symptoms and the individual’s overall health. In some cases, the person may need to be hospitalized for monitoring and treatment.

Supportive care. Supportive care includes monitoring the person’s vital signs, administering oxygen and fluids, and providing medications to control symptoms such as seizures

Medications. In some cases, medications such as benzodiazepines or antipsychotics may be used to control symptoms such as anxiety, agitation or hallucinations


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Have you watched “Cocaine Bear”? Tell us what they got right and wrong about EMS in the comments. If you’re on the fence about watching, here’s the trailer.

Rachel Engel is an award-winning journalist and the senior editor of and In addition to her regular editing duties, Engel seeks to tell the heroic, human stories of first responders and the importance of their work. She earned her bachelor’s degree in communications from Cameron University in Lawton, Oklahoma, and began her career as a freelance writer, focusing on government and military issues. Engel joined Lexipol in 2015 and has since reported on issues related to public safety. Engel lives in Wichita, Kansas. She can be reached via email.