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Medical Author:

Roxanne Dryden-Edwards, MD

Roxanne Dryden-Edwards, MD

Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Often, the final diagnosis of someone who is abusing cocaine is not made by emergency department evaluation and may require admission to the hospital, further testing, and results of tests, which take time or are not done in a hospital emergency department.

Overall, the doctor will conduct whatever tests are necessary to evaluate the symptoms of someone with cocaine-induced conditions. In addition to a physical exam and medical history, tests may include blood and urine analysis, chest X-ray, CT scans, MRI scans, and spinal tap.

• Cocaine-induced headache diagnoses can include such conditions as tension headache, stroke (bleed in head), sinusitis, meningitis, or brain abscess.
• Cocaine-induced seizures might indicate more serious problems such as bleeding in the brain, meningitis, very high blood pressure with organ injury, or low blood pressure, respiratory failure, and heart problems. Infants may experience seizures caused by parents' smoking cocaine in their presence. It is important to note that this is a form of child abuse and should immediately be reported to local child welfare services.
• Psychiatric problems caused by cocaine abuse may include cocainomania, anxiety, hallucinations, paranoia, psychoses, violence, major depression, suicidal or homicidal tendencies, or attempted suicide or homicide.
• Nasal and throat complications of cocaine abuse can include diagnoses of nasal itching, post-nasal drip, nosebleed, sinusitis, laryngitis, and perforated nasal septum.
• Pulmonary diagnoses may include pneumonia, bronchitis, COPD (chronic obstructive pulmonary disease or emphysema), asthma or reactive airway disease, or a collapsed lung.
• Cardiovascular diagnoses include heart problems such as chest pain, heart attack, abnormal heart rhythms, and various heart conditions that can lead to sudden death.
• Pregnancy diagnoses may include vaginal bleeding, threatened abortion, incomplete abortion, or spontaneous abortion, or miscarriage. Ultrasound may be used to establish the diagnosis in these cases.
• Infectious diagnoses may include cellulitis, shooter's abscess, lung abscess, brain abscess, septic shock, hepatitis, and any of the opportunistic infections associated with AIDS if you are HIV infected.
• Body packers and stuffers may have various diagnoses depending on whether the packets leak or remain intact. If they leak, the diagnoses may be massive cocaine intoxication with seizures, high temperatures, hypertension, muscle breakdown, kidney failure, and death. If the abuser has no symptoms with normal vital signs and refuses medical care, invasive procedures may not be done until proper legal documentation has been provided.

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