Cocaine psychosis can be precipitated by which usage pattern?

• A. Regular caffeine use
• B. Sleep deprivation alone
• C. Cocaine binges and sprees
• D. Alcohol consumption

Answer: (C)

Cocaine psychosis is most likely triggered by intense, repeated, high-dose cocaine use over a short period—cocaine binges. During a binge, frequent dosing keeps dopamine flooding the brain because cocaine blocks dopamine reuptake, so there’s prolonged dopaminergic activity in circuits tied to perception, judgment, and reality testing. That sustained surge can lead to paranoid thoughts, delusions, and hallucinations. Sleep deprivation often accompanies a binge and can worsen symptoms, but the key driver of the psychosis is the binge pattern itself. Regular caffeine use produces only milder stimulant effects, sleep deprivation alone can cause temporary perceptual disturbances but doesn’t reliably precipitate cocaine-specific psychosis, and alcohol doesn't create the same cocaine-induced psychotic pattern (though mixing with cocaine adds other risks).