How does cocaine overdose most commonly lead to death?

Cocaine overdose most commonly leads to death through respiratory depression, which occurs as a result of the drug's effects on the central nervous system. Cocaine is a powerful stimulant that can cause increased heart rate, hypertension, and vasoconstriction. In cases of overdose, these effects can lead to severe cardiovascular complications, including arrhythmias and myocardial infarction.

However, respiratory depression is particularly critical because it can compromise the body’s ability to oxygenate blood, leading to hypoxia and potentially fatal outcomes. The overstimulation caused by cocaine can also lead to a decreased level of consciousness, impairing the individual's protective reflexes and further contributing to respiratory failure.

While fatigue, fever, and severe anxiety may occur with cocaine use or overdose, they are not the direct causes of death in the way respiratory depression is. Understanding the mechanisms of cocaine toxicity is essential for recognizing the serious risks associated with its use and overdose.