Using cocaine can lead to a number of short-term and long-term health effects, some of which can be life-threatening.

Short-Term Health Effects of Cocaine Use

Cocaine is a powerful stimulant drug and its recreational use can cause serious short-term health effects including elevated body temperature, high blood pressure, anxiety, and psychosis. While most cocaine users describe an intense euphoric feeling immediately after using the drug, there are some negative symptoms that can develop as well.

The effects of cocaine appear almost immediately and last for less than an hour, depending on the method of use. Some people feel more mentally alert and physically energetic after cocaine use, with a reduced need for food and sleep. However, many cocaine users become over-talkative and overly sensitive to external stimuli such as touch, sound, and sight. [1]

The stimulating effects of the drug can lead to physical symptoms such as loss of appetite, insomnia, increased body temperature, elevated blood pressure and heart rate, constricted (narrowed) blood vessels with reduced blood supply to vital organs, dilated (widened) pupils of the eyes. tremor, vertigo, and muscle twitching. Additional psychological symptoms in people using large amounts of cocaine may include irritability, restlessness, panic attacks, anxiety, and paranoia.

Serious health complications can occur after a single dose of cocaine. These may include cardiovascular problems such as heart rhythm abnormalities and heart attack; neurological effects such as headache, convulsions, stroke, loss of consciousness, and coma; gastrointestinal symptoms such as abdominal pain and nausea; and even sudden death. In addition, cocaine use can worsen existing medical problems, including kidney disease, heart disease, and lung disease. [2]

Using cocaine is also associated with a risk of overdose which can be fatal. Most deaths that are attributed to cocaine use occur due to seizures or heart attack. Keep in mind that cocaine is commonly cut with other drugs, such as opioids, to increase the intensity of the high or increase drug dealer profits. Using adulterated cocaine further heightens the risk of an overdose.

Using cocaine with other substances is even more dangerous. When cocaine is combined with alcohol, the two substances form a chemical called cocaethylene in the body, which can accelerate the toxic effects of both alcohol and cocaine on the heart. [3]

Using cocaine in combination with opioids, including the illegal opioid drug heroin, is especially dangerous. The stimulating effects of cocaine are offset by the sedating effects of the opioid drug. This seemingly reduces the effects of both substances, causing the user to take larger quantities of the drugs, which can lead to a fatal overdose. [4]

Long-Term Health Effects of Cocaine Use

In addition to the short-term health consequences mentioned above, cocaine use can have many long-term effects on the brain and body. Studies in animals have shown that long-term exposure to cocaine causes significant changes in neurons (brain cells) that release the an excitatory neurotransmitter (natural chemical) called glutamate. [5]

Animal studies have shown that consistent exposure to cocaine changes how much glutamate is released in the brain’s reward pathways. Over time, the brain becomes less sensitive to natural reward reinforcers (natural things that bring pleasure). These changes in the reward pathways in the brain ultimately drive drug-seeking behavior in cocaine-addicted individuals. [6]

The double danger with cocaine use is that on the one hand it makes the brain less sensitive to natural pleasure reinforcers and on the other hand it causes the brain’s circuits to become increasingly sensitive to stress. As a result, when cocaine is absent from the body’s system, a person accustomed to using cocaine becomes increasingly unhappy and experiences extreme mood swings.

Another danger is that a drug user builds tolerance to cocaine over time. This means that with the passage of time, with regular and prolonged use, a cocaine user will need larger quantities of the drug to achieve the same effects as they initially experienced. [7] As the body builds tolerance to the drug, the brain also becomes increasingly sensitive to its potential toxic effects, increasing the risk of health effects such as seizures, depression, anxiety, and mood swings. [8]

Psychological adverse effects of long-term cocaine use can include irritability, restlessness, anxiety, panic attacks, paranoia, and potentially even psychosis. The more cocaine a person uses and the longer they use it, the more damaging the effects. [9]

Continued cocaine use has serious negative health effects on not only the brain but also other major organs in the body. The drug can affect vital organs such as the heart and lungs. It can also cause problems in the gastrointestinal tract, including ulcers and perforations. Many long-term users of cocaine experience a loss of appetite, which can lead to malnourishment and significant weight loss. [10]

The effects of long-term cocaine use on the heart are well documented with an increased risk of heart attack and heart rhythm abnormalities. Even occasional cocaine have been found to have elevated blood pressure, thicker heart muscle walls, ECG abnormalities, harder arteries, and heart attack. [11]

Last updated: March 11, 2024

Hailey Shafir, M.Ed., LCMHCS, LCAS, CCS

Hailey Shafir is a licensed addiction specialist and mental health counselor. She graduated from North Carolina State University with a master of education in clinical mental health counseling in 2012, and has developed deep expertise in the areas of mental health, behavioral addictions and substance abuse. She is passionate about using this knowledge to raise awareness, provide clear and accurate information, and to improve the quality of treatment for these disorders.

Hailey is an LCMHCS (license number: S9539) under the North Carolina Board of Mental Health Counselors, and an LCAS (ID: LCAS-21333) and CSS (ID: CCS-20721) under the North Carolina Addictions Specialist Professional Practice Board.

References

References
1 National Institute on Drug Abuse. What are the short-term effects of cocaine use? Available online. Accessed on March 11, 2024.
2 Dis–Mon DM. 2009;55(1):6-38. doi:10.1016/j.disamonth.2008.10.002. Goldstein RA, DesLauriers C, Burda AM. Cocaine: history, social implications, and toxicity–a review Available online. Accessed on March 11, 2024.
3 Addict Abingdon Engl. 2002;97(7):773-783. Pennings EJM, Leccese AP, Wolff FA de. Effects of concurrent use of alcohol and cocaine. Available online. Accessed on March 11, 2024.
4 Am J Public Health. 2017;107(3):430-432. doi:10.2105/ AJPH.2016.303627 McCall Jones C, Baldwin GT, Compton WM. Recent Increases in Cocaine-Related Overdose Deaths and the Role of Opioids. Available online. Accessed on March 11, 2024.
5 National Institute on Drug Abuse. What are some ways that cocaine changes the brain? Available online. Accessed on March 11, 2024.
6 Trends Neurosci. 2010;33(9):391-398. doi:10.1016/j.tins.2010.06.003. Wolf ME. The Bermuda Triangle of cocaine-induced neuroadaptations. Available online. Accessed on March 11, 2024.
7 Curr Med Chem. 2012;19(33):5597-5600 Büttner A. Neuropathological alterations in cocaine abuse. Available online. Accessed on March 11, 2024.
8 Curr Med Chem. 2012;19(33):5624-5646. Riezzo I, Fiore C, De Carlo D, et al. Side effects of cocaine abuse: multiorgan toxicity and pathological consequences. Available online. Accessed on March 11, 2024.
9 Dis–Mon DM. 2009;55(1):6-38. doi:10.1016/ j.disamonth. 2008.10.002. Goldstein RA, DesLauriers C, Burda AM. Cocaine: history, social implications, and toxicity–a review. Available online. Accessed on March 11, 2024.
10 Curr Med Chem. 2012;19(33):5624-5646. Riezzo I, Fiore C, De Carlo D, et al. Side effects of cocaine abuse: multiorgan toxicity and pathological consequences. Available online. Accessed on March 11, 2024.
11 Int J Mol Sci. 2019 Feb; 20(3): 584. Published online 2019 Jan 29. doi: 10.3390/ijms20030584 Tae Kim, S and Park, T. Acute and Chronic Effects of Cocaine on Cardiovascular Health. Available online. Accessed on March 11, 2024.