Cocaine has a number of short-term and long-term health effects, including elevated body temperature, high blood pressure, anxiety, and psychosis.

Short-Term Health Effects of Cocaine Usage

The disturbing part about cocaine usage is that it can have some serious short-term health effects. While much of what a user experiences immediately after taking the drug is a euphoric feeling, there are also negative things they may experience as well.

While they may feel more alert mentally and more energetic physically, they also might become more talkative as well as hypersensitive to touch, sound, and sight. [1]

People using cocaine may also experience irritability or paranoia. Cocaine’s stimulating effects also reduce appetite and can create insomnia.

Cocaine usage can also result in serious health complications, even if a person is using it for the first time or doesn’t use it often. These include increased body temperature, blood pressure, and heart rate, constricted blood vessels, and dilated pupils. Not surprisingly, these maladies could cause more serious health issues. These can be cardiovascular in nature, including heart attacks and a disturbance in one’s heart rhythm.

Other health complications can include strokes, seizures, and headaches. There can also be complications in the gastrointestinal tract, resulting in nausea, abdominal pain, and issues with ulcers. Muscle tics and twitches, vertigo, and body tremors can also arise, even from short-term cocaine usage. [2]

Taking too much cocaine can even lead to a fatal overdose. Most deaths that are attributed to cocaine usage come from a seizure or heart attack. Also, cocaine is commonly cut with other drugs like opioids to increase the high or increase the profits, which further heightens the risk of overdose.

Using cocaine with other substances can be highly dangerous. When combined with alcohol, the body produces cocaethylene. This chemical is believed to accelerate toxic effects that both alcohol and cocaine are known to have on the heart. [3]

Using cocaine in combination with opioids, alcohol, or any other drug with sedative properties is especially dangerous. The stimulating effects that cocaine has can actually be offset by the sedating effects of other drugs. This can seem to reduce the effects of both substances, which often causes the user to take more, even leading to an overdose. [4]

Long-Term Health Effects of Cocaine Usage

Cocaine usage can have many long-term effects not only on the brain but on the entire body. Studies in animals have shown that continuous exposure to cocaine can cause significant neuroadaptations in neurons that release the excitatory neurotransmitter glutamate. [5]

Animals that are consistently exposed to cocaine experience a change in how much of the receptor protein is released into the reward pathway of the brain. Over time, the brain becomes less sensitive to natural reward reinforcers, which then signals to the person to use more cocaine. [6]

The double-whammy of cocaine usage is that while it makes the brain less sensitive to these natural reinforcers, it also causes the brain’s circuits to become increasingly sensitive to stress. When cocaine isn’t in the body’s system, therefore, a person can become increasingly displeased and have extreme negative moods.

The body also can build up a tolerance to cocaine over time, and will need more to achieve the same level of pleasure as initially experienced. [7]While the body builds this tolerance to the drug, the brain also becomes increasingly sensitive to potential toxic effects such as convulsions or anxiety. [8]

Typical side effects of long-term cocaine usage are paranoia, panic attacks, irritability, restlessness, and potentially even psychosis. The more cocaine a person uses, and the longer they use it, the more damaging the effects can be. [9]

Continued cocaine usage negatively affects not only the brain but also major organs in the body. Some people experience tears or ulcers in the gastrointestinal tract, since cocaine reduces blood flow in that area of the body. Many long-term users of cocaine experience a loss of appetite, which can lead to malnourishment and significant weight loss.[10]

Cocaine use also leads to a significantly higher risk of experiencing a stroke or heart attack. Even users who would be considered recreational have been found to have higher blood pressure, thicker heart muscle walls, and harder arteries. They’re also 35 times more susceptible to getting a hardened aorta compared to people who’ve never used cocaine.

Last updated: November 14, 2022

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.


1 NIDA. What are the short-term effects of cocaine use? National Institute on Drug Abuse website. June 11, 2020. Accessed July 16, 2020.
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