What are the Side Effects of Cocaine Use?

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Cocaine Side Effects

Cocaine is a highly addictive stimulant drug with a variety of negative side effects – both physical and mental. These include but are not limited to increased heart rate, blood pressure and body temperature, nausea, convulsions and seizures, and paranoia, anxiety, and delusions. The method of administration – whether smoking, snorting, injecting or swallowing - strongly affects which specific side effects one will experience. Combining cocaine with other substances can amplify negative effects well beyond one’s initial intention and have fatal results.  

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What is Cocaine?

Cocaine is a naturally-occurring stimulant drug derived from the leaves of two species of the Coca plant, native to western South America – Erythroxylum coca and Erythroxylum novogranatense. It is most commonly processed into a white powdered substance known as cocaine hydrochloride, which can be snorted, sublimated and then inhaled, rubbed on the gums, or dissolved and injected. The intense euphoria it induces and the rapidity with which one becomes desensitized to it both cause it to be highly addictive. The DEA has classified cocaine as a Schedule II drug, indicating that it possesses a high abuse potential as well as a legitimate medical use in some instances.1 Cocaine is illegal for recreational use and to be included as an ingredient in products sold to the public- Coca-Cola stopped using cocaine almost a century ago.

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How Does Cocaine Work?

Cocaine operates by interfering with the reward circuit in the brain, also known as the mesolimbic dopamine system. This system connects a number of brain structures which control and regulate our ability to feel pleasure, and is aroused by all sorts of natural reinforcing stimuli – such as food, warmth, shelter, and relationships. This is the reason why we find specific actions to be pleasurable, and pursue them repeatedly. 

When the body engages in a pleasure-inducing activity, each neuron in the limbic circuit releases the neurotransmitter dopamine into the synapse – the tiny gap between neurons. There, the dopamine binds to dopamine receptors on the neighboring neuron, which receive the pleasure signal and continue to pass it along. Once its job is complete, the dopamine is taken back into the parent neuron by “transporter” proteins so it can be recycled and used again.  

When an individual uses cocaine, however, it disrupts this natural communication process within the brain. Cocaine acts by binding to the transporter proteins and blocking its removal of dopamine from the synapse. This results in an abnormal buildup of dopamine in this area, which relays a greatly amplified pleasure signal to the neighboring neuron. Understandably, this causes the signature euphoria which accompanies drug use. 2 

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Side Effects of Cocaine Use (Acute and Chronic Exposure)

Cocaine has a range of deleterious short and long-term effects on the physical, mental, and emotional health of its users. Although the severity of these side effects is dependent upon the length and frequency of abuse, even one episode of cocaine use has the potential to cause damage.  

Even acute (short-term) exposure to cocaine can result in the following: 

  • Physical Effects 
  • Increased/ irregular heart rate 
  • Increased blood pressure 
  • Increased body temperature 
  • Cardiac arrhythmias 
  • Constricted blood vessels 
  • Dilated pupils 
  • Abdominal Pain 
  • Nausea 
  • Tremors / Convulsions 
  • Muscle twitches 
  • Itching 
  • Fever 
  • Decreased Appetite 
  • Dehydration 

  • Mental Effects 
  • Euphoria 
  • Inflated ego 
  • Feelings of extreme competence 
  • Excited behavior 
  • Increased libido 
  • Paranoia 
  • Panic 
  • Delusions/ hallucinations 
  • Physical aggression and violence 
  • Anxiety 
  • Restlessness 
  • Irritability 
  • Depression

Cocaine use (even short-term) affects critical bodily functions and can result in severe medical complications. Its effects include cardiac arrhythmias, ruptured arteries and heart attack (cardiovascular), seizures, hemorrhaging, stroke and coma (neurological), and severe abdominal pain (gastrointestinal). A pregnant woman who uses cocaine may experience a miscarriage. In extreme cases, first-time use can result in death – most often caused by severe seizures or cardiac arrest.3

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Long-term Effects of Cocaine Abuse

The longer the exposure to any toxic drug, the greater grow the health conditions and risks. Prolonged use of cocaine has a variety of side effects, including but not limited to: 

  • Physical Effects 
  • Hemoptysis (coughing up blood/ bloodied phlegm) 
  • Chronic nosebleeds 
  • Chest pain 
  • Heart muscle inflammation 
  • Aortic ruptures 
  • Lung damage 
  • Sore throat 
  • Asthma 
  • Dyspnea (Shortness of breath) 
  • Permanent blood vessel damage 
  • Intracerebral hemorrhaging 
  • Chronic hypertension (high blood pressure) 
  • Liver damage 
  • Kidney damage 
  • Infertility 
  • Tooth Decay 
  • Malnutrition 
  • Bruxism (Involuntary tooth grinding) 
  • Gingivitis (Gum infection) 

  • Mental Effects 
  • Severe depression 
  • Anxiety  
  • Paranoia 
  • Mental confusion and disorientation 
  • Extreme irritability 
  • Physical aggression and violence 
  • Complete psychosis (loss of touch with reality) 
  • Shortened attention span 
  • Decreased impulse control 
  • Poor memory 
  • Decreased motor function 
  • Decreased decision-making abilities4

The above are lists of general physical and mental effects of sustained cocaine use. However, the chosen method of administration (i.e., smoking, snorting, injecting, and swallowing) largely impact the specific side effects experienced.  

Smoking Effects 

When smoked consistently, cocaine can cause lung damage and lung infections like pneumonia. Additionally, it can worsen an existing asthmatic condition and cause low blood oxygen levels. 

Snorting Effects 

When snorted, cocaine irritates and inflames the nasal septum (the piece of cartilage and bone separating the nasal cavity into two nostrils).  This commonly leads to chronic nosebleeds and runny nose, as well as anosmia (loss of smell), difficulty swallowing, and hoarseness.  

Injection Effects 

Those who choose to inject cocaine will find scarring and puncture marks (known as “tracks”) at the sites of injection, usually along the forearm. If sterile injection equipment was not used each time, they are at a high risk of developing blood-borne diseases such as HIV/ AIDS and Hepatitis C. They are also likely to experience damaged and collapsed veins and a variety of skin and soft tissue infections.  

Swallowing Effects 

Oral ingestion of cocaine is rather unusual because it requires the longest timespan to take effect. However, those who favor swallowing cocaine in pill/ tablet form may experience severe damage to the gastrointestinal tract – such as tears, ulcerations, and bowel decay. 5

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Effects of Combining Cocaine with other Substances

A common and dangerous practice among drug users is to combine cocaine with different drugs in order to intensify its euphoric effect and duration. One such amalgamation is the mixture of cocaine and heroin, commonly known as “speedballing”. Because cocaine is a stimulant and heroin is a depressant, people very mistakenly assume that one will offset and “balance” the negative effects of the other. In truth, however, combining stimulants and depressants merely causes a dangerous push-pull reaction as the body strains to process and respond to two contradictory substances. Cocaine necessitates increased oxygen intake while heroin slows all bodily systems – leaving an overstimulated yet restrained brain, lungs, and heart unable to accommodate the body’s needs. This greatly increases the risk of a stroke, aneurysm, heart attack or respiratory failure.

Another common and lethal compound is that of cocaine and alcohol - another stimulant/ depressant combo. Aside from the previously explained risks of using stimulants and depressants in tandem, cocaine and alcohol react to form a toxic substance known as cocaethylene, which can greatly increase the drugs’ negative effects on the heart. 6 

Additionally, ingesting stimulants and depressants together always heightens the risk of overdose. Because each substance muffles the effects of the other, it is very difficult to correctly assess how drunk/ high you are. An individual is liable to continue using and drinking well past their threshold until tragic consequences result.  

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Cocaine Tolerance and Addiction Liability

Yet another negative effect of cocaine is the rapidity with which it desensitizes users to its properties. A single dose already induces tolerance to the drug’s effects, and a user seeking to replicate his previous high will now have to take increasingly larger dosages merely in order to experience a similar euphoria.7 This is the vicious cycle of use, tolerance, and dependence – a slippery slope that can only end in addiction and a possibly fatal overdose. 

Cocaine addiction is only one facet of the drug epidemic plaguing our society and claiming countless lives. If you or a loved one is struggling with cocaine addiction, know that lasting recovery is always possible. Reach out to Avenues today to discover how we can help you with cocaine addiction treatment and start you on journey home! 

To learn how to identify signs of drug abuse in a family member, read our informative resource on this topic. Identifying substance abuse is the first step to preventing a loved one's habits from spiraling into a serious addiction.

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