Cocaine effects

What are the systemic effects of cocaine on your body and mind? We explore in-depth here.

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Have you ever considered the real effects of cocaine on your body? Or how it affects the mind? We’ve compiled a thorough list of possible side effects of cocaine here, and invite you to take a look at our “Long Term Effects of Cocaine” series, as well. Then, we welcome your questions or comments about cocaine use and its consequences at the end.

Cocaine effects are individual!

The first principle in exploring the topic is to understand that the effects of cocaine vary from person to person. Any consequence of use will depend on the size, weight and health of the person taking cocaine, whether they are used to taking the drug, whether other drugs are present in their body, the amount taken, dosing frequency, and duration of use. When combined, factors related to medical, health, and environmental determine the outcome of the use of any psychoactive drug. So, the following list is necessarily generalized.

Cocaine effects on the body

Effects of how cocaine works in the body vary from person to person, but one effect is common: cocaine has a stimulating effect on the central nervous system. Effects of cocaine can last anywhere from a few minutes to a couple of hours, depending on how the cocaine is taken. When the immediate “rush” of the cocaine has worn off, the person may experience a “crash”.

Cocaine effects on the brain

Cocaine is a strong central nervous system stimulant that increases levels of the neurotransmitter, dopamine, in brain circuits regulating pleasure and movement. Normally, dopamine is released by neurons in these circuits in response to potential rewards (like the smell of good food) and then recycled back into the cell that released it, thus shutting off the signal between neurons. Cocaine prevents the dopamine from being recycled, causing excessive amounts to build up in the synapse, or junction between neurons. This amplifies the dopamine signal and ultimately disrupts normal brain communication.

Cocaine effects on the nervous system

Although cocaine affects all systems in the body, the central nervous system (CNS) is the primary target. Cocaine blocks the reuptake of neurotransmitters in the neuronal synapses. Almost all CNS effects of cocaine can be attributed to this mechanism. Euphoria, pharmacological pleasure and intense cocaine craving share basis in this system. The effects of cocaine on other organ systems, in addition to its effects on the CNS, account for the majority of the complications associated with cocaine abuse.

Cocaine effects on dopamine

Cocaine is an indirect dopamine agonist. Once in the brain, it works in large part by occupying, or blocking, dopamine transporter sites in the terminal buttons of neurons in the brain. This prevents the re-uptake of dopamine by the neurons that release it, allowing higher concentrations of dopamine to remain in the synapse for an extended period of time. This abnormally long presence, and high concentration, of dopamine in the synapse is believed to cause the high (among other effects) associated with cocaine use. Dopamine has been implicated in several important functions, including movement, attention, learning, and the reinforcing effects of drug use. Therefore, its extended presence in high concentrations will be effective in the particular parts of the brain that control these functions, such as the basal ganglia and the limbic system.

Cocaine effects on personality and behavior

Cocaine can produce a spectrum of psychiatric symptoms such as nervousness, restlessness, tremors, anxiety, and irritability. Chronic use may lead to personality changes, hyperactivity, psychosis, paranoia, and fear. Co-morbid psychiatric disorders are frequent in patients with cocaine use disorders and can worsen with cocaine use. Nonaddictive medication may be necessary to treat co-morbid conditions such as anxiety and depressive disorders.

Cocaine effects on the mind

As tolerance to the drug increases, it becomes necessary to take greater and greater quantities to get the same high. Prolonged daily use causes sleep deprivation and loss of appetite. A person can become psychotic and begin to experience hallucinations. As cocaine interferes with the way the brain processes chemicals, one needs more and more of the drug just to feel “normal”. People who become addicted to cocaine (as with most other drugs) lose interest in other areas of life.

Cocaine effects on the heart

Most seriously, people who use cocaine can suffer heart attacks or strokes, which may cause sudden death. Cocaine-related deaths are often a result of the heart stopping (cardiac arrest) followed by an arrest of breathing.

Cocaine effects on heart rate

Those who take cocaine experience higher rates of the multiple factors associated with increased risk of heart attack and stroke. It is found that users had a 30 to 35% increase in aortic stiffening, higher blood pressure and 18% greater thickness of the heart’s left ventricle wall.

Cocaine effects on blood pressure

In healthy cocaine-naive individuals, cocaine can inhibit norepinephrine reuptake in the human peripheral circulation. However, this mechanism does not contribute importantly to the blood pressure-raising effect of cocaine because activation of baroreceptor reflexes decreases sympathetic neural activity (SNA), the neural stimulus for norepinephrine release.

Cocaine effects on blood sugar

Cocaine can:

  1. Suppress the feeling of hunger and disturb sleep patterns, which can cause hypoglycemia (abnormally low blood sugar levels);
  2. Indirectly affect blood glucose levels due to its effect on the brain – e.g. users might not recognize signs of hypoglycemia or mistake such symptoms for the effects of the drug;
  3. Cause people to forget or avoid taking their insulin (cocaine users have a tendency to omit insulin for extended periods of time).
  4. This can lead to high blood sugar levels (hyperglycemia), dehydration and exhaustion, especially if used in a hot environment, like a club.

Cocaine effects on the liver

Cocaine is believed to cause liver injury by its conversion to a toxic metabolite as a result of P450 metabolism. In experimental animal models, modulation of P450 activity by inducers, inhibitors, or alcohol changes the relative toxicity and pattern of injury from cocaine. In humans, it is less clear whether the hepatic injury is mediated by a toxic metabolite of cocaine as opposed to the direct effects of hyperthermia, anoxia or hepatic ischemia.

Cocaine effects on the lungs

Upper respiratory and pulmonary complications associated with cocaine addiction have been increasingly reported in recent years, with most of the patients being intravenous addicts, users of freebase, or smokers of “crack.” The toxicity of cocaine is complex and is exerted via multiple central and peripheral pathways. Recurrent snorting of cocaine may result in ischemia, necrosis, and infections of the nasal mucosa, sinuses, and adjacent structures.

Cocaine effects on skin

Injections will rapidly destroy the skin tissues, and can cause open sores, or skin ulcers. In addition to open sores- or even as a result of the open sores -needles can cause skin infections known as cellulitis or abscesses. Some cocaine users have been known to leave the needle in the skin, most likely unknowingly.

Cocaine effects on teeth

Users sometimes rub cocaine over their gums which causes ulceration of gums and the underlying bone. When cocaine mixes with saliva it creates an acidic solution which erodes tooth enamel. Cocaine and crack cocaine cause dry mouth, which further increases the risk of tooth decay. Often users will grind their teeth (bruxism) which causes the teeth to wear down.

Cocaine effects on the nose, ears, and throat

Some effects of cocaine depend on the method of taking it. Regular snorting of cocaine, for example, can lead to loss of the sense of smell, nosebleeds, problems with swallowing, hoarseness, and a chronically runny nose. Ingesting cocaine by the mouth can cause severe bowel gangrene as a result of reduced blood flow. Injecting cocaine can bring about severe allergic reactions and increased risk for contracting HIV, hepatitis C, and other blood-borne diseases.

Cocaine effects on eyes and pupils

Cocaine users often have dilated pupils when they are high on the drug, they may also have constricted pupils when they are not on the drug.

Cocaine effects on women

Women are much less sensitive to the cocaine. When asked to rate the severity of  dysphoria after use, men judged bad feelings to be more unpleasant than the women did. The men also experienced greater heart rate and blood pressure increases and detected cocaine’s effects sooner than women. Although the men and women received equivalent doses of cocaine, women had lower levels of the drug in their blood than the men; their cocaine blood levels were even lower when they took the drug during the luteal phase of their menstrual cycle.

Cocaine effects on the menstrual cycle and birth control

On a chemical level, cocaine has not been found to decrease the effectiveness of hormonal birth control. (Some prescription drugs and herbs do, though, so be sure your healthcare providers know what you’re taking.)  If you’re taking your pills correctly and all the time, they’re more than 99% likely to prevent an unplanned pregnancy, even if you have recreational drugs in your system.

Cocaine effects on pregnancy

Cocaine use during pregnancy can affect a pregnant woman and her unborn baby in many ways. During the early months of pregnancy, it may increase the risk of miscarriage. When the drug is used late in pregnancy, it may trigger premature labor. It also may cause an unborn baby to die or to have a stroke, which can result in irreversible brain damage. Women who use cocaine during pregnancy are:

  • Twice as likely to have a premature baby;
  • More likely to have a low birth-weight baby;
  • More likely to have babies born with smaller heads and smaller brains proportionate to body size.

Cocaine effects on a fetus

Because cocaine cuts the flow of nutrients and oxygen to the fetus, the baby may be much smaller at birth than it would be otherwise. Cocaine-exposed babies also tend to have smaller heads, which may indicate a smaller brain. These problems appear more commonly in babies of women who use cocaine throughout pregnancy than in babies whose mothers stop using the drug in the first trimester.

Cocaine effects on breast milk

Breastfeeding while using cocaine is not recommended. If a woman uses cocaine, she should not breastfeed within three days of using the drug (i.e., she should pump and discard the milk). The risks of breastfeeding while using cocaine must be weighed against the overall benefits of breastfeeding.

Cocaine effects on sperm

The ability of cocaine to decrease the percentage of motile sperm at high concentrations may explain the decreased sperm motility associated with cocaine use. Cocaine’s ability to augment sperm penetration at low concentrations suggests an interaction of cocaine with the sperm adrenergic system.

Reference Sources: NIH: Cocaine
Livertox: Cocaine
NCBI:  Cocaine and the nervous system
NCBI: Respiratory complications of cocaine abuse
NCBI: Cocaine and Psychiatric Symptoms
NCBI: Mechanism of the blood pressure–raising effect of cocaine in humans 
NCBI: The effect of cocaine on sperm motility characteristics and bovine cervical mucus penetration
NHTSA: Cocaine
Dailymail: Cocaine is ‘the perfect heart attack drug’ – even if you only use it only a few times a year
Livestrong: What Are the Effects on the Skin for Cocaine Users?
DentalHealthWeek: Drugs
NIDA: Cocaine Affects Men and Women Differently
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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