Cocaine Use and Addiction: Signs, Effects, and Health Risks
Kayla GillKayla Gill
Kayla GillKayla GillCocaine is an extremely well-known stimulant drug, notorious for its high addiction potential and harmful effects on physical and mental health. But despite its reputation, many people don’t fully understand how quickly it can lead to addiction—or the broad range of consequences it can cause.
We’ll help you understand how cocaine works on your body and brain, the dangers of prolonged (and even short-term) use, and the warning signs of addiction. We’ll also discuss treatment options and harm reduction strategies to support you if you’re struggling with cocaine addiction.
What Is Cocaine?
Cocaine as a Stimulant Drug
Cocaine is a strong stimulant that comes from the coca plant,1 native to South America. While indigenous people of the Americas use coca leaves for medicinal purposes, refined cocaine is much more potent—and dangerous. Cocaine use swept the U.S. in the ‘70s, followed by the crack epidemic of the ‘80s. Stimulants like cocaine remain some of the most widely abused substances2 to this day.
Cocaine works by speeding up the central nervous system, giving people a rush of energy, alertness, and euphoria. But it also has a high risk of addiction. Because of its strong effects, it quickly takes over the brain’s reward system, making those who use it almost instantaneously want to do so again, often in increasing amounts. Addiction can develop quickly—sometimes even after just a few uses—so it’s crucial to learn to spot the early signs of abuse and get help right away.
Forms of Cocaine and Methods of Use
Cocaine usually comes in 2 main forms: powder (often called coke or blow) and rock (known as crack). Powdered cocaine is typically snorted, though some people inject it after dissolving it in water. Crack cocaine is smoked. Smoking crack leads to a faster and more intense high than snorting, which also makes it more addictive.
The way someone uses cocaine can affect the risks and health problems that result. Injecting cocaine, for example, increases the chances of contracting bloodborne diseases like HIV or hepatitis. Smoking crack can cause lung damage3 and breathing issues.
Is Cocaine Addictive?
Yes, cocaine is a highly addictive drug. Its immediate, intense effects create feelings of high energy, alertness, confidence, and euphoria. But over time, your brain gets used to the presence of cocaine and becomes less sensitive to natural dopamine, making it harder to feel happy when you’re not using drugs. This eventually leads to cravings and compulsive use, which is what we call cocaine addiction (or cocaine use disorder).
Cocaine’s extremely addictive nature4 might be due partly to the fact that repeated use increases a genetic factor called ΔFosB, which may prompt more compulsive behavior:
“Chronic administration of cocaine has recently been shown to increase ΔFosB in several additional brain regions, such as the frontal cortex and amygdala…the presence of ΔFosB in the frontal cortex may contribute to the loss of frontal cortex control over cocaine urges that is seen in addiction.”
Addiction to cocaine can happen very quickly, even after using cocaine for just a short time. That’s why it’s so important to spot the signs early and get professional help if you can’t quit on your own.
How Cocaine Affects the Body and Brain
Immediate Effects on the Brain
When you use cocaine, it triggers a huge surge of dopamine, a chemical in the brain that makes you feel good and gives you a sense of reward. Normally, dopamine is released when we do things we enjoy, like eating or hanging out with friends, and then it gets recycled back into the brain. But cocaine blocks that recycling process, causing a buildup of dopamine that causes the intense high and feeling of alertness it’s known for.
But the catch is, this high doesn’t last long. Once the effects wear off, people usually crash—they feel tired and irritable, and they crave more cocaine. This rollercoaster of highs and lows propels repeated use and heightens the risk of addiction.
Short-Term Physical and Mental Effects
Right after using cocaine, people often feel a rush of energy. Some may even feel overly confident or invincible, which is often what leads to high-risk behavior. Cocaine has other physical effects6 that can be pretty intense:
- Hyperalertness
- Racing heart
- Increased blood pressure
- Dilated pupils
- Sensory sensitivity
- Insomnia
- Loss of appetite
As the high fades, things take a turn. You might start feeling confused, anxious, restless, or paranoid. The more often or heavily you use cocaine, the more pronounced these effects become over time.
Long-Term Effects on Brain Chemistry and Function
Using cocaine over a longer period of time can significantly change how your brain works. It lowers your brain’s ability to feel pleasure naturally, so things that used to make you happy—like your hobbies or spending time with friends—don’t feel quite the same. For many people, this eventually leads to depression, anxiety, and other mood disorders, and can even develop into more severe mental health issues like paranoia or psychosis.
A large body of research shows that long-term cocaine use affects brain functions7 like executive function and working memory, citing “significant differences between cocaine users and non-drug-using controls in brain structures, blood-oxygen-level dependent signals, and brain metabolism.”
Cocaine affects how well you can focus, remember things, control your impulses, and make decisions.
Explore Cocaine Treatment Centers
Signs and Symptoms of Cocaine Addiction
Recognizing the signs of cocaine addiction and intervening early is important for avoiding the damaging impacts cocaine can have on your health and your life. These symptoms can be physical, behavioral, or psychological.
Physical Indicators
List of physical signs that may indicate cocaine addiction, such as weight loss, frequent nosebleeds, dilated pupils, and tremors.
Physical signs of cocaine addiction may include:
- Rapid weight loss
- Frequent nosebleeds (from snorting)
- Dilated pupils
- Tremors or muscle twitches
- Track marks (from injecting)
- Chronic respiratory issues (from smoking)
Behavioral Changes
Cocaine addiction often causes noticeable behavioral changes:
- Increased secrecy and isolation
- Neglecting responsibilities at work or home
- Risky behaviors like unprotected sex or reckless driving
- Erratic mood swings, including bouts of irritability or aggression
- Financial difficulties due to the high cost of maintaining the addiction
Psychological Symptoms
Psychologically, cocaine addiction can result in:
- Anxiety and restlessness
- Paranoia or hallucinations
- Aggressive or violent behavior
- Depression, particularly during withdrawal periods
- Suicidal thoughts or ideation
Dangers of Cocaine Use
Long-Term Health Complications
Using cocaine for a long time can lead to some serious health problems, including:
- Heart issues:8 Cocaine puts a lot of stress on your heart, raising the risk of heart attacks, strokes, and high blood pressure.
- Lung damage: Smoking crack cocaine can harm your lungs, causing infections, a chronic cough, and in some cases, a collapsed lung.
- Brain problems: Over time, cocaine impairs your brain’s working abilities, causing memory loss, trouble thinking clearly, and problems with movement and coordination.
Impact on Mental Health
Cocaine’s effect on mental health can be equally devastating. Many long-term users struggle with mood disorders like anxiety and depression, and some may develop a condition known as cocaine-induced psychosis,9 which is similar to the symptoms of acute paranoid schizophrenia.
Cocaine use is also associated with an increased risk of suicidal behavior,10 especially in periods of withdrawal or after long-term use.
If you or someone you know is struggling with suicidal thoughts, help is available. Contact the National Suicide Prevention Lifeline at 1-800-273-8255 or text HELLO to 741741 for free, confidential support. You don’t have to go through this alone—reach out now.
Cocaine Overdose Risks
Cocaine overdose is a life-threatening medical emergency. Signs of overdose include:
- Rapid heart rate or heart attack
- Stroke or seizure
- Difficulty breathing
- Extreme agitation or hallucinations
- High body temperature
- Loss of consciousness
In the event of a suspected overdose, seek emergency medical attention immediately. Cocaine overdoses can cause sudden death, particularly when combined with other substances like alcohol or opioids.
Treatment Options for Cocaine Addiction
Behavioral Therapies
Treatment for cocaine addiction11 often starts with therapies that help change the thoughts and behaviors that drive drug use. Two common and effective approaches include:
- Cognitive behavioral therapy (CBT): This type of therapy helps you recognize and shift negative thought patterns that lead to substance use.
- Contingency management (CM): In this approach, you receive rewards for staying drug-free, encouraging positive behavior changes and helping you stay motivated.
Medication-Assisted Treatments
Currently, there aren’t any FDA-approved medications specifically for treating cocaine addiction like there are for opioid and alcohol addiction. However, researchers are working on potential treatments that might help manage cravings and ease cocaine withdrawal symptoms in the future.
Importance of Aftercare
Aftercare is a huge part of staying on track in your recovery from cocaine addiction. It usually includes a combination of practices, like living in a sober environment after rehab, attending continuing therapy, and support groups (such as Narcotics Anonymous). Learning relapse prevention strategies—like healthy coping skills for dealing with challenges—is also essential to helping you stay sober in the long run.
Learn more about continuing care and how to set yourself up for success in lifelong recovery.
Harm-Reduction Strategies
Overview of Harm Reduction
Harm reduction is all about making drug use safer, even if you’re not ready to quit yet. The idea is to reduce the risks and adverse effects of cocaine use, understanding that not everyone can stop right away. This approach focuses on safety and minimizing harm, rather than immediate and total abstinence as the only path to getting better.
Practical Approaches to Minimize Risks
Some ways to reduce the risks of cocaine use include:
- Safe consumption spaces: Supervised places where people can use drugs with medical staff available to step in if something goes wrong, like an overdose
- Needle exchange programs: These provide clean syringes for people who inject drugs, helping prevent the spread of infections like HIV and hepatitis.
- Drug testing kits: These kits let people test their drugs for dangerous substances, like fentanyl, which can help prevent accidental overdoses.
Recovery From Cocaine Addiction
Recovery from cocaine addiction isn’t just about abstinence—it’s about reclaiming your life and rediscovering joy, purpose, and connection. While the journey may at times seem daunting, it’s important to remember that there’s joy in healing, too! People recover, and you can too.
Search for cocaine addiction treatment programs that meet your unique needs, and reach out to a support specialist today.
-
"Drug Fact Sheet: Cocaine." Department of Justice/Drug Enforcement Administration. https://www.dea.gov/sites/default/files/2020-06/Cocaine-2020_1.pdf
-
Stimulant Abuse: Pharmacology, Cocaine, Methamphetamine, Treatment, Attempts at Pharmacotherapy Ciccarone, Daniel Primary Care: Clinics in Office Practice, Volume 38, Issue 1, 41 - 58
-
Tashkin DP, Gorelick D, Khalsa ME, Simmons M, Chang P. Respiratory effects of cocaine freebasing among habitual cocaine users. J Addict Dis. 1992;11(4):59-70. doi: 10.1300/J069v11n04_05. PMID: 1486094.
-
Nestler EJ. The neurobiology of cocaine addiction. Sci Pract Perspect. 2005 Dec;3(1):4-10. doi: 10.1151/spp05314. PMID: 18552739; PMCID: PMC2851032.
-
Cocaine Fact Sheet | Coast to Forest | Oregon State University. 21 Feb. 2023, https://c2f.oregonstate.edu/understand/fact-sheets/cocaine.
-
Cocaine Fact Sheet | Coast to Forest | Oregon State University. 21 Feb. 2023, https://c2f.oregonstate.edu/understand/fact-sheets/cocaine.
-
Frazer KM, Richards Q, Keith DR. The long-term effects of cocaine use on cognitive functioning: A systematic critical review. Behav Brain Res. 2018 Aug 1;348:241-262. doi: 10.1016/j.bbr.2018.04.005. Epub 2018 Apr 16. PMID: 29673580.
-
Xavier Carrillo, Antoni Curós, Robert Muga, Jordi Serra, Arantza Sanvisens, Antoni Bayes-Genis, Acute coronary syndrome and cocaine use: 8-year prevalence and inhospital outcomes, European Heart Journal, Volume 32, Issue 10, May 2011, Pages 1244–1250, https://doi.org/10.1093/eurheartj/ehq504
-
Brady KT, Lydiard RB, Malcolm R, Ballenger JC. Cocaine-induced psychosis. J Clin Psychiatry. 1991 Dec;52(12):509-12. PMID: 1752853.
-
Cornelius JR, Thase ME, Salloum IM, Cornelius MD, Black A, Mann JJ. Cocaine use associated with increased suicidal behavior in depressed alcoholics. Addict Behav. 1998 Jan-Feb;23(1):119-21. doi: 10.1016/s0306-4603(97)00019-1. PMID: 9468750.
-
Kampman KM. The treatment of cocaine use disorder. Sci Adv. 2019 Oct 16;5(10):eaax1532. doi: 10.1126/sciadv.aax1532. PMID: 31663022; PMCID: PMC6795516.
Our Promise
How Is Recovery.com Different?
We believe everyone deserves access to accurate, unbiased information about mental health and addiction. That’s why we have a comprehensive set of treatment providers and don't charge for inclusion. Any center that meets our criteria can list for free. We do not and have never accepted fees for referring someone to a particular center. Providers who advertise with us must be verified by our Research Team and we clearly mark their status as advertisers.