What are the effects of cocaine on the brain?

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If a person uses cocaine, it can have both short- and long-term effects on their brain. Some effects of cocaine are almost instantaneous and typically last from a few minutes to 1 hour.

After using cocaine in smaller amounts, a person may feel more:

• mentally alert
• talkative
• euphoric
• energized
• sensitive to sound, touch, and light

Individuals also may experience:

• anxiety
• panic attacks
• paranoia
• increased irritability

Short-term cocaine use can increase the risk of stroke, seizures, headaches, and coma. A person may also suddenly behave in a violent and erratic way.

Long-term effects of cocaine use on the brain may include:

Changes to the reward system

Within this system, the brain associates events or objects outside the body, or stimuli, with a positive outcome. The brain releases dopamine, which reinforces that the stimuli are desirable.

Prolonged use of cocaine may interfere with this natural process, resulting in a buildup of dopamine that can make the drug seem even more desirable. However, 2020 research on monkeys suggests that another neurotransmitter called glutamate may also play a role in the reward system and addiction.

Stress

Over time, cocaine use can cause the stress receptors in the brain to become more sensitive, which can lead to an increase in feelings of dissatisfaction and negative moods when a person is not using the substance.

Tolerance

If a person uses cocaine regularly for a long period, their brain may develop a tolerance to the drug.

This means that a person may need to use larger amounts of cocaine more frequently to feel the same short-term effects. Cocaine tolerance can increase a person’s risk of experiencing an overdose.

Sensitization

Repeated use of cocaine may cause the brain to be more sensitive to the negative or toxic effects of cocaine, such as anxiety, at lower doses. This can also increase the risk of an overdose.

Psychological effects

If a person uses cocaine repeatedly and at increasingly higher doses, they may start to feel increasingly irritable and restless. A person may also experience paranoia, panic attacks, and psychosis.

Neurological disorders

People who use cocaine for long periods may have an increased risk of:

• a brain hemorrhage
• stroke
• a brain aneurysm
• seizures
• Parkinson’s disease

Cognitive functions

Over time, cocaine use can impair functions such as attention, memory, decision-making, and motor skills.

Cocaine use can affect the other parts of the body as well as the brain. Some of the other health effects of cocaine use can include:

• Heart problems: According to some studies in a 2019 research review, usingcocaine can affect the cardiovascular system in several ways — for example, by causing high blood pressure, an irregular heartbeat, or a heart attack.
• Gastric issues: Cocaine use can reduce blood flow in the gastrointestinal tract, which may lead to conditions such as stomach ulcers and gastrointestinal perforations. A person may also experience loss of appetite, which may lead to weight loss and malnutrition.
• Other complications: These may include chest pain and insomnia.

Depending on how a person administers cocaine, there may be several other side effects:

• If an individual inhales cocaine through the nasal passages, they may experience:
  • nosebleeds
  • difficulty swallowing
  • loss of sense of smell
  • an inflamed nasal septum
• If they use needles to inject cocaine, this may lead to puncture wounds and the risk of contracting conditions such as HIV and hepatitis C.
• If someone smokes crack cocaine, it may cause lung damage and worsening asthma symptoms.

Substance use disorder (SUD) is a mental health condition that can affect the brain and alter a person’s behavior. This means they may find it difficult to manage their use of cocaine and may experience addiction in the most severe cases of SUD.

A person with SUD may also be living with other mental health conditions. Some of these can include:

• bipolar disorder
• depression
• schizophrenia
• anxiety
• attention deficit hyperactivity disorder (ADHD)
• personality disorders

Treatment for SUD may include:

• cognitive behavioral therapy
• living in drug-free residences so that a person can recover alongside others with similar experiences
• motivational incentives — rewarding individuals who do not use cocaine
• support groups

A person should contact a doctor if they are using cocaine to discuss the health effects of the substance and support to help stop using it.

If an individual thinks they or someone else may be experiencing a cocaine overdose, they should call 911 immediately. Signs of a cocaine overdose may include:

• seizures
• altered mental state, which may involve hyperactivity, restlessness, or confusion
• extreme paranoia
• aggression or unusual strength
• unusually high body temperature
• increased heart rate
• blurred vision or loss of vision
• vomiting, diarrhea, and abdominal pain
• itchy skin
• a headache
• chest pain
• difficulty breathing

Cocaine is a highly addictive stimulant drug that can have both short- and long-term effects on the brain, including irritability, paranoia, and impaired cognitive functions. It can also increase the risk of stroke, seizures, and heart attack.

If a person uses cocaine, they may develop substance use disorder. A doctor can recommend treatment to help a person stop taking cocaine, including behavioral therapy and motivational incentives.

People should call 911 immediately if they think they or someone else is experiencing a cocaine overdose.