Some people take cocaine in binges, in which cocaine is used repeatedly and at increasingly higher doses. Because cocaine’s effects wear off sooner, this can lead to an opioid overdose.22,23 Many people who use cocaine also use alcohol, and this combination can be particularly dangerous. Some people who use cocaine report feelings of restlessness, irritability, anxiety, panic, and paranoia. The duration of cocaine’s euphoric effects depends upon the route of administration. Chronic cocaine exposure affects many other areas of the brain too.
What are the side effects of cocaine use?
As cocaine is absorbed through the nasal mucosa, the remaining hydrochloride component forms a dilute hydrochloric acid. About 30% of people who had snorted cocaine at least 25 times but less than daily, and 47% of daily users, reported experiencing nasal irritation, crusting or scabbing, and frequent nosebleeds. Drugs which help to re-stabilize the glutamate system such as N-acetylcysteine have been proposed for the treatment of addiction to cocaine, nicotine, and alcohol. While many CA members have been addicted to cocaine, crack, speed or similar substances, CA accepts all who desire freedom from “cocaine and all other mind-altering substances” as members. Cocaine Anonymous (CA) is a twelve-step program formed in 18 November 1982 for people who seek recovery from drug addiction.
Large-scale coca cultivation and cocaine production occurred in Taiwan Asia, in Taiwan (then known as Formosa) and Java (today part of Indonesia) before World War II. However, due to its toxic effects and potential for abuse, safer alternatives eventually replaced it in medical practice. While some studies indicate that psychostimulant therapy may reduce cocaine use and cravings, the evidence is mixed and further research is needed. This hypothesis suggests that some individuals use cocaine to address underlying neurochemical or psychological issues.
When taken in larger amounts and upon prolonged and repeated use, cocaine can produce depression, anxiety, irritability, sleep problems, chronic fatigue, mental confusion, paranoia, and convulsions that can cause death. Cocaine, white crystalline alkaloid that is obtained from the leaves of the coca plant (Erythroxylum coca), a bush commonly found growing wild in Peru, Bolivia, and Ecuador and cultivated in many other countries. We believe everyone deserves access to accurate, unbiased information about mental health and recovery.
- Some people who use cocaine report feelings of restlessness, irritability, anxiety, panic, and paranoia.
- Cocaine acts pharmacologically as a serotonin–norepinephrine–dopamine reuptake inhibitor (SNDRI), producing reinforcing effects such as euphoria, increased alertness, concentration, libido, and reduced fatigue and appetite.
- In other cultures the active alkaloid is chemically extracted from coca leaves and is converted into the hydrochloric salt of cocaine, cocaine hydrochloride.
Cocaine Complications
Seizures rose by 68% from 2019 to 2023, while the number of users increased from 17 million in 2013 to 25 million in 2023, according to the UNODC World Drug Report 2025. Cocaine production, seizures, and use all reached record levels in 2023, making it the world’s fastest-growing illicit drug market. The provisions as to how much a coca farmer can yield annually is protected by laws such as the Bolivian Cato accord.
Cocaine is also injected in solution or smoked in a chemically treated form known as freebase; either of these methods produces a markedly more compulsive use of the drug. Cocaine is an irritant, however, and acts to constrict blood vessels, causing a chronic runny nose or, in severe cases, ulcerations in the nasal cavity. This fine white powder is sniffed through a hollow tube and is readily absorbed into the bloodstream through the nasal mucous membranes. For centuries the Indians of Peru and Bolivia have chewed coca leaves mixed with pellets of limestone or plant ashes for pleasure or in order to withstand strenuous working conditions, hunger, and thirst.
Alcohol
In the National Survey on Drug Use and Health, white respondents reported a higher rate of powdered cocaine use, and Black respondents reported a higher rate of crack cocaine use. The Anti-Drug Abuse Act of 1986 mandated the same prison sentences for distributing 500 grams of powdered cocaine and just 5 grams of crack cocaine. In 1914, The New York Times published an article titled “Negro Cocaine ‘Fiends’ Are a New Southern Menace,” portraying Black people who used cocaine as dangerous and able to withstand wounds that would normally be fatal. In Peru, for example, legal coca cultivation is monopolized by the state company National Coca Company (ENACO), yet approximately 90% of coca leaves produced in the country are diverted to illegal actors for cocaine manufacturing. Approximate cocaine purity can be determined using 1 mL 2% cupric sulfate pentahydrate in dilute HCl, 1 mL 2% potassium thiocyanate and 2 mL of chloroform.
Men died of overdose at 2-3 times greater a rate than women in the U.S. in 2020-2021
Cocaine addiction has a serious impact on your brain chemistry. People who stop using cocaine will likely experience cocaine withdrawal. If you or a loved one is struggling with a cocaine use disorder, getting help is an important start to your recovery journey. They have expanded their cocaine distribution efforts to Africa, Asia, Australia and Europe.12 As a result, they began to collect more of the profits from the cocaine trade.12 Once the cocaine has reached the United States, Mexican traffickers sell it to American wholesale dealers.
For Treatment Providers
They may refer you to a substance abuse counselor or recommend community-based programs. They’ll evaluate your overall health. Start with your healthcare provider. For example, it affects the amount of glutamate, a neurotransmitter that sends messages between nerve cells in the brain. Cocaine use has short-term and long-term side effects.
Therapeutic communities (TCs)—drug-free residences in which people in recovery from substance use disorders help each other to understand and change their behaviors—can be an effective treatment for people who use drugs, including cocaine.46 TCs may require a 6- to 12-month stay and can include onsite vocational rehabilitation and other supportive services. Cocaine has significant and well-recognized toxic effects on the heart and cardiovascular system.3,27,28 Chest pain that feels like a heart attack is common and sends many people who use cocaine to the emergency room.3,28 Cocaine use is linked with increased risk of stroke,27 as well as inflammation of the heart muscle, deterioration of the ability of the heart to contract, and aortic ruptures.28 Short-term physiological effects of cocaine use include constricted blood vessels; dilated pupils; and increased body temperature, heart rate, and blood pressure.20 Large amounts of cocaine may intensify the high but can also lead to bizarre, erratic, and violent behavior. The brain’s mesolimbic dopamine system, sometimes called the reward pathway, is stimulated by all types of reinforcing stimuli, such as food, sex, and many drugs, including cocaine. Discover the effects of crack cocaine use, signs of crack addiction, and effective treatment options to help you or a loved one on the path to recover… Using cocaine may change how people’s brains work and increase their risk for many serious medical issues.
More on Substance Abuse and Addiction
Mexican drug cartels, such as the Guadalajara Cartel, often transport cocaine from South America into the United States and other countries and are distributors rather than suppliers.4,12 Countries that transport cocaine across national lines, such as Mexico or Caribbean countries including Haiti, the Bahamas, and the Dominican Republic, are also big players.4,5,11,12,13,15 The major countries in the cocaine trade include those where coca plants are grown and processed, such as Colombia, Bolivia and Peru. Along the supply chain, cocaine is cut with adulterants to reduce its purity and create a larger profit margin.3,12 Common cutting agents include amphetamines, baking sugars, caffeine, acetaminophen, cornstarch, flour, talcum powder and certain anesthetics.1,2,4 Some adulterants, or cutting agents, can be filtered out through the creation of crack cocaine.1 While there are some core ingredients that must be included in the production of cocaine, there are several that can be used interchangeably.17 Manufacturers may utilize different chemicals than one another based on factors such as availability, financial limitations, and personal preferences.
- Cleveland Clinic is a non-profit academic medical center.
- While this act is often seen as the start of prohibition, the act itself was not actually a prohibition on cocaine, but instead it set up a regulatory and licensing regime.
- Depending on liver and kidney functions, cocaine metabolites are detectable in urine between three and eight days.
- In early tests, a vaccine helped reduce the risk of relapse in people who use cocaine.
Repeated use raises the risk of developing “cocaine nose,” referring to severe nasal tissue damage from intranasal use, as well as “crack lung,” a condition involving lung tissue Cocaine Withdrawal Guide damage caused by inhaling crack cocaine. Aside from the toxic effects of cocaine, there is also the danger of circulatory emboli from the insoluble substances that may be used to cut the drug. As physician boards—but not pharmacy boards—continue to assess knowledge of licit cocaine, attention may shift toward drugs with more contemporary medical use. However, current pharmacoepidemiological trends suggest that cocaine may soon reach the point where, in practical terms, it is no longer used medically in health care as a Schedule II substance.
In a healthy eye, cocaine stimulates the sympathetic nervous system (SNS) by inhibiting norepinephrine reuptake, causing the pupil to dilate. Occasionally, cocaine is mixed with adrenaline and sodium bicarbonate and used topically for surgery, a formulation called Moffett’s solution. Although some absorption and systemic effects may occur, the use of cocaine as a topical anesthetic and vasoconstrictor is generally safe, rarely causing cardiovascular toxicity, glaucoma, and pupil dilation. Cocaine is rarely prescribed in modern medicine due to its high potential for abuse and significant risk of adverse effects; its use is now almost exclusively limited to health facilities for specific diagnostic procedures or surgeries. Although cocaine was once widely preferred for topical anesthesia, the search for replacement agents intensified due to rising costs, strict regulations, and its habit-forming potential.
How common is cocaine use?
Research indicates that people who are committed to abstinence, engage in self-help behaviors, and believe that they have the ability to refrain from using cocaine (self-efficacy) are more likely to abstain. Movies present examples and information that support the development of coping skills; quizzes, games, and homework assignments reinforce the lessons and provide opportunities to practice skills.43-45 Studies have shown that adding CBT4CBT to weekly counseling boosted abstinence43 and increased treatment success rates up to 6 months after treatment.44 Cognitive-behavioral therapy (CBT) is another effective approach for treating cocaine addiction. Research indicates that CM benefits diverse populations of people who use cocaine. CM may be particularly useful for helping patients achieve initial abstinence from cocaine and stay in treatment.38-40 This approach has been shown to be practical and effective in community treatment programs.39
For crack, the dose is usually 15 to 50 milligrams. Comedown is a term that describes symptoms you feel when you come off the drug. When you snort it, it takes slightly longer to feel the effects. Cocaine’s effects start quickly after you take a dose. Someone who uses the drug heavily might test positive for up to 2 weeks after their last use.