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Substance Abuse and Addiction Health Center

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Cocaine Use and Its Effects

Cocaine: Anatomy of a High

Smoking or injecting cocaine results in nearly instantaneous effects. Rapid absorption through nasal tissues makes snorting cocaine nearly as fast-acting. Whatever the method of taking it in, cocaine quickly enters the bloodstream and travels to the brain.

Deep in the brain, cocaine interferes with the chemical messengers -- neurotransmitters -- that nerves use to communicate with each other. Cocaine blocks norepinephrine, serotonin, dopamine, and other neurotransmitters from being reabsorbed. The resulting chemical buildup between nerves causes euphoria or feeling "high."

What's so great about being high on coke? Cocaine users often describe the euphoric feeling as:

  • an increasing sense of energy and alertness
  • an extremely elevated mood
  • a feeling of supremacy

On the other hand, some people describe other feelings tagging along with the high:

  • irritability
  • paranoia
  • restlessness
  • anxiety

Signs of using cocaine include:

  • dilated pupils
  • high levels of energy and activity
  • excited, exuberant speech

Cocaine's immediate effects wear off in 30 minutes to two hours. Smoking or injecting cocaine results in a faster and shorter high, compared to snorting coke.

Physiological Effects of Cocaine

Cocaine produces its powerful high by acting on the brain. But as cocaine travels through the blood, it affects the whole body.

Cocaine is responsible for more U.S. emergency room visits than any other illegal drug. Cocaine harms the brain, heart, blood vessels, and lungs -- and can even cause sudden death. Here's what happens in the body:

  • Heart. Cocaine is bad for the heart. Cocaine increases heart rate and blood pressure while constricting the arteries supplying blood to the heart. The result can be a heart attack, even in young people without heart disease. Cocaine can also trigger a deadly abnormal heart rhythm called arrhythmia.
  • Brain. Cocaine can constrict blood vessels in the brain, causing strokes. This can happen even in young people without other risk factors for strokes. Cocaine causes seizures and can lead to bizarre or violent behavior.
  • Lungs and respiratory system. Snorting cocaine damages the nose and sinuses. Regular use can cause nasal perforation. Smoking crack cocaine irritates the lungs and, in some people, causes permanent lung damage.
  • Gastrointestinal tract. Cocaine constricts blood vessels supplying the gut. The resulting oxygen starvation can cause ulcers, or even perforation of the stomach or intestines.
  • Kidneys. Cocaine can cause sudden, overwhelming kidney failure through a process called rhabdomyolysis. In people with high blood pressure, regular cocaine use can accelerate the long-term kidney damage caused by high blood pressure.
  • Sexual function. Although cocaine has a reputation as an aphrodisiac, it actually may make you less able to finish what you start. Chronic cocaine use can impair sexual function in men and women. In men, cocaine can cause delayed or impaired ejaculation.

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