Cocaine Use and Its Effects

Cocaine -- a high-priced way of getting high -- has a mystique. Called "the caviar of street drugs," Cocaine is seen as the status-heavy drug of celebrities, fashion models, and Wall Street traders. Movies like "Blow" and books like Killing Pablo sensationalize the business and use of cocaine.

The reality of cocaine hits after the high. Cocaine has powerful negative effects on the heart, brain, and emotions. Many cocaine users fall prey to addiction, with long-term and life threatening consequences. Even occasional users run the risk of sudden death with cocaine use. Read on for the not-so-glamorous truth about cocaine use and its effects.

Coca, Cocaine, and Crack

Cocaine is a purified extract from the leaves of the Erythroxylum coca bush. This plant grows in the Andes region of South America. Different chemical processes produce the two main forms of cocaine:

  • Powdered cocaine -- commonly known on the street as "coke" or "blow" -- dissolves in water. Users can snort or inject powdered cocaine.
  • Crack cocaine -- commonly known on the street as "crack" or "rock" -- is made by a chemical process that leaves it in its "freebase" form, which can be smoked.

About 14% of U.S. adults have tried cocaine. One in 40 adults has used it in the past year. Young men aged 18 to 25 are the biggest cocaine users, with 8% using it in the previous 12 months.

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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 interrupts blood flow to the heart muscle itself, which can cause a heart attack, even in young people without heart disease. Cocaine can also trigger potentially deadly abnormal heart rhythms (called arrhythmias)..
  • 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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Cocaine: Psychological Effects and Addiction

Cocaine acts in the deep areas of the brain. These are the areas that create a feeling of "reward" from highly pleasurable behaviors. Stimulating this brain area with cocaine feels good. And it can create a powerful craving to use more cocaine. Repeated cocaine use leads to tolerance (that is, increasingly higher doses are needed to attain the same effect), dependence, and addiction.

There is no "safe" frequency of use for cocaine. It's impossible to predict whether a person will become physically or psychologically dependent on cocaine.

After using cocaine regularly for an extended period, dependence (addiction) develops. When dependence is present, stopping cocaine suddenly leads to withdrawal. Symptoms of withdrawal from cocaine are more psychological than physiological. Typically, cocaine withdrawal symptoms include:

  • depression and anxiety
  • fatigue
  • difficulty concentrating
  • inability to feel pleasure
  • increased craving for cocaine
  • physical symptoms including aches, pains, tremors, and chills

Cocaine withdrawal is rarely medically serious. In certain people, withdrawal from cocaine may cause suicidal thoughts. Typically, withdrawal symptoms from cocaine addiction resolve within one to two weeks. However, intense craving for cocaine may return, even years after the last use.

WebMD Medical Reference Reviewed by Joseph Goldberg, MD on January 16, 2016

Sources

SOURCES:

National Institute on Drug Abuse: "Cocaine."

National Institute on Drug Abuse Research Report Series: "Cocaine Abuse and Addiction."

Substance Abuse and Mental Health Services Administration: "Drug Abuse Warning Network, 2005: National Estimates of Drug-Related Emergency Department Visits."

Westover, A. Archives of General Psychiatry, 2007.

Boghdadi, M. Heart & Lung, 1997.

Rothman, R. Synapse, 2001.

Kilts, C. Archives of General Psychiatry, 2001.

Warner E. Annals of Internal Medicine, 1993.

Cottler, L. Drug and Alcohol Dependence, 1993.

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