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Cocaine's Effect on the Brain: Everything You Need to Know

By Taylor Weeks
Learn how acute and long-term cocaine use can change how your brain functions.

Cocaine belongs to a class of drugs called stimulants (or “uppers”), which cause increased activity and energy. Other examples of stimulants are caffeine, amphetamine and methamphetamine. Cocaine’s effects on the brain can lead to long-term disruptions in normal brain function.

How Does Cocaine Affect the Brain?

Cells in the brain called neurons communicate with one another partially using molecules called neurotransmitters. Neurotransmitters are released from one cell and enter an area called the synapse—a tiny gap between neurons. The neurotransmitter molecules then attach to the cell on the opposite side of the synapse, where they can have a number of different effects. After neurotransmitters are released into the synapse, they are taken back up into the releasing cell, where they can be either broken down or “recycled” and released again later.

Cocaine primarily affects a neurotransmitter called dopamine, which plays an important role in the brain's reward and reinforcement systems. The drug prevents dopamine molecules from being taken back up into the cell. This allows dopamine to build up in the synapse and have a much stronger effect on surrounding cells than it normally would. This is how cocaine causes the intense happiness and energy that it is often associated with. According to the National Institute on Drug Addiction, other short-term effects of cocaine use include:

  • Mental alertness
  • Extreme sensitivity to sight, sound and touch
  • Irritability and restlessness
  • Paranoia 

Bankole Johnson, DSc, MD, a board-certified psychiatrist and addiction researcher, tells WebMD Connect to Care that, in addition to these immediate effects, long-term cocaine use can also cause changes to how the brain functions. Chronic cocaine use is associated with an increased risk for stroke, depression, anxiety and drug addiction, Johnson says. 

Since cocaine dramatically increases the amount of dopamine available in the synapse, when the drug is used repeatedly the brain will compensate by reducing the number of dopamine receptors—areas on the neuron where dopamine attaches. According to The Hazelden Betty Ford Foundation, this can alter how the brain functions and cause symptoms like compulsive behavior and loss of pleasure and motivation.

Don’t Wait. Get Help Now.

If you or a loved one are struggling with addiction, WebMD Connect to Care Advisors are standing by to help.