Addiction Drug Use Cocaine The Health Effects of Cocaine Use Short-Term and Long-Term Effects of Cocaine By Buddy T Buddy T Facebook Twitter Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. Learn about our editorial process Updated on April 08, 2021 Medically reviewed Verywell Mind articles are reviewed by board-certified physicians and mental healthcare professionals. Medical Reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more. by Steven Gans, MD Medically reviewed by Steven Gans, MD Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Print Jose Azel / Aurora Open / Getty Images Table of Contents View All Table of Contents How Cocaine Works The High The Crash Short-Term Health Effects Methods of Use Effects of a Cocaine Overdose Statistics Cocaine is a highly addictive and illegal recreational drug that has a wide variety of well-understood effects on the body. The drug produces euphoria, which is described as a feeling of pleasure and an extreme sense of invincibility, often leading to abuse of the drug and negative health consequences. Cocaine users develop a tolerance over time and report that they are never able to achieve the "high" they felt the first time they used the drug. As tolerance to cocaine develops, most users say that the euphoric feeling they get with repeated use is not as intense or as long-lasting as it was with early use, even with escalating doses. This often leads to further physical and mental health problems. How Cocaine Works Cocaine is a strong central nervous system stimulant that affects the way the brain processes dopamine, a naturally produced neurotransmitter that is associated with regulating pleasure, movement, and other functions. Cocaine interferes with the brain's reabsorption (removal) of dopamine, prolonging dopamine's action, which produces a variety of effects. Cocaine works almost immediately, but its effect ultimately leads to a depletion of dopamine resulting in a "crash". Many users deal with this feeling by using more cocaine, which creates a cycle of use and withdrawal. Immediately after cocaine use, users will exhibit the following physical symptoms: Constricted blood vesselsDilated pupilsIncreased heart rateHigher blood pressure The High Shortly after using cocaine, the user experiences a euphoric period, which can last up to 30 minutes. Users typically feel: HyperstimulatedReduced fatigue or need for sleepFeelings of invincibilityMore talkative than usual or conversely, more contemplative and deep in thoughtAn increased libidoAn inability to comprehend signs of dangerNumbing of physical and mental painMental alertness The Crash Men and women who have used cocaine report feeling extremely depressed and agitated without the drug. When the immediate euphoric rush of the cocaine wears off, the individual may experience a crash with the following effects on the body: Anxiety and tensionMood swingsDepressionExhaustion Short-Term Health Effects Many cocaine users also have unpleasant experiences along with the euphoria. These experiences include: Restlessness Irritability Anxiety Paranoia Hallucinations Unpredictable violent/aggressive behavior Dry mouth Reduced appetite These experiences can last anywhere from a couple of minutes to a few hours, depending on the dose and method by which the drug is taken. Long-Term or Chronic Use Repeated cocaine use can cause a variety of health effects on the body. These effects can happen right after using cocaine, or they can occur even after the drug wears off. Consequences of long-term cocaine use include: Irregular heartbeat Chest pain Hypertension Abdominal pain and nausea Seizures Headaches Insomnia and exhaustion Depression Anxiety Paranoia Psychosis Hallucinations Light and sound sensitivity Weight loss and eating disorders Sexual dysfunction Cerebral atrophy and impaired thinking Bizarre, aggressive or violent behavior Heart attack Stroke Some of the long-term effects and symptoms associated with cocaine use are related to the dosage and method of use. Methods of Use Cocaine can be snorted, injected into the skin, or smoked. The method of cocaine use not only affects the length of the high, but it also comes with certain risks that further exacerbate long-term use symptoms. Injected When cocaine is injected, the euphoric feeling can last from 15 to 30 minutes. With chronic injections into the skin, cocaine can cause severe vasoconstriction (constricted blood vessels) that may prevent blood flowing into the tissue, resulting in severe tissue damage. The effect on the body can include severe allergic reactions, and increased risk for contracting HIV, hepatitis, heart infections, or sepsis (a blood infection). Since cocaine is often ‘cut’ with toxic substances, it can cause abscesses, collapsed veins, and even damage to the heart, liver, and brain. Smoked When cocaine is smoked, the high may last only five to 10 minutes. Risks include breathing difficulties, inflammation of the lungs, a chronic cough, and bronchitis. Snorted When cocaine is snorted, it tends to reach the brain at a slower rate than smoking it and gives a milder euphoria, but it may last from 15 to 30 minutes. Health effects of snorting cocaine include a chronically runny nose, nosebleeds, loss of smell, hoarse voice, and problems swallowing. Long-term effects commonly seen in chronic cocaine users include a damaged nose called “septal perforation” or a “hole in the septum,” which happens when repeated snorting of cocaine damages the nasal lining and the structure (the nasal septum) that separates the nostrils. This condition is also referred to as "coke nose". Effects of a Cocaine Overdose When used in higher doses, cocaine can lead to overdose (a condition where there is more of the substance in the body than the individual can cope with). Injecting cocaine increases the risk of overdose, as users often do not know the strength or purity of the cocaine being used. Because cocaine affects the heart and respiratory system, an overdose can cause death, especially when you inject or smoke it. Higher doses of cocaine can lead to coma and even death resulting from the following symptoms: Heart attackKidney failureHyperthermiaRepeated convulsions or seizuresBrain hemorrhagingStroke Know How to Recognize the Signs of Drug Overdoses to Save a Life Statistics A total of 70,237 persons died from drug overdoses in the United States in 2017; approximately two-thirds of these deaths involved an opioid. Among all 2017 drug overdose deaths, 13,942 (19.8%) involved cocaine. Deaths from a combination of cocaine and opioids have more than doubled since 2010. While cocaine abuse is a well-known problem, the drug can result in such a strong addiction that users often continue to abuse it even after having suffered serious problems, such as seizures or heart attacks. Often, recovering from drug addiction requires professional treatment, medical supervision, and methods of accountability. If you or a loved one are struggling with substance use or addiction, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database. 8 Sources Verywell Mind uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Richards JR, Laurin EG. Cocaine. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing. National Institute on Drug Abuse. What is cocaine? National Institute on Drug Abuse. What are the short-term effects of cocaine use? Riezzo I, Fiore C, De Carlo D, et al. Side effects of cocaine abuse: multiorgan toxicity and pathological consequences. Curr Med Chem. 2012;19(33):5624-5646. doi:10.2174/092986712803988893 Center for Substance Abuse Treatment. Treatment for Stimulant Use Disorders. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 1999. (Treatment Improvement Protocol (TIP) Series, No. 33.) [Table], Figure 5-1: Effects of Route of Administration for Cocaine and MA. Advokat C, Comaty J, Julien R. Julien’s Primer of Drug Action. 14th edition. New York, NY: Worth Publishers; 2019. Ballage A, El Harti M, Naceur S, et al. Nasal Septum Perforation due to Cocaine Abuse. SAJ Case Reports. 2017;4(3). Kariisa M, Scholl L, Wilson N, Seth P, Hoots B. Drug Overdose Deaths Involving Cocaine and Psychostimulants with Abuse Potential - United States, 2003-2017. MMWR Morb Mortal Wkly Rep. 2019;68(17):388-395. doi:10.15585/mmwr.mm6817a3 Additional Reading Gunja A, Stanislawski MA, Barón AE, Maddox TM, Bradley SM, Vidovich MI. The Implications of Cocaine Use and Associated Behaviors on Adverse Cardiovascular Outcomes Among Veterans: Insights From the VA Clinical Assessment, Reporting, and Tracking (CART) Program. Clin Cardiol. 2018 Jun;41(6):809-816. doi:10.1002/clc.22961. Epub 2018 Jun 9. Tan D, Nuno-Perez A, Mameli M, Meye FJ. Cocaine Withdrawal Reduces GABAB R Transmission at e/Entopeduncular Nucleus - Lateral Habenula Synapses. Eur J Neurosci. 2018 Aug 17. doi:10.1111/ejn.14120. [Epub ahead of print] By Buddy T Buddy T is an anonymous writer and founding member of the Online Al-Anon Outreach Committee with decades of experience writing about alcoholism. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit Get Treatment for Addiction Advertiser Disclosure × The offers that appear in this table are from partnerships from which Verywell Mind receives compensation.