Short- and Long-Term Effects of Cocaine

Cocaine is an illegal, powerful, and very addictive stimulant drug that people often use recreationally for different purposes.¹ If you or a loved one misuse cocaine, you should be aware of the serious and dangerous short- and long-term effects of cocaine.¹

Cocaine use is relatively common in the U.S., particularly among younger people.² According to the 2021 National Survey on Drug Use and Health, 4.8 million people aged 12 and older used cocaine, including crack cocaine, in the past year.³ This number was highest among people aged 18-25, with 1.2 million reporting past year use.³

Professional treatment is available to help people struggling with cocaine use. This article will help you understand:

• Short-term effects of cocaine.
• Long-term aftereffects of cocaine.
• Treatment options for cocaine misuse and addiction.

Short-Term Effects and Risks of Cocaine

People misuse cocaine for the immediate euphoria (or “high”) and other perceived desirable effects, such as increased energy and alertness.¹ The time of onset of these effects and their duration can vary by route of administration, with the high from smoking occurring within seconds and lasting around 5-10 minutes, while the high from snorting cocaine occurs more slowly and lasts around 15-30 minutes.^1,4

Adverse coke side effects may include:^1,4-7

Although some of the immediate side effects of cocaine may be perceived as benign, cocaine use is also associated with many dangers. Short-term risks of cocaine use can include:⁵

• Cardiovascular and cardiopulmonary effects. Cocaine’s short-term physiological effects include constricted blood vessels and increased body temperature, heart rate, and blood pressure. Chest pain is the most common complaint in cocaine-taking patients with cardiovascular complications and may be a sign of potentially fatal disturbances in heart rhythm and heart attacks.
• Behavioral effects. This includes bizarre, unpredictable, or violent behavior, and even psychosis, which can be more common when large doses are used.
• Neurological effects. This includes headaches, seizures, strokes, and coma, which can be serious and potentially fatal physical effects of cocaine.
• Gastrointestinal complications. This can include abdominal pain and nausea.

Other rare short-term effects of cocaine on the body are possible, including:^8,9

• Cough due to smoking crack.⁸
• Muscle hematoma.
• Spontaneous acute subdural hematoma, a neurological emergency.
• Splenic hemorrhage (bleeding in your spleen) due to rapid hypertension.

Many of the above symptoms indicate a cocaine overdose, when a person has used enough cocaine to overwhelm their body and cause serious adverse effects, life-threatening symptoms, or death.¹ This can occur from your first cocaine use or even unexpectedly afterward.¹ Sudden death from cocaine is often due to seizures or cardiac arrest.⁵

Different short-term side effects of cocaine can also depend on specific routes of administration and whether you used other substances along with cocaine. Some of these effects of cocaine may include:⁵

• Toxic effects on your heart if you mix cocaine with alcohol.
• Overdose from combining heroin and cocaine.

Long-Term Effects and Risks of Cocaine Use

Repeated cocaine use can cause brain adaptions where the reward system becomes less sensitive to natural reinforcers, while neurological pathways associated with stress become more sensitive; this can cause people to develop negative feelings or displeasure, when they stop using cocaine, which are two signs of withdrawal.¹⁰

People may continue to use cocaine to decrease these negative feelings and increase feelings of pleasure, which can reinforce the cycle of cocaine use and eventually lead to cocaine addiction.¹

People who chronically use cocaine may develop cocaine long-term effects that can impact their physical and mental health, and they can run a risk of serious and potentially life-threatening dangers.¹ Certain health effects of cocaine may vary by route of administration, and effects can also vary from person to person.¹

Some risks and other associated long-term effects of cocaine may include:^10,11

• This means you need to use more cocaine to experience previous effects.
• This means your brain is less sensitive to natural reinforcers and at the same time you need less cocaine to experience adverse effects such as anxiety, convulsions, and other toxic effects.
• Dependence characterized by withdrawal symptoms.
• Psychiatric problems. This can include panic attacks, paranoia, and possibly full-blown psychosis involving auditory hallucinations, which can occur when people repeatedly take cocaine in binges at increasing doses.
• Gastrointestinal problems. Chronically reduced blood flow in the gastrointestinal tract can cause tears and ulcerations.
• Appetite loss. This is common and may lead to unintended weight loss and malnourishment.
• Heart and cardiovascular problems. Although these can occur with short-term use, chronic use increases the risk of chest pain, stroke, and heart attack, as well as inflamed heart muscle, reduced ability of heart to contract, and aortic ruptures.
• Neurological problems. Chronic cocaine use increases the risk of experiencing stroke and seizures and intracerebral hemorrhage (bleeding in the brain), all of which is possible after short-term use as well. Some studies indicate an association with many years of cocaine use and Parkinson’s disease. People who use cocaine regularly over long periods of time can also suffer from long-term cognitive problems, such as difficulty with attention, impulse inhibition, memory, decision-making, and performing motor tasks.
• Allergic reactions such as rash and vasculitis as a result of levamisole, a chemical commonly used to cut illicit cocaine.

Long-term, chronic use can lead to side effects of cocaine that are specific to the way you use it can include:^6,9,10

• Loss of sense of smell, nosebleeds, nasal damage, trouble swallowing, hoarseness, mucosal damage, and irritated nasal septum leading to a chronically inflamed, runny nose (from snorting cocaine).
• Lung damage, collapsed lung, pneumonia, pulmonary edema, hemoptysis (coughing up blood), emphysema, respiratory failure, and worsened asthma (from smoking). One study showed that cocaine use caused bronchospasm (tightening of airway muscles) and wheezing in 32% of people who chronically smoked crack. Another study showed that 6%-26% of people who smoked crack had hemoptysis.
• Puncture marks in your arms, pulmonary edema, and a risk of contracting HIV, hepatitis, and other infectious diseases (from injecting cocaine using shared needles). In autopsies of people who injected or smoked cocaine, pulmonary edema was reported in 77%-85% of cocaine-related deaths.

Specific populations may also face additional long-term risks from cocaine effects. For example, pregnant women who use cocaine face a risk of premature delivery, low birth weight, and problems with self-regulation and attention when their prenatally exposed children enter school.⁶ Additionally, teens who binge on cocaine have an increased risk of developing ongoing cocaine problems later.¹⁰

Treatment Options for Cocaine Addiction

People who are struggling with cocaine use should know that help is available. Professional cocaine addiction treatment can help people who are dealing with cocaine use disorder or other substance use.

Treatment can include different options, such as inpatient or outpatient programs. As there are no FDA-approved medications to treat stimulant addiction, treatment often involves different behavioral therapies, such as cognitive-behavioral therapy or contingency management, combined with participation in mutual support groups, such as 12-step programs.¹

No matter how things might seem right now, there is always hope. American Addiction Centers (AAC) is a leading provider of treatment for cocaine misuse and addiction, with AAC locations across the nation.