Long-Term Side Effects of Cocaine Abuse

Long-term abuse of cocaine can cause a myriad of physical problems. Sometimes, it is possible to reverse the damage done to the body through cocaine or crack cocaine abuse; however, years of abuse may cause irreversible effects. Treating chronic problems leads to a lifetime of medical complications, hospital and doctor visits, and medical bills.
What Are the long-term Effects of Cocaine?

It is important to get help overcoming addiction to cocaine or crack cocaine as soon as possible – not just because of the psychological, financial, and social issues associated with substance abuse, but also because of long-term physical harm caused by the drug.

Heart attack is the leading cause of death among people who abuse cocaine. One report shows it accounts for 25 percent of deaths among people ages 18-45 who have abused cocaine or crack cocaine.

  • Damage to the nose and mouth: Snorting cocaine causes direct damage to the mucous membranes in the nose. With drier environments and less blood flow, the soft tissues in the nose will become damaged and eventually die. This will expose the cartilage lining between nasal cavities, which is the septum. Once the septal cartilage is exposed, it too will die, creating a hole. Many people who struggle with cocaine abuse develop septal perforations, which can cause a collapse of the nose structure, and, eventually, breathing problems. Sometimes, this issue can be corrected with plastic surgery but not always.

    A similar process can occur in the upper palate of the mouth. Palatal perforations are not as common as septal perforations, but they can occur through long-term abuse.

  • Respiratory problems and pulmonary damage: Snorting cocaine can cause mucous membrane damage through the sinus cavity, leading to the throat and upper respiratory system; however, smoking crack cocaine is more likely to cause serious respiratory problems. Blood vessels in the lungs constrict; alveolar walls are destroyed so oxygen does not enter the bloodstream as well; and capillaries that carry oxygen to the rest of the body can be destroyed. Chronic cough, higher risk of infections like pneumonia and tuberculosis, acute respiratory distress, asthma, and pulmonary edema are all associated with freebasing cocaine.

    People who chronically abuse crack cocaine can develop “crack lung,” or eosinophilic pneumonitis. Symptoms of this condition include:

    • Black sputum
    • Cough
    • Diffuse wheezing sounds
    • Pain
    • Increased presence of white blood cells
    • Raised body temperature
  • Brain damage: Consistent constricting of blood vessels can reduce the amount of oxygen the brain receives, which can cause brain damage. It also increases the risk of aneurysm due to damage to the vascular walls feeding the brain. Further brain damage from cocaine or crack cocaine can include:
    • Mini-strokes, or transient ischemic attacks
    • Seizures
    • Cerebral atrophy, or brain shrinking
    • Cerebral vasculitis, or inflammation of the blood vessels in the brain and/or spinal column
    • Hyperpyrexia, or exceptionally high fever from a disease that requires medical attention
    • Changes to prefrontal and temporal lobe functioning, which hurts problem-solving, decision-making, spatial understanding, vocabulary, attention, learning, and memory
    • Changes to neurotransmitter production and absorption, which can lead to mood disorders
    • Changes to movement, causing tremors, muscle weakness, changes in gait, etc.

Additionally, cocaine ages the brain, so dementia risk increases. Long-term memory problems can turn into conditions mimicking Alzheimer’s. People who have a higher risk of developing dementia anyway are more likely to trigger this condition earlier in life if they abuse cocaine for a long time.

  • Gastrointestinal damage: With reduced blood flow throughout the body, several organ systems can be indirectly damaged over time, including the stomach and intestines. Short-term side effects from cocaine abuse include stomach pain, reduced appetite, nausea, vomiting, and constipation; over time, these side effects will become more permanent, indicating necrotic bowel or death of important tissues in the gastrointestinal system. People who struggle with cocaine abuse are also more likely to get ulcers due to changes in the pH of the stomach. In addition, cocaine abuse can lead to the development of ischemic colitis, which is inflammation and injury of the large intestine; this can cause serious digestive problems and even lead to death.
  • Liver damage: Long-term cocaine abuse means higher risk of overdose, and cocaine overdose can lead to liver injury, as the body is flooded with toxins that the liver cannot filter out. While most damage to the liver resolves if the person recovers from the overdose or if they get help ending their cocaine addiction, there have been instances of death due to acute liver damage. Chronic liver damage is less likely, unless the person mixed cocaine and alcohol, which can cause the liver to produce cocaethylene, which increases the depressive effects of alcohol, increases aggression, stresses the heart, and damages the liver.
  • Kidney damage: Chronic cocaine abuse can damage the kidneys in two ways. First, permanently increased blood pressure leads to kidney damage due to loss of blood flow. While many organ systems are damaged through lack of oxygen and high blood pressure, the kidneys are especially susceptible. Second, long-term cocaine abuse causes rhabdomyolysis, or the destruction of skeletal muscles; as these muscles die, toxins are released into the body, and they flood the liver and kidneys. Kidney failure is a late-stage result of rhabdomyolysis.
  • Infectious diseases: People who struggle with cocaine and crack cocaine addiction are more likely to contract several infectious diseases, including HIV and hepatitis. Sometimes, this is because of needle-sharing; however, more often, the intense stimulant contributes to poor decision-making, increased risk-taking, and enhanced sexual drive, which can lead to risky sexual encounters. Additionally, cocaine abuse impairs the immune system, so diseases spread rapidly through the body.

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