Medically Reviewed

Dangers of Smoking, Snorting, and Injecting Cocaine

Cocaine is an illegal stimulant drug with a high potential for abuse. People typically use cocaine by smoking, snorting, or injecting it to experience the drug’s stimulant effects, such as increased mental alertness and euphoria. Unfortunately, cocaine can potentially bring about short-term and long-term health risks to a user that are not only caused by the drug’s typical mechanisms, but also the user’s method of administration.1,2

If you or a loved one are suffering from cocaine addiction, therapeutic interventions such as inpatient and outpatient cocaine treatment can help someone quit cocaine and return to a healthy lifestyle. Otherwise, read on to learn more about the dangers of smoking, snorting, and injecting cocaine and how you can help you or your loved one .

Dangers of Smoking Cocaine

Someone who smokes cocaine may experience an almost-instantaneous high that is more intense than the high they’d experience through snorting a powder form of cocaine. This rapid and concentrated effect can make smoking cocaine a more alluring method of consumption and account for some of the reasons why people may choose this method of cocaine use.6

When someone buys cocaine on the street, it comes in a white powdery substance that isn’t easily smoked without first changing its formula and consistency. This can be done in one of two ways — freebasing cocaine or smoking crack cocaine.8

Freebasing cocaine involves a lengthy, and potentially dangerous, extraction process that eventually results in a purified and very potent form of cocaine.Crack cocaine does not involve a purification process and is usually less pure carrying along with it any additives and dilutants alongside as a result, with only about 40% (on average) of it being pure.8

After inhaling the smoke from crack cocaine, it only takes about 10-15 seconds before someone experiences an intense rush of euphoria. Someone may experience certain respiratory side effects within minutes or hours after smoking cocaine: 9

  • Cough.
  • Shortness of breath.
  • Wheezing.
  • Chest pain.
  • Hemoptysis.
  • Exacerbation of asthma.
  • Pulmonary edema.
  • Pneumothorax.
  • Pulmonary hemorrhage.
  • Pneumomediastinum.
  • Thermal airway injury.

There are potentially some long-term complications associated with smoking cocaine, too. Various respiratory issues are associated with chronic cocaine smoking, such as a chronic cough with chest pain and blackened sputum (blackened phlegm). Some people may even experience lung scarring and reduced lung capacity, making it difficult for some people to breathe normally.

Dangers of Snorting Cocaine

If someone snorts cocaine, they risk irreversible damage to their nose, mouth and throat. Snorting cocaine can cause severe tissue and bone degeneration, which may result in a perforation of the nasal septum, which is the divider between the two nostrils, or perforations in the roof of the mouth. Other potential risks include.3

  • Loss of smell.
  • Frequent nosebleeds.
  • Chronic runny nose.
  • Difficulty swallowing.
  • Sores, lesions, and ulcers in the nose and throat.

Dangers of Injecting Cocaine

Injecting cocaine involves dissolving the powdery substance with water, then injecting it into a vein. Intravenous injection allows for the drug to be absorbed into the system quickly, providing an almost immediate high.two people share a needle of cocaine.

When someone injects themselves with cocaine, they put themselves at increased risk for blood-borne diseases, such as hepatitis C and HIV/AIDS. Many people who use drugs share needles, a primary method of spreading HIV/AIDS and hepatitis C.9

Contracting IV-related diseases and infections are not the only dangers of injecting cocaine. There is a risk for vein collapse, scarring, and soft tissue infections, too.10

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Recognizing the Signs of Addiction

No matter how someone uses cocaine, they risk developing an addiction to this substance. Troubling signs that indicate a person may be suffering from or developing a cocaine addiction include: 10

  • Unusual paranoia.
  • Changes in sleep or eating patterns.
  • Agitated or edgy mood.
  • Continual runny nose.
  • Going through times of extreme depression.
  • Frequent upper respiratory infections.
  • Loss of interest in things usually enjoyed.
  • Experiencing visual or auditory hallucinations.
  • Going through large amounts of money or having large amounts of cash without explanation.
  • Lack of care for personal hygiene.
  • Weight loss.

If you recognize these signs in yourself or someone you love, reach out for help immediately. With the proper treatment, you can begin the journey to healing and vacate from a life ruled by cocaine use. Although first step may be difficult, with effective, evidence-based treatment you can overcome a cocaine addiction and live a healthier, better life.

Risks of All Cocaine Use

Cocaine, no matter how someone ingests it, may induce changes in a person’s brain that encourage repetitive use and can lead to addiction.11 In fact, evidence suggests that up to one in six persons who use cocaine will develop a moderate or severe stimulant use disorder. Heavier use through smoking and injection is more heavily associated with developing a stimulant use disorder than lighter use, or use the intranasal and oral pathways.12

Other short-term and long-term health risks to associated with chronic cocaine use that extend long after a person stops using include:4,12,13

  • Cognitive impairment.
  • Persisting intermittent psychosis.
  • Seizures (even in those without a preexisting seizure disorder).
  • Irregular heartbeat (cardiac arrhythmia).
  • Organ ischemia or infarction, which can result in kidney failure, gastrointestinal issues, and liver damage.
  • Skin and muscle vasculitis and lesions.

Though the dangers of cocaine use alone are dangerous, analyzing risk for a person’s cocaine use is incomplete without the full examination of their method of use. Heavier users and those who inject or smoke cocaine are more likely to become addicted than lighter users or those who snort or ingest cocaine orally.12 Although any cocaine use carries with it  a risk of addiction as well as neurological and cardiovascular complications, each manner of ingestion has its own associated and unique health risks.


  1. Foundation for a Drug Free World. (2020). Cocaine.
  2. National Institute on Drug Abuse. (2016). What is Cocaine?
  3. National Institute on Drug Abuse. (2018). Cocaine DrugFacts What is Cocaine?
  4. National Institute on Drug Abuse. (2018). What are the long term effects of cocaine use?
  5. National Institute on Drug Abuse. (2016). How does cocaine produce its effects?
  6. Kiluk, B. D., Babuscio, T. A., Nich, C., & Carroll, K. M. (2013). Smokers versus snorters: do treatment outcomes differ according to route of cocaine administration? Experimental and clinical psychopharmacology21(6), 490–498.
  7. Forensic Research & Criminology International Journal. (2019). Crack cocaine, a systematic literature review.
  8. Fukushima, A.R., Corrêa, L.T., Peña Muñoz, J.W., Lopes Ricci, E., Martins Carvalho, V., Gonçalves de Carvalho, D…. Aparecida da Matta Chasin, A. (2019). Crack Cocaine, A Systematic Literature Review. Forensic Research & Criminology International Journal, 7(5).
  9. National Institute on Drug Abuse. (2016). Why are Cocaine Users at Risk for Contracting HIV/AIDS and Hepatitis?
  10. Cleveland Clinic. (2019). Cocaine (Crack) Addiction.
  11. University of Cambridge. (2012). Chronic cocaine use may speed up aging of brain.
  12. Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine, Sixth Edition. Philadelphia: Wolters Kluwer. Qureshi AI, Suri MF, Guterman LR, Hopkins LN. Cocaine use and the likelihood of nonfatal myocardial infarction and stroke: data from the Third National Health and Nutrition Examination Survey. Circulation. 2001;103(4):502-506
Last Updated on Sep 14, 2022
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