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Short and Long-Term Effects of Cocaine Use and Addiction

3 min read · 5 sections

Cocaine is a highly addictive stimulant and a Schedule II drug that’s widely used in the U.S. and elsewhere.1 In fact, according to the 2021 National Survey on Drug Use and Health, more than 4.8 million people aged 12 and older used cocaine in the past year, with 996,000 of those people using crack, a form of cocaine.2

Cocaine is typically used in two forms—powdered (e.g., cocaine hydrochloride), which is often snorted, and solid or “rock” form (e.g., crack and freebase), which is typically smoked.3 Regardless of the form, cocaine has both short-term effects and consequences of long-term use, as it can impact a person’s health and lead to overdose, tolerance, dependence, and addiction.1

This page provides a deep dive into the various short-term effects and potential long-term health risks of cocaine use. Plus, it offers treatment options if you or a loved one is struggling with cocaine use.

Short-Term Effects of Cocaine

So how does cocaine produce its high and why is it so addictive? Dopamine is related to the control of movement and reward, and cocaine increases the activity of dopamine in the brain. It also enhances the activity of norepinephrine, which serves multiple brain functions, including arousal, attention, mood, learning, memory, and stress response.4

As a result, even relatively small doses lead to feelings of euphoria, mental alertness, and increased energy, along with hypersensitivity to touch, sound, and sight.1 Cocaine’s impact on dopamine can also reinforce drug-taking behavior.1,4

After a single dose, cocaine effects occur almost immediately and disappear quickly, anywhere from a few minutes to an hour depending on the dose and the way it was taken.1 Cocaine constricts the blood vessels, dilates the pupils, and increases heart rate, blood pressure, and body temperature. In addition to the high commonly associated with cocaine, it also makes a person more energetic and alert.1,4

Additional short-term effects of cocaine can include:1,4

  • Restlessness/irritability.
  • Anxiety/paranoia.
  • Tremors/muscle twitches.
  • Vertigo.

Other potential short-term effects include panic attacks, psychosis, heart-rhythm disturbances, and violent, erratic, and bizarre behavior. Some of the aforementioned effects are more likely to occur as a result of sensitization or at higher doses, as a person tries to intensify their high. However, certain cardiovascular effects can also occur with somewhat isolated use. That is, any amount of cocaine taken at any time has the potential to cause sudden death via a stroke, heart attack, seizure, etc.1

Cocaine Effects Related to the Cardiovascular System

Cocaine use can also impact the cardiovascular system, leading to both chronic and acute conditions.5 Through a variety of mechanisms, cocaine use can increase the risk of conditions such as:5,6

  • Acute hypertension and coronary spasm.
  • Arrhythmia.
  • Aortic dissection.
  • Endocarditis.
  • Heart attack.
  • Cardiomyopathy.
  • Atherosclerosis.
  • Coronary artery disease.

Effects and Risks of Long-Term Cocaine Use

When a person continues to use cocaine over time, the brain eventually adapts to the presence of the drug. Ultimately, tolerance can develop, which means the person needs higher and more frequent doses to achieve the same effects.1 Furthermore, cocaine has a high potential for abuse and may lead to severe physical or psychological dependence as well as significant withdrawal symptoms (e.g., depression, fatigue, slowed thinking, increased appetite, unpleasant dreams, and insomnia).4,5

Additionally, long-term cocaine use can increase the risk of the following conditions, among others:1,7,8

  • Appetite and nutrition changes, malnutrition.
  • Gastrointestinal issues (e.g., ulcers and tears caused by reduced blood flow).
  • Liver and kidney damage.

Cocaine Use During Pregnancy

Cocaine use during pregnancy can also lead to the following:1

  • Migraines.
  • Premature membrane rupture.
  • Seizures.
  • Separation of the placental lining of the uterus prior to delivery.
  • High blood pressure.
  • Preterm labor.
  • Difficult delivery.
  • Hypertensive crises.
  • Spontaneous miscarriage.

Route of Cocaine Exposure and Associated Health Risks

The way in which a person uses cocaine is also associated with short- and long-term health risks.

Snorting. Among people who snort cocaine, more than half have some type of complication such as intranasal crusting, chronic sinusitis, and/or recurrent nosebleeds.9

Other snorting-related conditions include:4,10

  • Loss of smell and
  • Problems swallowing.
  • Lung injury.
  • Barotrauma, which is physical damage to body tissues caused by a pressure-related change in body compartment gas volume (such as the pressure inside the lung vs. the surrounding fluid).

There are several cases where snorting cocaine has led to pneumothorax (i.e., a collapsed lung), emphysema, and pneumomediastinum (which is air in the chest between the lungs and around the heart).10

Oral Ingestion. Using cocaine orally can lead to mouth sores. And while not necessarily tied to oral ingestion, dental treatment may be complicated by the use of cocaine. After recent cocaine use, cocaine can interact with dental anesthesia and can result in increased blood pressure.9

Smoking. Smoking crack cocaine may:4

  • Worsen asthma and
  • Lead to chronic cough.
  • Cause respiratory distress.
  • Increase the risk of pneumonia and other infections.

Additionally, it can lead to an acute pulmonary complication known as crack lung, which includes symptoms such as:11-13

  • Fever.
  • Cough.
  • Difficult or labored breathing
  • Hemoptysis (i.e., coughing up blood from the lower respiratory tract), which may progress to respiratory failure.
  • Thermal airway injuries.
  • Lung injury
  • Pulmonary edema.
  • Barotrauma caused by spasmodic or violent coughing after smoke inhalation.

Injecting. Intravenous cocaine use is related to a host of complications that include skin or soft-tissue infections, scarring or collapsed veins, and a higher risk of blood-borne infections such as HIV and hepatitis.4

Treatment for Cocaine Misuse and Addiction

Cocaine’s effects can be serious—not to mention scary. However, if you or someone you love is struggling with cocaine addiction, you’re not alone. Plus, treatment, which comprises a variety of formats and therapies to fit your unique needs, is available.

Depending on several individual variables and the severity of the stimulant use disorder, treatment can include one or more levels of care. But often, people begin treatment for cocaine addiction with detox and withdrawal management.14

However, completing detox is just the first step in the road to recovery. After detox, it’s important to seek ongoing inpatient and/or outpatient treatment, both of which offer behavioral interventions to help conquer addiction.15 American Addiction Centers provides a host of treatment programs, including everything from intensive outpatient programs and inpatient medical detox to one-on-one counseling and aftercare programs.


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