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Long-Term Effects of Cocaine

Cocaine is a powerful, stimulant drug which is under Schedule II due to its high potential for addiction and abuse. Rates of cocaine consumption have been stable since 2014, when 1.5 million people over the age of 12 reported past month cocaine use; however, the Monitoring the Future Survey (which looks at drug use trends among 8th, 10th, and 12th graders) has found that, after a peak in the 1990s, that powdered cocaine use has declined dramatically among this particular population.1

Cocaine Effects on the Body

Using cocaine over the long term can affect people across multiple body systems and lead to a wide range of health problems, including the following:

Cardiovascular System

Chronic cocaine use can lead to a number of severe cardiac issues, some of which can be fatal.Chronic cocaine use can lead to a number of severe cardiac issues, some of which can be fatal.2-5 These issues can include:

  • Chest pain (angina).
  • Increased heart rate and blood pressure.
  • Narrowing of the coronary arteries, which decreases blood flow to the heart.
  • Heart attacks (myocardial infarction).
  • Irregular heartbeat (arrhythmia).
  • Heart muscle dysfunction (cardiomyopathy).
  • Inflammation of the heart muscle (myocarditis).
  • An often fatal infection of the heart valve (endocarditis).
  • Bleeding in the wall of the body’s main artery, the aorta (aortic dissection).
  • Sudden death.

Central Nervous System

The brain, as well as the heart, can also suffer severe damage from cocaine use.The brain, as well as the heart, can also suffer severe damage from cocaine use.5-8 Users can experience any of the following issues:

  • Severe headaches.
  • Seizures.
  • Narrowing of blood vessels to the brain.
  • Strokes due to bleeding or oxygen depletion (known as hemorrhagic or ischemic strokes).
  • Deterioration of brain structure and function.
  • Rupture of aneurysms, which can be fatal.
  • Movement disorders such as Parkinson’s disease.

Other Bodily Systems Effected by Cocaine

Apart from the cardiac and central nervous systems, cocaine use can have a wide and negative impact on many other systems in the body, including the respiratory, renal, hepatic, reproductive, and dermal systems.2,6-13

Respiratory System

Cocaine has the potential to damage nearly ever part of the respiratory system.Cocaine has the potential to damage nearly ever part of the respiratory system. Cocaine users can suffer from the following:

  • Chronic nasal congestion and sinus inflammation.
  • Foreign body aspiration (inhaling an object into the lungs).
  • Respiratory infection.
  • Shortness of breath, wheezing and coughing (due to bronchoconstriction).
  • Coughing up blood (hemoptysis).
  • Perforation of the nasal septum.
  • Pneumothorax (collapsed lung).

Hepatic and Renal Systems

The liver and kidney act as some of the main filters in the body and can also suffer from exposure to cocaine. Use leads to problems such as:

  • Infection of the liver (viral hepatitis in association with injection use).
  • End-stage renal disease.
  • Chronic renal failure.
  • Decreased kidney function.

Gastrointestinal System

Cocaine can cause a wide variety of gastrointestinal problems. These can include:

  • Malnutrition, due to the fact that cocaine acts as an appetite suppressant.
  • Ulcers.
  • Motility problems (impaired movement of GI tract contents).
  • Mesenteric vasospasm.
  • Perforation of intestines or stomach.

Reproductive System

Despite the fact that cocaine has a reputation for enhancing sexual performance, research has not supported this myth. Sexual and reproductive problems can also result from chronic cocaine use as well; this can include:

  • Irregular periods.
  • Decreased sexual response in both male and female subjects.
  • Sexual dysfunction.

Dermal System

There are a variety of skin problems associated with cocaine use. These include:

  • Vascular problems.
  • Skin lesions.
  • Scarring from intravenous drug use.

Health Problems Related to Particular Routes of Cocaine Use

Some health effects will depend on the way cocaine is used (i.e., the route of administration). There is a difference, for instance, in issues related to intravenous and oral use.13

Intravenous Use

Injecting cocaine intravenously results in a number of risks.Injecting cocaine intravenously results in a number of risks, including:

  • Scars on the arms or at other injection sites, sometimes called “track marks.”
  • Serious, system-wide allergic reactions that can sometimes be fatal.
  • Bloodborne diseases such as HIV and hepatitis.

Nasal Use

Snorting cocaine can lead to a number of long-term problems in the nose and throat, such as:

  • Losing one’s sense of smell, a condition called anosmia.
  • Chronic nosebleeds, which can be serious enough to emergency surgery.
  • Nose infection.
  • Chronic runny nose.
  • Nasopharyngeal mucosal inflammation.
  • Ulcers in the nose.
  • Nasal septum perforation.
  • Hoarseness of the throat.
  • Difficulty swallowing.

Oral Use

Ingesting cocaine over the long term can lead to a higher risk of bowel tissue necrosis (the death of bowel tissue). This is because cocaine severely decreases blood flow to the bowels themselves.

Consequences of Mixing Cocaine with Other Substances

Many people mix cocaine with other substances which can potentially compound the inherent dangers of both drugs and worsen the long-term health outcomes from the combination of substances.

Many people mix cocaine with other substances which can potentially compound the inherent dangers of both drugs and worsen the long-term health outcomes from the combination of substances. Frequently, cocaine is mixed with substances like alcohol, heroic, amphetamines, and prescription opioids, with the following consequences:14-17

Cocaine and Alcohol

Mixing alcohol with cocaine can result in abnormal heart rhythms and increase cocaine levels in the blood due to changes in cocaine metabolism in the presence of ethanol. It can also lead to an increased tendency toward violent behavior and the formation of a heart-toxic metabolite called cocathylene.

Cocaine and Heroin

The combination of cocaine and heroin can cause wheezing, irregular heartbeat, and sudden death. This combination is known as a “speedball” and caused the death of actor River Phoenix in 1993.

Cocaine and Prescription Opioids

When used in combination with cocaine, opioids such as oxycodone or hydrocodone can lead to breathing problems, coma, and death.

Cocaine and Amphetamines

Using both cocaine and amphetamines can lead to a heightened stimulant effect as well as problems including hypertension, tachycardia, hyperthermia, stroke, cardiac arrest, and death.

Cocaine and Mental Health

Apart from the severe physical consequences of cocaine use, this drug can lead to a variety of mental health problems as well.12,18 This includes:

  • Delirium, a potentially fatal state characterized by severe confusion and instability of the autonomic nervous system.
  • Psychosis, a condition characterized by problems like hallucinations and paranoid delusions.
  • Mood disorders such as anxiety, depression, suicidal thoughts, or behaviors.
  • Sleep disorders such as insomnia.
  • Decreased cognition.
  • Paranoia, an extreme suspicion of others.
  • Violent behaviors sometimes leading to injury or death.

Cocaine’s Effect on Maternal and Infant Outcomes

Prenatal Cocaine Use

The largest portion of female cocaine users are of reproductive age, and it is estimated that 750,000 cocaine-exposed babies are born in the United States annually. Cocaine use during pregnancy is associated with a wide variety of negative outcomes for both mother and baby.1

Women who use cocaine while pregnant are at a higher risk for:

  • Seizures.
  • Severe headaches.
  • Dangerously high blood pressure (known as a hypertensive crisis).
  • Early and/or difficult delivery.
  • Uterine problems such as rupture or placental abruption.
  • Spontaneous abortion (miscarriage).

For babies who are exposed to cocaine in utero, there are also a wide variety of both short- and long-term issues, such as:

  • Early birth.
  • Reduced length and birth weight.
  • Reduced head circumference.
  • Emotional/behavior issues.
  • Cognitive deficits such as difficulty with self-regulation and task focus.

Social Consequences of Cocaine Use

In addition to the variety of negative impacts on physical and mental health, there are a number of serious social consequences associated with cocaine use.19,20 These include:

  • Social isolation.
  • Breaking of commonly accepted social rules.
  • A decreased emotional response to interactions with others.
  • The valuing of drug use over positive behaviors such as financial responsibility or maintaining a healthy lifestyle.

Researchers note that “social interaction deficits in drug users likely impede treatment, increase the burden of affected families and consequently contribute to the high costs for society associated with addiction.”19

How Cocaine Dependence Develops

Scientists believe that addiction is “a complex disease process of the brain that results from receiving drug intoxication and is modulated by genetic, developmental, experiential, and environmental factors.”21

Research also shows that addiction physically changes the structure of the brain, specifically reducing the frontal cortex, which is known for its executive functions like self-control.

It is believed that dopamine plays a vital part in the underlying processes of addiction; drugs like cocaine lead to an increase in dopamine activity and this can lead to reinforcement of the drug taking as dopamine is associated with feelings of pleasure. However, research also shows that addiction physically changes the structure of the brain, specifically reducing the frontal cortex, which is known for its executive functions like self-control. Reduction of the frontal cortex, then, can lead to behaviors that are otherwise closely regulated.21

Treatment for Cocaine Addiction

When you have decided that continued cocaine use is too destructive to continue, we are here to help walk you through your addiction treatment options.

As you begin exploring your options, you’ll find that addiction rehabilitation facilities can look a bit different, depending on where you to choose to go:

  1. Luxury rehab facilities offer 24/7 residential addiction treatment alongside a wide array of lavish, resort-like amenities designed to help make your recovery process as comfortable as possible.
  2. Executive rehab facilities are very similar to luxury facilities except that they also offer busy professionals the opportunity to maintain an active involvement in the workplace throughout the recovery process.
  3. Standard rehab facilities offer quality addiction treatment on either a residential (inpatient) or a non-residential (outpatient) basis. While these facilities don’t offer as many plush amenities as do luxury or executive programs, they also come with a lower price tag—offering a more affordable option to those individuals who need it.


  1. National Institute on Drug Abuse. (2016). What is cocaine?
  2. McCord, J., Jneid, H., Hollander, J. E., de Lemos, J. A., Cercek, B., Hsue, P.,…Newby, L.K. (2008). Management of Cocaine-Associated Chest Pain and Myocardial Infarction: A Scientific Statement From the American Heart Association Acute Cardiac Care Committee of the Council on Clinical Cardiology. Circulation, 117(14), 1897-1907.
  3. Lange, R. A., Hillis, L. D. (2001). Cardiovascular Complications of Cocaine Use. N Engl J Med, 345(5), 351-358.
  4. Ghuran, A., Nolan, J. (2000). Recreational drug misuse: issues for the cardiologist. Heart, 83(6), 627-633.
  5. Eagle, K. A., Isselbacher, E. M., DeSanctis, R. W. (2002). Cocaine-Related Aortic Dissection in Perspective. Circulation, 105:1529-1530.
  6. Boghdadi, M. S., Henning, R. J. (1997). Cocaine: pathophysiology and clinical toxicology. Heart Lung 26(6), 466-483.
  7. Neiman, J., Haapaniemi, H. M., Hillbom, M. (2000). Neurological complications of drug abuse: pathophysiological mechanisms. Eur J Neurol, 7(6), 595-606.
  8. Rojas, R., Riascos, R., Vargas, D., Cuellar, H., Borne, J. (2005). Neuroimaging in drug and substance abuse part I: cocaine, cannabis, and ecstasy. Top Magn Reson Imaging, 16(3), 231238.
  9. Warner, E. A. (1993). Cocaine abuse. Ann Intern Med, 119(3), 226-235.
  10. Tseng, W., Sutter, M. E., Albertson, T. E. (2014). Stimulants and the lung: review of literature. Clin Rev Allergy Immunol, 46(1), 82-100.
  11. Macdonald, P. T., Waldorf, D., Reinarman, C., Murhpy, S. (1988). Heavy Cocaine Use and Sexual Behavior. J Drug Issues, 18, 437-455.
  12. Palha, A. P., Esteves, M. (2008). Drugs of abuse and sexual functioning. Adv Psychosom Med, 29: 131-149.
  13. National Institute on Drug Abuse. (2018). DrugFacts: What is cocaine?
  14. Pennings, E. J., Leccese, A. P., Wolff, F. A. (2002). Effects of concurrent use of alcohol and cocaine. Addiction, 97(7), 773-783.
  15. Lipman, J. J. (1997). Recent Forensic Pharmacological Developments in Drug Abuse: The Growth and Problems of Speedballing. The Forensic Examiner, Jul-Aug 1997: 9-13.
  16. Ciavarri, A. (2015). RPD: Combination of cocaine and fentanyl cause at least three deaths. WHEC Rochester News, 27 March 2015.
  17. Sobic, E.M. (2004). Cocaine and amphetamine combined. BMJ, 328(7452), 1365.
  18. Morton, W. A. (1999). Cocaine and Psychiatric Symptoms. Prim Care Companion J Clin Psychiatry, 1(4), 109-113.
  19. Verdejo-Garcia, A. (2014). Social Cognition in Cocaine Addiction. Proc Natl Acad Sci U S A, 111(7):2406-2407.
  20. Preller, K.H., Herdener, M., Schillbach, L., Stampfli, P., Hulka, L.M., Vonmoos, M.. Quednow, B.B. (2014). Functional Changes of the Reward System Underlie Blunted Social Response in Cocaine Users. Proc Natl Acad Sci U S A, 111(7), 2842-2847.
  21. Goldstein, R.Z., Volkow, N.D.  Drug Addiction and Its Underlying Neurobiological Basis: Neuroimaging Evidence for the Involvement of the Frontal Cortex. Am J Psychiatry, 159(10), 1642-1652.

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