Cocaine and its Negative Side Effects
- Julie Myers, PsyD, MSCP
- Jul 31, 2022
- 2 min read
Updated: 6 days ago
As with other drugs, cocaine affects the nerve cells of the ventral segmental area, which extends into the nucleus accumbens, one of the reward centers of the brain. Cocaine acts as a reuptake inhibitor of dopamine, whose increased presence creates the euphoria associated with cocaine. The euphoric effects of cocaine are generally shorter acting than other drugs, lasting anywhere from a few minutes to a few hours, depending on the route of administration. Because of its short duration, it is not uncommon for users to administer repeated doses (“binging”.)
In the short-term with small amounts, cocaine acts similarly to amphetamines, making the user feel euphoric, energetic, talkative, and mentally alert. It dilates pupils and increases vital signs such as temperature, heart rate, and blood pressure. With larger doses, the user can experience tremors, vertigo, and twitches. A user may experience increasing irritability and restlessness. Bizarre, erratic, and violent behaviors are associated with cocaine. Chronic use can cause severe psychiatric symptoms, including anxiety, depression and psychosis. Full-blown psychosis may result with paranoia, hallucinations, and delusions.
Medical complications associated with cocaine use include cardiovascular effects. “Cocaine causes the blood vessels to thicken and constrict, reducing the flow of oxygen to the heart. At the same time, cocaine causes the heart muscle to work harder, leading to heart attack or stroke, even in healthy people” (CAMH, 2007.) It raises blood pressure, which can explode the weakened blood vessels in the brain. It may also cause abdominal pain, nausea, and blurred vision.
As with other drugs, the route of administration can produce different adverse effects. Snorting cocaine can cause nasal effects, including loss of sense of smell, nosebleeds, problems with swallowing, hoarseness, and an even a perforated nasal septum. Ingested cocaine can cause severe bowel gangrene, due to reduced blood flow. Smoking cocaine can cause “crack lung”, which includes severe chest pain and breathing problems.
When cocaine is mixed with alcohol, the two drugs are converted by the body to cocaethylene, a cocaine metabolite. Cocaethylene appears to have more cardiovascular toxicity and hepatoxity than either drug alone.
Even though a user becomes tolerant to cocaine, they may not become sensitized to its anesthetic and convulsant effect, which may explain some cocaine deaths. Overdose can cause seizures, heart failure, and arrest breathing. Withdrawal can include exhaustion, sleepiness or sleeplessness, hunger, irritability, depression. Cocaine has a small index of tolerability.
The bulk of the information for this article was taken from NIDA (2004, 2020) and CAMH (2007.) These resources offer a wealth of up-to-date information about the different drugs of abuse and are one of the first places to look for the most current information about any drug. I urge you to check out these resources for the latest information on addiction.
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Julie Myers, PsyD, MSCP
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