Long-Term Effects of Cocaine Use

Cocaine is a central nervous system stimulant that causes an increase in heart rate, blood pressure, and body temperature, as well as a narrowing of the blood vessels throughout the body (vasoconstriction).[1]

With chronic use, cocaine can damage the cardiovascular system, leading to chronic high blood pressure (hypertension), an irregular heart rate (arrhythmia), or chest pain from the tightening of the blood vessels (angina).[2]

Cocaine use can also cause blood clots leading to a heart attack, stroke, deep vein thrombosis (DVT), or pulmonary embolism – all of which can be fatal.[3]

Snorting is a common method of use for cocaine. Over time, snorting cocaine can cause mucous membrane damage in the sinus cavities, throat, and upper respiratory system.[4] Cocaine constricts the blood vessels in the nasal lining, leading to death of the tissue, sores in the lining and septum, loss of supporting cartilage, scarring, and eventually, collapse of the nose, known as “cocaine nose.”[5]

As awful as this sounds, smoking crack cocaine produces more devastating respiratory effects. Smoking cocaine exposes the lungs directly to the drug and the other combustion materials, increasing the risk of complications like pulmonary hypertension, burning in the throat, emphysema, inflammation of the lungs (pneumonitis), chronic cough, respiratory distress, and an increased risk of infections like tuberculosis and pneumonia.[6]

Smoking crack cocaine is associated with eosinophilic pneumonitis, or “crack lung,” a condition that includes symptoms like:

• Pain
• Black sputum
• Cough
• Wheezing
• Increased white blood cells
• Elevated body temperature[7]

Long-term use of cocaine has a profound impact on the brain, including an increased risk for strokes and seizures. Years of cocaine use can increase the risk of bleeding in the brain or movement disorders like Parkinson’s disease.[8]
Along with the physical effects, cocaine impairs cognitive functions and mood. People who abuse cocaine over the long term may have impairments in memory, decision-making, motor function, attention span, and impulse inhibition.[9]

With cocaine binges, which is when cocaine is used repeatedly and at increasingly higher doses, people experience more irritability, restlessness, paranoia, panic attacks, and possible psychosis with hallucinations. As cocaine use increases, the risk of adverse psychological effects increases.

The long-term effects of cocaine on the cardiovascular system and reduced blood flow have wide-reaching effects on the rest of the body. Several organ systems, including the stomach and intestines, can be indirectly damaged over time.

The short-term effects of cocaine abuse may include reduced appetite, stomach pain, nausea, vomiting, and constipation. With chronic use, these effects can become more persistent and potentially lead to long-term gastrointestinal issues.

People who use cocaine are more likely to experience ulcers and develop conditions like ischemic colitis, which happens when blood flow is reduced to part of the large intestine. Without treatment, ischemic colitis can cause tissue damage or tissue death.[10]

The kidneys receive 20% to 25% of cardiac output to function properly.[11] Because cocaine restricts blood flow, chronic cocaine use can damage the kidneys.[12] Cocaine use can also cause muscle injury, including rhabdomyolysis, a breakdown of the muscle tissue.[13] With this condition, damaged muscles release proteins and electrolytes into the blood, damaging the heart and kidneys.