How Cocaine Affects the Body

What Does Cocaine Do to the Body?

How Cocaine Works

Cocaine stimulates the brain’s reward pathway – the mesolimbic dopamine system –which also responds to food, sex, and other pleasurable stimuli.[2] When someone takes cocaine, it can change the way dopamine neurons in a certain area of the brain (called the ventral tegmental area) react to incoming signals, which can then lead to changes in the neural connections in this part of the brain. These changes can ultimately influence how someone’s behavior is affected by drug use.[3]

The brain’s typical communication process releases dopamine from neurons into the synapse – a gap between two neurons – where it can bind to dopamine receptors. It acts as a messenger delivering information from neuron to neuron before being removed by a dopamine transporter and recycled for future use.[4]

Drugs like cocaine disrupt the communication process in the brain by blocking the dopamine transporter, causing an increase in dopamine levels. This leads to heightened dopamine signaling and a release of reserve dopamine vesicles, enhancing its stimulating effects.[5]

Immediate Effects on the Body

Cocaine is a fast-acting drug with effects that appear almost immediately after the first dose. The high is intense but can fade within a few minutes to an hour.

The duration of the euphoric effects depends on how cocaine is used. Methods with faster absorption, such as injecting cocaine or smoking crack cocaine, have an immediate, potent high that’s short-lived.[6] Snorting cocaine has a slower onset, but the effects can last up to 30 minutes or longer.

Cocaine has powerful stimulant effects on the body, constricting the blood vessels and raising the heart rate, blood pressure, and body temperature quickly. This makes the person feel alert and energetic but can cause erratic or violent behavior.[7] Some people experience adverse psychological effects like irritability, panic, and paranoia.

Long-Term Effects on the Body

Chronic cocaine use conditions the brain’s reward pathway to the drug itself rather than natural pleasurable stimuli like food or sex.[8] Then, when cocaine isn’t present, the circuits involved in stress become overly sensitive and lead to bad moods and withdrawal symptoms. As cocaine use is reinforced, the person ignores other natural rewards in search of the drug.

Over time, cocaine use builds tolerance, meaning higher and higher doses or more frequent doses are needed to achieve the same level of pleasure.[9] Though people become less sensitive to the euphoric effects of the drug, they also become more sensitive to some of the adverse effects, like anxiety or convulsions. Together, these two effects can increase the risk of overdose.

Cocaine’s intense effects encourage binging, which is when cocaine is used in repeated cycles and higher doses. Tolerance builds quickly, as does the likelihood of irritability, panic attacks, paranoia, and psychosis.[10]

Why Is Cocaine Dangerous?

Though often thought of as safe, cocaine is an extremely dangerous drug that can cause a range of complications in health and life, including heart rhythm disorders, heart attacks, neurological issues, seizures, strokes, coma, and drug addiction.[11]

How dangerous is cocaine? In rare cases, sudden death can occur from the first use of cocaine or shortly after.[12] Usually, this is caused by cardiac arrest or seizures, which are risks with any level of cocaine use.

Cocaine is even more dangerous when it’s combined with other substances, especially opioids or alcohol. Mixing a stimulant like cocaine with a depressant like alcohol or opioids can mask the effects of each drug. Instead, the effects can mask each other, leading people to take higher amounts and overdose.[13]

Cocaine Addiction and Treatment

Along with the physical effects on the body, cocaine abuse and addiction can significantly impact your quality of life, mental health, and interpersonal relationships. As the addiction becomes more severe, you may find yourself struggling to keep up with responsibilities, withdrawing from social situations, or even getting into trouble with the law.

Cocaine use has indirect risks as well, such as engaging in reckless behavior that could lead to injury, illness, or death. For example, driving a vehicle under the influence can cause a collision, and sharing needles or having risky sex could contribute to bloodborne illnesses like HIV or hepatitis.

If you or a loved one is struggling with cocaine abuse or addiction, help is available. Addiction treatment is tailored to your needs but may include medical detox and inpatient or outpatient treatment in a rehab facility.
Regardless of your path, evidence-based behavioral therapies are often involved. Combined with traditional therapies like individual and group counseling or 12-step programs, behavioral therapies are highly effective for treating cocaine addiction.

One of the leading therapies is cognitive behavioral therapy (CBT). This evidence-based therapy focuses on awareness of unhelpful thoughts and behaviors that contribute to drug use and develops coping strategies to correct them.[14]