In addition to the increased risk for stroke and seizures, other neurological problems can occur with long-term cocaine use. 7, 20 Cocaine use is linked with increased risk of stroke, 16 as well as inflammation of the heart muscle, deterioration of the ability of the heart to contract, and aortic ruptures. 7, 16, 20 Chest pain that feels like a heart attack is common and sends many cocaine users to the emergency room. Cocaine has significant and well-recognized toxic effects on the heart and cardiovascular system.
7 Many chronic cocaine users lose their appetite and experience significant weight loss and malnourishment. It reduces blood flow in the gastrointestinal tract, which can lead to tears and ulcerations. They also may experience allergic reactions, either to the drug itself or to additives in cocaine, which in severe cases can result in death.Ĭocaine damages many other organs in the body. 2, 3 People who inject cocaine have puncture marks called tracks, most commonly in their forearms, 7 and they are at risk of contracting infectious diseases like HIV and hepatitis C (see " Why Are Cocaine Users at Risk for Contracting HIV and Hepatitis?"). 15 Smoking crack cocaine damages the lungs and can worsen asthma. Regularly snorting cocaine can lead to loss of sense of smell, nosebleeds, problems with swallowing, hoarseness, and an overall irritation of the nasal septum leading to a chronically inflamed, runny nose. Specific routes of cocaine administration can produce their own adverse effects. 19 Thus, binge use of cocaine during adolescence may further increase vulnerability to continued use of the drug among some people. 2, 7 Animal research suggests that binging on cocaine during adolescence enhances sensitivity to the rewarding effects of cocaine and MDMA (Ecstasy or Molly). 2 With increasing doses or higher frequency of use, the risk of adverse psychological or physiological effects increases.
This can lead to increased irritability, restlessness, panic attacks, paranoia, and even a full-blown psychosis, in which the individual loses touch with reality and experiences auditory hallucinations. Users take cocaine in binges, in which cocaine is used repeatedly and at increasingly higher doses.
7 Tolerance to cocaine reward and sensitization to cocaine toxicity can increase the risk of overdose in a regular user. 10, 18 At the same time, users can also develop sensitization, in which less cocaine is needed to produce anxiety, convulsions, or other toxic effects. With regular use, tolerance may develop so that higher doses, more frequent use of cocaine, or both are needed to produce the same level of pleasure and relief from withdrawal experienced initially. These combined effects make the user more likely to focus on seeking the drug instead of relationships, food, or other natural rewards. At the same time, circuits involved in stress become increasingly sensitive, leading to increased displeasure and negative moods when not taking the drug, which are signs of withdrawal. With repeated exposure to cocaine, the brain starts to adapt so that the reward pathway becomes less sensitive to natural reinforcers 10, 18 (see " What Are Some Ways that Cocaine Changes the Brain?").
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