Cocaine: Effects, Health Risks, Overdose and Addiction

Cocaine is a very addictive drug made from the leaves of the coca plant of South America. It is mostly sold illegally and used to get high; rarely, it is used as a prescription anesthetic during certain surgeries.

Forms and use

As a street drug, cocaine is usually a fine, white, crystalline powder. Dealers sometimes cut it with cornstarch, talcum powder or flour to stretch their supply and make more money, or mix it with other illegal drugs. Crack cocaine has been heated into a rock crystal.

People snort the powder or rub it on their gums, dissolve it and inject it — sometimes combined with heroin as a “speedball” — or smoke crack.

Short-term effects

Cocaine is a stimulant. It can make people feel energetic and extra alert, but also restless, irritable, anxious and paranoid, and large amounts can lead to bizarre, unpredictable and violent behavior. Its effects begin almost immediately and fade within minutes to an hour, depending on how it was taken. It can cause a heart attack, stroke or coma.

Long-term effects

The damage depends on how the drug is used:

• Snorting — loss of smell, nosebleeds, nasal damage and trouble swallowing.
• Smoking — cough, asthma, trouble breathing and a higher risk of infections such as pneumonia.
• Injecting — skin and soft-tissue infections, scarring, collapsed veins that block blood flow, and a higher risk of HIV and hepatitis C.

Other long-term effects can include malnutrition and movement disorders, including Parkinson’s disease.

Tolerance, dependence and addiction

With repeated use, people develop tolerance, needing more for the same effect. At higher doses over time the body becomes dependent, and stopping brings withdrawal: depression, restlessness, fatigue, increased appetite, bad dreams and insomnia, and slowed thinking.

Repeated use can also lead to cocaine use disorder — addiction, which is more than physical dependence. It is a chronic brain disorder in which people keep using cocaine despite the problems it causes, from poor health to failing at work, school or home, until getting and using the drug becomes the main purpose of their lives.

Overdose

An overdose — using so much that it causes a life-threatening reaction or death — is possible, and mixing cocaine with other drugs or alcohol raises the risk. It can cause stroke, seizures, irregular heartbeat and heart attack. There is no specific medicine to reverse a cocaine overdose; health care providers treat the problems it causes.

Treatment

Cocaine use disorder is treated with behavioral therapies. There are no medicines that treat it.

Sources

Based on "Cocaine," MedlinePlus, National Library of Medicine, with information from the National Institute on Drug Abuse; a work of the United States government in the public domain.