Most people are aware that cocaine is a highly addictive psychostimulant drug associated with increases in energy and feelings of euphoria. Cocaine functions by flooding the brain with the neurotransmitter dopamine, leading to feelings of pleasure and euphoria. Some consider the “crack” format of cocaine to be among the most addictive drugs in the world.
In the United States, cocaine is considered a “Schedule II” drug, meaning that it has a high potential for abuse and it’s only medical usage is as a topical anesthetic. Medical usage of cocaine is relatively rare, but recreational use of the drug is fairly common. Frequent partiers tend to seek out the drug for its ability to increase energy and confidence in social situations.
Although the drug is generally used by most on occasion, some individuals become addicted and use it often over a long-term. Without proper intervention, the long-term effects of cocaine can take a toll on a person’s brain function and physical health.
Factors the influence long-term effects of cocaine
Before getting to the long-term effects, it is important to highlight the fact that the effects a person experiences are often subject to individual variation. Two people could be using cocaine for the same amount of time, yet one may experience different effects than the other. Factors that account for differences include: exact duration of usage, frequency of usage, the format of cocaine, dosage, and other individual factors.
1. Time Span
The duration over which you’ve used cocaine may play a role in influencing the number and severity of long-term effects that you experience. If you’ve been using cocaine over an extremely long-term such as a decade, you’re more likely to experience unwanted effects than someone who has been using the drug for just a few years. That said, the frequency, format, and dosage also are important to consider.
2. Frequency of usage
How often have you used cocaine? Those that use the drug on a daily basis for a long-term are likely to end up with more severe long-term effects than someone who used the drug infrequently. Obviously the greater the frequency that you use the drug, the more likely you are going to end up with severe and prolonged long-term adverse effects.
Someone who uses the drug once a month isn’t likely going to suffer the same degree of impairment as someone who uses the drug four times a month. The more staggered the frequency, the less likely you will be to experience long-term effects.
3. Format + Administration
The type of cocaine that a person tends to use can play a role in the long-term effects that they experience. Snorting cocaine hydrochloride will not be as potent or addictive over the long-term as smoking freebase forms or “crack.” Those who use more potent formats of cocaine tend to end up with the most severe long-term problems.
- Cocaine hydrochloride: This is a white, powdery cocaine that is often insufflated (i.e. snorted) through the nose, but can be injected. This type of cocaine cannot be snorted simply because smoking will destroy its effect.
- Freebase cocaine: This is a type of cocaine that has been chemically altered. It is most commonly smoked and tends to make the user fee an instant “high.”
- Crack cocaine: This is a specific subtype of freebase cocaine that is in the format of “rocks” or “crystals.” Preferred method of administration is generally via smoking. This format involves the blending of baking soda and water or ammonia and water (or both). This removes the hydrochloride from the molecule, creating a more immediate “high.”
Smoking vs. Snorting
Smoking tends to reach the brain more quickly than snorting. When a person snorts cocaine, it needs to travel from the blood vessels in the nose to the heart, then needs to get pumped up to the lungs for oxygenation. Next the oxygenated blood makes its way back to the heart, and the heart pumps it out to the brain; resulting in the “high.”
When the cocaine is smoked, it travels a direct path from the lungs to the heart and then brain, leading to a seemingly immediate high. People like immediate gratification and/or elevation in dopamine because it gives them a rapid pleasure response. Hence the reason that smoking various forms of cocaine is more likely to lead to abuse, addiction, and ultimately more unwanted long-term effects.
4. Amount (Dosage)
The amount of cocaine that you administer each time you use it plays a role in determining how severe the long-term effects will be. If you frequently abuse the substance and are smoking large quantities, you’re going to likely end up with more long-term problems than someone who only snorted a small amount. Since people tend to develop quick tolerance to cocaine, it is possible to end up using high doses to achieve a “high.” Unfortunately the higher the dose used on a consistent basis, the greater the severity of long-term effects.
5. Individual variation
It is also important to acknowledge that individual variation plays a role in determining what a person will experience after long-term cocaine usage. Various factors that likely contribute to long-term effects include: age at which cocaine was used, diet, genetics, whether the person also used other drugs, stress level, exercise habits, sleep patterns, etc.
A younger person who abuses cocaine may find that it affects the development of their brain, particularly the prefrontal cortex over a long-term. Genetics may also dictate the degree to which you experience impairment after long-term cocaine usage. Some people may have favorable genetics and may not experience much of any health problems from their usage.
Long term Effects of Cocaine on the Brain
Below is a list of long-term effects that are associated with cocaine usage. Keep in mind that you may not experience all of these effects and that not all of them are well-documented in the scientific community. Also realize that individual variation will contribute significantly in determining what effects you experience.
- Accelerated brain aging: There is some preliminary evidence suggesting that cocaine may cause the brain to age at a quicker rate than average. This is in part due to significant losses in the amount of grey matter in important areas of the brain, but also due to functional deficits in various brain regions. Cocaine usage over the long-term can yield significant detrimental effects on the brain, increasing speed of neurodegeneration.
- Blood vessel damage: Some researchers believe that cocaine usage can contribute to blood vessel damage within the brain. The constriction of blood vessels within the brain can lead to increased susceptibility to experiencing a stroke. There also appears to be a significant drop in the overall speed of blood flow throughout the brain with increased cocaine usage.
- Cognitive deficits: Many people experience long-term cognitive impairment resulting from cocaine. This is due to the fact that dopamine levels drop and activity in the prefrontal cortex decreases. Peak cognition is heavily reliant on the prefrontal cortex for processing complex data, attention, and logic. When this region is impaired, a person may display classic signs of ADHD.
- Dependence: Many people become dependent on cocaine in order to function throughout the day. Once the brain has become tolerant to the drug, a person will continuously need more of it in order to maintain their same level of functioning. Should they attempt to go through cocaine withdrawal, symptoms may prove to be too severe to cope with. Over time, a person may become dependent on higher doses of the drug, leading to greater psychological damage.
- Dopamine levels: It is known that dopamine is involved in regulating attention, appetite, motivation, and a variety of other processes in the brain. Those that use cocaine can endure lasting changes to the levels of dopamine within the brain. Increased usage leads to dopamine deficiency, which can create problems such as attentional deficits, impulsivity, mood swings, brain fog, and cognitive impairment.
- Emotional dysfunction: It is extremely common to experience emotional disturbances over the long-term that stem from cocaine usage. Many of these emotional disturbances are associated with alterations in regional functioning within the brain as well as neurotransmitter changes. Fortunately most of these disturbances can be corrected if a person abstains from cocaine use for a prolonged period of time.
- Aggression: Some people become increasingly aggressive over the long-term. This is due to the fact that the brain is unable to handle much stress and becomes sensitized. You may find yourself lashing out at others in order to cope with the pent-up aggression that you feel.
- Anger: You may find yourself angry at the world as a result of cocaine use. The anger is believed to be due to changes in neurotransmitter levels as well as certain changes in regional functioning such as the prefrontal cortex.
- Anxiety: It is common for a person to develop extreme anxiety as a result of their cocaine habit. This may be a result of dopamine deficiency and/or an alteration in the way their brain processes fear-inducing stimuli.
- Apathy: When a person has severely decreased dopamine and prefrontal activity, they may become apathetic. This is characterized as a lack of caring about their situation and inability to summon up motivation to make changes.
- Depression: With decreased prefrontal activity as well as deficiency in the neurotransmitter dopamine, depression can become a long-term effect. This is why it is so important to consider dopamine vs. serotonin in depression among drug abusers as most who’ve abused psychostimulants likely have deficient dopamine production.
- Paranoia: Most people tend to recover from paranoia over the long-term, but it still can last awhile and be highly disturbing. As a person remains sober and dopamine levels stabilize, paranoia tends to decrease.
- Psychosis: The fact that cocaine can alter dopamine levels to a significant extent can produce a drug-induced form of psychosis. In other words, you may develop hallucinations and/or delusions that mimic schizophrenia as a result of long-term usage. Although this isn’t permanent, it can be difficult to overcome.
- Stress response: It is thought that your resilience against stress significantly decreases the more frequently you use cocaine. The brain becomes unable to properly process stress and with frequent cocaine usage, you may react with more animalistic instincts instead of using higher-order brain functions (e.g. prefrontal cortex) to combat any stress. Things that previously wouldn’t have caused stress may start to drive you crazy over the long-term.
- Gray matter reduction: Brain scans of individuals with cocaine dependence compared to a control group revealed that the group with dependence had lost significant amounts of grey matter. On average, those who used cocaine had lost approximately 3.08 ml (milliliters) of brain volume per year, which was approximately double that of the healthy control group.
- Headaches: Many people report headaches as a long-term effect of using cocaine. This could be due to a variety of reasons including damage to the brain, changes in brain activity, alterations in blood flow, and constriction of blood vessels. Some individuals may even experience migraines as a result of their cocaine use.
- Prefrontal cortex impairment: Perhaps the most detrimental aspect of using cocaine is that it alters activity in the prefrontal cortex. This is a region involved in high-level processes such as logic, decision making, solving complex equations, critical thinking, and attention. Using cocaine can result in lasting impairment to this region, leading the user to display increasingly animalistic behavior.
- Receptor dysregulation: Some experts also hypothesize that the brain’s neurotransmitter receptors, particularly those for dopamine experience dysregulation. Not only do dopamine levels tend to be abnormally low compared to a non-cocaine user, but the receptors of these neurotransmitters are also affected; potentially causing a variety of problems.
- Stroke risk: Some studies have suggested that using cocaine over a long-term may lead to increased risk for a stroke. A stroke is characterized as lack of blood flow to the brain, which leads a person to suffer (potentially) irreversible mental impairment.
Long-Term Physical Effects of Cocaine
Although this is a mental health website, it is important to highlight some of the long-term physical effects that have been associated with cocaine usage. Many of the physical effects are just as impairing as the mental effects.
- Bone density decrease: You may find that using cocaine causes you to lose both muscle mass and bone density. People that use this drug often do not eat enough food because it suppresses the appetite. The malnourishment can lead to a host of health problems, one of which is decreased bone density. Studies in rats have also suggested that exposure may cause decreases in spine density.
- Coughing: Another effect over the long-term that you may experience is chronic coughing. It may seem as if you’ve developed a cough that you cannot get rid of no matter how hard you try. This is due to an array of damaging effects that the drug has on the respiratory system.
- Chest pains: Over time, chest pains may start to become more severe with increased usage. This is because the cocaine takes a toll on the heart, and some may experience cardiovascular toxicity. The damage endured by various organs may also contribute to the pain that you experience.
- Heart problems: Some believe that there are clear links between long-term cocaine abuse and heart attacks. There is also some evidence to suggest that cocaine usage is capable of causing an irregular heartbeat. It is also thought that long-term usage is capable of damaging the heart muscle walls.
- High blood pressure: You may find that your blood pressure spikes over the long-term from using this drug. Although it is common to experience elevated blood pressure while intoxicated, blood pressure may stay high as a result of long-term usage.
- Malnutrition: The highly stimulating nature of cocaine leads people to experience a loss of appetite. A reduced appetite may lead a person to skip meals, resulting in nutritional deficiencies. If a person is deficient in various vitamins and nutrients, this can put them at increased risk for a variety of other chronic health conditions.
- Organ damage: Cocaine can cause cumulative damage to major organs such as your heart, kidneys, liver, and lungs – especially when used over the long-term. This is mostly due to a chemical intermediate being released called “methylecgonidine.” It is this substance that is directly capable of eliciting damage, which can increase over time.
- Reproductive damage: Another physical effect that’s associated with long-term cocaine usage is that of reproductive problems. Some hypothesize that long-term usage can damage sperm quality, decrease sperm count, cause sexual dysfunction, as well as infertility (in both males and females).
- Tooth decay: Although tooth decay isn’t directly caused by cocaine, it can be caused by “bruxism” (or tooth grinding). Many people who use cocaine over the long-term are unable to deal with the tension they experience while “high” – leading to frequent grinding of teeth. This grinding mashes the tooth enamel and can lead to decay.
- Weight loss: Using any CNS stimulant over the long-term can lead to a significant amount of weight loss. As was already mentioned, some of the weight loss is a result of bone density reduction and muscle loss (stemming from decreased food consumption). In some individuals, losing excessive weight can be unhealthy, and put them at risk for a variety of health conditions.
Is it possible to overcome the long-term effects of cocaine?
There’s no definitive answer to this question simply because long-term effects are largely based on the individual. Someone who heavily abused cocaine may not be able to fully repair the damage that they’ve inflicted upon their brain and body. Another person may be able to achieve nearly 100% recovery by making the right changes and targeted efforts.
Obviously the sooner you quit using the drug and the more time you’ve been off the drug, the better your long-term prognosis. With proper efforts and lifestyle changes, most people should be able to restore their mental and physical health (over time).
Does everyone experience long term effects from cocaine?
No, not everyone is going to experience long-term effects from cocaine. Someone who snorted a small amount at a party may not experience much (if any effects). However, someone that frequently abused cocaine over a long-term is more likely to experience long-term effects. The severity and number of long-term effects that you experience will be highly individualized.
If you want a more in-depth understanding of what cocaine has done to your brain, you may want to have some tests conducted. By having tests conducted, you will know what can be done to repair any potential damage that you endured.
Have you experienced any unwanted long-term effects from cocaine?
If you have used cocaine for an extended period and have endured long-term effects, feel free to share them in the comments section below. Be sure to mention what effects you experienced and whether they’ve lessened in intensity over time. Also discuss how long you had used cocaine, the type you used, and frequency at which you used it. Any other details that you’d like to include such as steps you’ve taken to mitigate the long-term effects may be helpful to others.