Risks of Use

Cocaine Addiction » Risks of Use

Cocaine (benzoylmethylecgonine) is a potent stimulant drug that is extracted from the leaves of the coca plant. The coca plant is native to Central and South America.  According to the National Institute on Drug Abuse (NIDA), cocaine is generally used in two different forms: 

A water-soluble form that is a hydrochloride salt: This form is often snorted or injected. When it is snorted, it is used as a powder. When injected, it is diluted in water or some other liquid. 

A base or freebase form that is made by processing the cocaine extracted from coca leaves with baking soda or ammonia and water: It is then heated to remove the hydrochloride portion of the drug, and this produces a substance that can be smoked as crack or as a freebase form.  

Cocaine remains classified as a Schedule II controlled substance by the United States Drug Enforcement Administration, indicating that it does have some medicinal uses but is very tightly controlled, and its distribution is very limited. Cocaine is considered to be a drug that is extremely prone to abuse and can result in the development of significant physical and/or psychological dependence. One of the major risks of using cocaine is the development of a formal substance use disorder.

Other Substances in Cocaine

Cocaine purchased illegally is most often not pure. NIDA reports that a number of other substances are included in cocaine in order to “cut” or dilute it, and extend the profits received from sales. These substances can include: 

  •  Mannitol, which is a diuretic
  • Cornstarch
  • Baking soda
  • Sugar
  • Powdered milk
  • Talcum powder
  • Boric acid
  • Amphetamines or methamphetamine
  • Lidocaine, benzocaine, or procaine (anesthetics)
  • Other substances including levamisole, which is a drug given to rid one of parasitic worms

Some of the additives in cocaine can obviously be dangerous. For example, the use of numbing agents such as lidocaine, can result in a toxic condition that can lead to seizures. There are rare cases where cocaine has been cut with extremely dangerous substances, such as poisons; however, these are very rare.

Effects of Cocaine Use

Cocaine is a particularly dangerous drug of abuse. Immediate effects of cocaine use include: 

  • A sense of euphoria
  • Increased energy and even hyperactivity 
  • Decreased need for sleep
  • A reduction in appetite
  • Pressured speech
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NIDA reports some of the long-term risks of cocaine use to be:

  • Loss of the sense of smell from snorting cocaine 
  • Frequent issues with nosebleeds or runny nose from snorting cocaine 
  • Severe decay of the intestines due to decreased blood flow (particularly in individuals who snort or swallow cocaine) 
  • Increased risk to contract hepatitis C, HIV, or other diseases as a result of injecting cocaine 
  • Increased probability to engage in a number of dangers and risky behaviors because of cocaine’s effect on judgment 
  • Because chronic use of cocaine results in significantly decreased appetite, a number of issues with nutritional deficiencies  
  • Increased risk of developing cardiovascular diseases, including high blood pressure, arteriosclerosis, heart disease including heart attack, and stroke 
  • Significant issues with dental health, such as accelerated tooth decay 
  • Increased risk for a number of neurological conditions, including Parkinson’s disease, Parkinsonism (some of the symptoms of Parkinson’s disease but not having enough symptoms to actually qualify for the disease), and dementia.  
  • Significant changes in the ability to concentrate, learn new information, and conceptualize abstract concepts 
  • A number of potential mental health issues, including the development of paranoid delusions (the belief that others are out to deceive or harm a person despite evidence to the contrary), the development of hallucinations (seeing or hearing things that are not really there), the development of issues with anxiety, and/or the development of clinical depression 
  • The development of a serious substance use disorder, bringing issues with relationships, career, finances, the law, and other aspects of life 

Effects of Cocaine Use

According to Addiction Science and Clinical Perspectives, cocaine affects the brain by acting on the limbic system, the part of the brain that controls pleasure and motivation. Cocaine increases levels of dopamine, causing feelings of euphoria. According to the National Institute on Drug Abuse, this increase in dopamine is what makes cocaine and similar drugs so addictive. Repeated exposure to cocaine causes the brain to become less sensitive to naturally occurring levels of dopamine. As a result, people are eventually unable to feel pleasure without the presence of cocaine.

The effects of cocaine can last for varying lengths of time, depending on the route of administration. Snorting cocaine is the most common method of taking in the drug, and its effects last 15-30 minutes when taken in this manner. Smoking the drug causes it to take effect almost immediately, but its effects will wear off more quickly, in about 5-10 minutes. Short-term effects of cocaine include:

  • Constricted blood vessels
  • Dilated pupils
  • Vertigo
  • Increased body temperature
  • Increase heart rate and blood pressure
  • Restlessness
  • Irritability
  • Anxiety
  • Paranoia
  • Tremors
  • Muscle twitches

“Complications can occur when abusing this drug, including heart attack, stroke, and seizure. Some individuals experience headaches, coma, abdominal pain, and nausea.

Long-term Effects of Cocaine Use

Long-term effects of cocaine use can include addiction, physical dependence, and increased tolerance to the drug’s effects. Cocaine is highly addictive, and relapse is common, even after years of recovery. Cocaine changes the structure and chemistry of the brain. Over time, the brain becomes less sensitive to dopamine, the neurotransmitter that cocaine releases within the brain. Individuals who frequently use cocaine find they need to use higher and higher doses of the drug to feel the same effects. Repeated use drastically increases the risk of addiction.

Other long-term effects of cocaine use include:

  • Loss of sense of smell
  • Nosebleeds
  • Difficulty swallowing
  • Hoarseness
  • Bowel gangrene
  • “Track marks” or scars at injection sites
  • Weight loss and malnourishment

Many users combine the use of cocaine with other substances, particularly alcohol, in an effort to intensify the “high” of cocaine and be able to drink more alcohol. Combining substances compounds the effects of each substance as well as the risks. Overdose is more likely when cocaine is combined with other substances of abuse.


If an individual has become physically or psychologically dependent on cocaine, meaning the body requires the substance in order to function, then withdrawal will occur whenever lessening or stopping drug use. Withdrawal from cocaine typically involves fewer physical symptoms, such as shaking and sweating, than what is seen in withdrawal from other drugs like heroin or alcohol. However, cocaine withdrawal can still be very unpleasant, and may last longer than withdrawal from other substances.

Symptoms of cocaine withdrawal include:

  • Agitation or restlessness
  • Depression
  • Fatigue
  • Feelings of discomfort
  • Increased appetite
  • Vivid, unpleasant dreams
  • Slowed movement and activity
  • Strong cravings

Most symptoms of withdrawal subside after a few days or weeks. However, symptoms like cravings and depression can last for months. Some people experience suicidal thoughts during the withdrawal process. As a result, medical supervision is recommended.

Individuals who are addicted to cocaine are usually addicted to other substances as well. Because of this, it is important that treatment addresses not only the cocaine addiction, but all co-occurring disorders, including addictions to other substances as well as other mental health disorders.

Treating Cocaine Addiction

Individuals who are addicted to cocaine are usually addicted to other substances as well. Because of this, it is important that treatment addresses not only the cocaine addiction, but all co-occurring disorders, including addictions to other substances as well as other mental health disorders.

There are currently no medications approved by the FDA to treat cocaine addiction. Many different medications are being explored as possible treatments for addiction to stimulants, including disulfiram, a drug used to treat alcoholism. Behavioral therapy is currently the preferred treatment method for cocaine addiction.

According to NIDA, many different types of therapy can be effective in treating addiction. The therapy method that works best depends on individual circumstances and needs. Effective treatment takes all of an individual’s needs into account, and addresses the person’s physical, emotional, and social circumstances.

One of the most commonly used methods in cocaine addiction treatment is Contingency Management. This type of therapy offers rewards like vouchers or increased privileges when goals are met, such as when sobriety is maintained for a certain length of time or when the individual actively participates in the therapy process. This type of therapy is used frequently in inpatient or residential programs. These programs usually last several months, providing a solid basis for long-term recovery. With residential treatment, clients live at the treatment facility fulltime, allowing them to receive 24-hour supervision and care.

Other methods, such as Cognitive Behavioral Therapy and family therapy, are also used in cocaine addiction treatment. The goal of therapy is to provide clients with new ways of thinking and behaving, so they are better equipped to deal with stressors and can therefore more successfully avoid relapse. Self-help and support groups have also been found to be effective in encouraging long-term recovery; as a result, they are often included in clients’ aftercare plans.

Addiction Recovery

Cocaine addiction can be devastating to virtually every area of an individual’s life. Addiction often leads a person to make choices that are detrimental to personal wellbeing, as well as the wellbeing of friends and loved ones. Thankfully, full recovery is possible with proper treatment and ongoing support.

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Brooke Abner,

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