Addiction and Mental Health

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Cocaine and its Negative Side Effects

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Cocaine and its Negative Side Effects

by Julie Myers, PsyD, MSCP

Licensed Clinical Psychologist in San Diego;


As with other drugs, cocaine affects the nerve cells of the ventral segmental area, which extends into the nucleus accumbens, one of the reward centers of the brain.  Cocaine acts as a reuptake inhibitor of dopamine, whose increased presence creates the euphoria associated with cocaine.  The euphoric effects of cocaine are generally shorter acting than other drugs, lasting anywhere from a few minutes to a few hours, depending on the route of administration.  Because of its short duration, it is not uncommon for users to administer repeated doses (“binging”.)

In the short-term with small amounts, cocaine acts similarly to amphetamines, making the user feel euphoric, energetic, talkative, and mentally alert. It dilates pupils and increases vital signs such as temperature, heart rate, and blood pressure. With larger doses, the user can experience tremors, vertigo, and twitches.  A user may experience increasing irritability and restlessness.  Bizarre, erratic, and violent behaviors are associated with cocaine.  Chronic use can cause severe psychiatric symptoms, including anxiety, depression and psychosis.  Full-blown psychosis may result with paranoia, hallucinations, and delusions.

Medical complications associated with cocaine use include cardiovascular effects.  “Cocaine causes the blood vessels to thicken and constrict, reducing the flow of oxygen to the heart.  At the same time, cocaine causes the heart muscle to work harder, leading to heart attack or stroke, even in healthy people” (CAMH, 2007.)  It raises blood pressure, which can explode the weakened blood vessels in the brain.  It may also cause abdominal pain, nausea, and blurred vision.

As with other drugs, the route of administration can produce different adverse effects. Snorting cocaine can cause nasal effects, including loss of sense of smell, nosebleeds, problems with swallowing, hoarseness, and an even a perforated nasal septum.  Ingested cocaine can cause severe bowel gangrene, due to reduced blood flow. Smoking cocaine can cause “crack lung”, which includes severe chest pain and breathing problems.

When cocaine is mixed with alcohol, the two drugs are converted by the body to cocaethylene, a cocaine metabolite.  Cocaethylene appears to have more cardiovascular toxicity and hepatoxity than either drug alone.

Even though a user becomes tolerant to cocaine, they may not become sensitized to its anesthetic and convulsant effect, which may explain some cocaine deaths.  Overdose can cause seizures, heart failure, and arrest breathing. Withdrawal can include exhaustion, sleepiness or sleeplessness, hunger, irritability, depression.  Cocaine has a small index of tolerability.

 – Julie Myers, PsyD, MSCP    (

The bulk of the information for this article was taken from NIDA (2004) and CAMH (2007.)  These resources offer a wealth of up-to-date information about the different drugs of abuse and are one of the first places to look for the most current information about any drug. I urge you to check out these resources for the latest information on addiction.


CAMH (2007), Centre for Addiction and Mental Health, Do You Know… Cocaine

Castane, A., F. Berrendero, & R. Maldonado (2005), The role of the cannabinoid system in nicotine addiction Pharmacol Biochem Behav. 81(2), pp. 381-6.

NIDA (2004), NIDA Research Report – Cocaine Abuse and Addiction: NIH Publication No. 99-4342..

NIDA (2006), Research Report – Tobacco Addiction: NIH Publication No. 06-4342.1346417

Picciolo, M., D. Gigante, & A. Nunziata (2005), Nicotine addiction and current therapy of smoking cessation Clin Ter. 156(4), pp.159-71.

Written by Julie Myers, PsyD, MSCP

July 23, 2011 at 7:22 am

12 Responses

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  1. Your authoritative summary regarding cocaine is a valuable resource.
    Thanks for including references.


    January 26, 2013 at 9:51 pm

  2. what effects can cocaine cause with people who have diabetes, gastroparesis, high triglycerides, depression and kidney reflux? she has all of the above and claimed sickle cell disease.

    fatimah hasan

    April 22, 2013 at 9:14 pm

    • Unfortunately, I don’t have any answers to this. You might want to check-out some more scholarly articles. – Julie Myers, PsyD

      Julie Myers, PsyD, MSCP

      July 22, 2013 at 7:36 am

  3. I’ve been exploring for a little bit for any high quality articles or blog posts on this sort of area . Exploring in Yahoo I ultimately stumbled upon this website. Studying this info So i’m satisfied to
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    • Thanks very much for your comments. My goal is to help educate people about what they choose to do. With that, they can make their own informed decisions. Hope you enjoy other articles! – Julie Myers, PsyD

      Julie Myers, PsyD, MSCP

      June 17, 2013 at 9:35 am

    • Thanks for your comments. I try to publish regularly, in order to help inform others. I hope this helps you in some way. – Julie Myers, PsyD

      Julie Myers, PsyD, MSCP

      July 22, 2013 at 7:35 am

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    July 19, 2013 at 4:12 am

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    July 19, 2013 at 2:07 pm

    • Thanks so much for your comments. I have been working in the field of a addiction for many years, and I understand pretty well what people are going through. Best to your cousin! – Julie Myers, PsyD

      Julie Myers, PsyD, MSCP

      July 22, 2013 at 7:34 am

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    • Feel free to share this with anyone. I believe that the more people learn about these things, the better. – Julie Myers

      Julie Myers, PsyD, MSCP

      July 22, 2013 at 7:32 am

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