Cocaine: What is it, Addiction, and Side Effects

What started out as a medical miracle is now one of the most addictive stimulants around. In 2020, 1.3 million people in the United States used cocaine at least once. It’s a very powerful stimulant that is used by people in all walks of life. However, even short-term use can lead to health problems and addiction.

So how does cocaine cause all of these health concerns, and what exactly are the dangers?

What is Cocaine and How is Cocaine Made? 

Cocaine is a Schedule II drug according to the DEA, and carries the street names ‘coke’, ‘blow’, and ‘snow’. In terms of illicit stimulants, cocaine seems to have less of a stigma attached to it than methamphetamine—perhaps due to its expensive price. Where meth is often a drug of choice for those in lower socio-economic situations, cocaine is considered a substance of the ‘elite’. 

What is Cocaine Used For Medically? 

Before its addictive potential and harmful effects were fully realized, cocaine was a popular anesthetic in the late 1800s. 

It might come as a shock, but cocaine is still used in medical settings—albeit, infrequently. According to the DEA, cocaine hydrochloride solution is still used as a topical anesthetic, though it can be used to stop bleeding in mucous membranes like the mouth or nose. 

Because other, less harmful drugs have been developed in recent years, medicinal cocaine is relatively obsolete.  

What is the Difference Between Crack and Cocaine? 

Some manufacturers take cocaine production one step further to create crack cocaine. Adding baking soda or ammonia to cocaine and boiling it will create large crystals. This essentially creates a highly potent form of the drug, with effects that appear almost instantly and are more pronounced. 

These effects include euphoria, high levels of energy, full-body numbness and lack of pain, as well as aggression. 

Crack cocaine has much of the same dangers as cocaine, but its potential for addiction is much higher. Because it is in such a ‘pure form,’ its euphoric and numbing effects are significantly stronger. Additionally, crack cocaine is consumed through smoking, which delivers the drug to the brain almost instantly.

This application also causes it to leave the system quicker, however. While snorting cocaine makes you high for about a half an hour, smoking it will only give a high for up to 10 minutes.

What is Cocaine Made From?

All cocaine is derived from the coca plant of South America. Though similar in name, it’s very different from the cacao trees that are used to create chocolate or a warm mug of hot cocoa.

Coca plants grow mostly in hot, dry regions, and thrive in the Andes Mountains. Most coca is grown in Bolivia, Colombia and Peru. However, many cultures throughout the Andes have grown it for thousands of years. The leaves can either be chewed or made into a tea for energy, better mood, or appetite suppression. You can still find leaves and coca products being legally sold on the street for these benefits. Some compare the level of stimulation to coffee. 

South America is home to over 2000 species of coca plants. Only 17 contain the alkaloid needed to synthesize cocaine, and only two species even have enough of it to do so effectively. 

What Are the Side Effects of Cocaine Use? 

Many illegal drugs affect the reward center of the brain. This is where mood regulating neurotransmitters like dopamine, serotonin, and norepinephrine are released and recycled.

Cocaine is not only physically, but psychologically addictive.

Cocaine is no exception. When it enters your system, it causes those three neurotransmitters—primarily dopamine—to be released, and not recycled.  Not only does this create a high, it also causes lack of impulse control and excitability. 

Other signs that someone is using cocaine:

  • Dilated pupils
  • Talking fast
  • Decreased appetite
  • Unpredictable or aggressive behavior

Some people, depending on how much they take, feel paranoid when high on cocaine. This can lead to even more aggressive behavior and poor decision-making. 

How Addictive is Cocaine?

Cocaine is not only physically, but psychologically addictive. Abusing cocaine usually starts with more frequent consumption in an effort to relive the initial high. 

The real danger is the fact that cocaine is easy to build tolerance to. Cocaine tolerance means that more of it is required to feel the same effects when used long-term. 

Because the body adapts to the release of neurotransmitters, a person using cocaine might come to believe that they need some just to feel ‘normal.’ The brain starts to think that that excessive amount of dopamine is the ‘base’ level, so when it decreases following a high, it causes feelings of depression and lethargy. 

What Does Cocaine Overdose Look Like? 

Chasing a high can lead to taking dangerous amounts of cocaine and overdose. A cocaine overdose can look like:

  • Erratic and aggressive behavior
  • Hallucinations and paranoia
  • Muscle twitches
  • Irregular or accelerated heart beat
  • Accelerated breathing or trouble breathing

The overdose symptoms above, while not lethal in and of themselves, can be precursors to a heart attack or stroke, or seizures. Typically, deaths from cocaine overdoses are a result of a heart attack or stroke caused by the stimulant effects.

If you suspect a cocaine overdose, call 911 immediately. Medical intervention can increase blood flow, and oxygen in the blood to prevent deadly heart attacks and stroke.

If you suspect a cocaine overdose, call 911 immediately

Dangers of Cocaine in Polysubstance Abuse

Cocaine is sometimes considered a ‘party drug,’ or one that is used socially, and mixed with other substances like alcohol. However, combining cocaine with other drugs can lead to painful consequences.

For example, drinking alcohol and using cocaine is a fairly common combination. This is because people mistakenly believe that each substance can ‘cancel out’ the effects of the other. 

Since alcohol is a depressant and cocaine is a stimulant, having both at the same time can lead a person to think that they don’t ‘feel’ the effects of either. This can lead to them taking more of both substances. 

Combining alcohol and cocaine create a chemical in the body called cocaethylene. This lasts longer in the body than either substance, but acts similar to cocaine. It’s also significantly more toxic than cocaine or alcohol alone, and can cause heart attack and stroke much faster.

Another common drug taken with cocaine is heroin, and combining the two is called ‘speedballing.’ Heroin often causes extreme drowsiness, but cocaine can counter this effect when they are taken together. 

Combining alcohol and cocaine create a chemical in the body called cocaethylene...It’s also significantly more toxic than cocaine or alcohol alone, and can cause heart attack and stroke much faster.

Long-Term Health Effects of Cocaine Addiction

Recovery from addiction is possible no matter how long a person has been taking a particular drug. Nevertheless, it’s best to seek treatment as soon as possible, as using cocaine frequently can cause physical and neurological harm that lasts long after you’ve stopped.


A lot of the same benefits of using cocaine in an operating room are extremely harmful with long-term use. Any amount or method of cocaine consumption causes blood vessel restrictions, especially in the bowels and gut, which can lead to ulcers. When snorted, the blood vessels in the nose are restricted, significantly damaging the septum, and even causing it to deteriorate.

Snorting cocaine can cause a host of upper respiratory problems, such as loss of smell, nosebleeds, and trachea irritation. Injecting it, as is commonly done with crack cocaine, opens those who use it to infections, HIV, and Hepatitis.

Stimulants can increase activity all over the body, including heart rate and breathing. Those that abuse cocaine are at significantly higher risk for seizures, strokes, and heart attacks than those that don’t use it.


While outward physical problems associated with long-term cocaine use can be painful at best, or even deadly, it can also do quite a bit of damage to your brain. 

Some evidence suggests that enough cocaine use can change the physical structures in your brain that continue cravings even after years of abstinence. 

Extended use of cocaine can also negatively impact cognitive abilities, such as memory, information processing, and decision making. Taking stimulants, including cocaine, are also linked to Parkinson’s Disease

What Are Cocaine Withdrawal Symptoms?

Withdrawals happen when someone stops taking the substance that they are physically dependent on. Remember, that drugs like cocaine can alter your brain’s chemistry and biology, so purging your system of it can be a difficult process.

Cocaine withdrawal often involves:

  • Depression
  • Agitation
  • Fatigue
  • Increased appetite
  • Insomnia
  • Nightmares

Depending on how long you’ve been using cocaine and your natural body chemistry, these symptoms vary in severity. 

What Are the Options for Cocaine Addiction Treatment?

While these withdrawal symptoms can be unpleasant, they are better than the possible outcomes of continued cocaine use. Many people have recovered from cocaine addiction. Living sober is possible with empathetic and evidence-based counseling. 

Our goal at Sequoia Behavioral Health is to help you through any substance abuse or mental or behavioral health problems you may have. Often, these occur together, and our treatment programming is catered to providing holistic care. Call us today if you’re looking for help for yourself or a loved one.