Cocaine, whether used as a powder or smoked as “crack,” is a highly potent substance. Only a few uses can result in brain damage and other physical and neurological problems. Continual use can cause permanent changes to the structures of the brain and even the genes.
According to the National Institute on Drug Abuse (NIDA), cocaine use has represented up to 40% of all drug-related emergency room visits in recent years. The Foundation for a Drug-Free World states that it is the second-most trafficked drug in the world. Recent reports have shown that over 35 million Americans aged 12 and over have used cocaine. That represents a little over 20% of people over 26 who have used either cocaine or crack. Among the steady rise in drug-related deaths, cocaine overdose deaths have quintupled since 1999. In 2019, that amounted to 15,883 deaths from cocaine.
As we detail the effects of cocaine on the brain, remember that there is help available for you, both day and night, for cocaine and other substance use disorders. Highly effective, evidence-based treatment programs exist to help you find freedom from substances like cocaine. Though cocaine and substance use disorders are serious business, there is always hope right at your fingertips.
What Is Cocaine?
The NIDA defines cocaine as a powerful and highly addictive stimulant drug. It originated in South America with the coca plant (Erythroxylon coca). Aboriginal tribes chew the leaves, but in the last century, people began processing and distilling its psychoactive chemicals. It was the purified compounds from the plant, primarily cocaine hydrochloride, that would lead to the worldwide rise in use. At the turn of the 20th century, cocaine was used for surgical pain prevention before general and local anesthetics were innovated. It was also found in small amounts in early Coca-Cola formulas, though it was later removed from the process completely.
Today, cocaine is a Schedule II substance under the Controlled Substances Act (CSA) of 1971. This means it has a very high potential for misuse and both physical and psychological dependence. It can, however, be used in certain limited medical situations (specifically for surgical procedures on the throat, eyes or ears). It is also classified as a narcotic, placing it in a category with drugs ranging from the prescribed opioids tramadol and morphine to illicit drugs like heroin.
Cocaine exists in two forms. The first is a white powder which is often “cut” (diluted) with other common powders of the same color, like cornstarch, flour or talcum powder. This is so dealers can increase their profits. Sometimes, it is cut with procaine (an anesthetic) or amphetamine, which enhances its stimulant effect. When cocaine is mixed with heroin, it is called a “speedball,” which is an even more highly addictive and dangerous compound. These forms of cocaine are usually snorted, though they are sometimes dissolved in a liquid and injected.
A hard, crystalline version is the purest form of cocaine. It is smoked along with residual chemicals or in an even purer form, which is called freebasing. Because of the crackling sound it makes when smoked, these forms of cocaine are called “crack” or “crack cocaine.” Since it is in a less diluted form, crack cocaine is more potent and, therefore, more dangerous.
Though cocaine is an extremely powerful narcotic, many people have managed to get and stay clean after cocaine use and after a substance use disorder.
What Does Cocaine Do to the Brain?
Cocaine can affect the brain and even alter its structure after only a few uses. Usually, the initial feelings associated with cocaine use are a burst of energy and an overall sense of pleasure and well-being (euphoria). This is because, according to the National Institutes of Health (NIH), the drug floods the brain with a chemical called dopamine, a neurotransmitter that controls our pleasure response. There are many dopamine receptors in the limbic system, an area that is located just in front of the central brain. This area generally controls emotional responses. This is why cocaine creates both feelings of euphoria and the desire to use it again.
The NIH goes on to explain that the short-term effects on the brain are profound. Free-floating dopamine will attach to other neurons in the brain, transforming them into dopamine receptors and altering the brain’s electrical patterns. By hijacking other neurons with dopamine, cocaine interrupts the flow of other neurochemicals, like the calming serotonin and the balancer norepinephrine, meant to regulate it. However, cocaine’s primary effect is in the dopamine neurons, which are now overproducing the chemical and flooding the brain. As a result, the user does not just feel euphoria and energy. Competitiveness, aggression and risk-taking behaviors are also increased. A person on cocaine may feel “invincible” and attempt things they would otherwise not do, leading to potential injury or even death. This is all because the brain is being rewired to respond to and crave more cocaine.
What Are the Side Effects of Short-Term Cocaine Use?
As cocaine use continues, the brain is placed in a state of high euphoria over and over again. This activation of the brain’s pleasure centers is estimated to exceed the gratification felt after satisfying extreme hunger and thirst or even that which is felt during sexual activity. Because these euphoric states exceed those felt during regular life experiences, the psychological craving for cocaine increases with each use. However, there are also short-term side effects that do not include the pleasure response. The milder forms of these side effects include:
- Agitation and irritability
- Anger that borders on violence
- Severe reduction in appetite
- Feeling overstimulated, like oversensitivity to sounds, lights and touch
- Intense happiness that borders on mania
There can also be more serious side effects that warrant a visit to the doctor or even the emergency room. Such effects include:
- Convulsions, tremors or seizures
- Dilated (larger than normal) pupils
- Severe headaches or migraines
- Heart problems, including a rapid and irregular heartbeat or even a heart attack
- Communicable diseases, such as HIV and hepatitis (if injected)
- Temporary or permanent loss of smell, runny nose and nose bleeds (if snorted)
- Lung irritation and damage (if smoked or freebased)
- Mood swings
- Bowel perforation or decay (if swallowed or snorted)
- Difficulty swallowing
- Sexual and erectile dysfunction or inability to achieve orgasm
If you or someone you know is experiencing any of these symptoms, it is important to call 911 or take the person to the nearest emergency room. Since some of these symptoms are life-threatening, it crucial to know exactly what and how much the person has taken if at all possible.
What Are the Long-Term Effects?
Long-term side effects may build up slowly over time as cocaine damages the brain. Side effects caused by extended use include:
- Cognitive difficulties, such as trouble thinking, reduced reaction times, disruption of attention and problems with memory
- Alteration of the structures of nerve and brain cells
- Changes to the electrical impulses in the hippocampus, amygdala and frontal cortex, which can increase cravings for cocaine
- Prolonged, and even permanent, alteration of the genes’ activation and deactivation mechanisms as well as other genetic abnormalities
- Heart disease and heart failure
- Lung or stomach cancer
- Increased risk of overdose
- A tolerance to the drug, causing the user to increase dosages and frequency of use
The vast majority of these short- and long-term issues occur because of the alteration to the brain’s structure, electrical impulses and chemistry. If these side effects are occurring, managed withdrawal, drug rehabilitation and long-term care may all be necessary. Keep in mind that such help is only a phone call or mouse click away.
There are both physical and mental signs that indicate a cocaine overdose. If these occur, it is important to call 911 immediately because life-saving interventions are often necessary. The physical symptoms of an overdose include:
- A sudden rise in body temperature
- Breathing problems ranging from shortness of breath to respiratory arrest
- Chest pain that may or may not be indicative of a heart attack
- Confusion and disorientation or a fugue state (feeling disconnected from reality)
- Severe nausea and stomach cramps
- Tremors or convulsions
The mental and cognitive effects of overdose include:
- Anxiety and extreme paranoia
- Delirium (confusion, severe cognitive impairments and lack of awareness of one’s surroundings)
- Panic attacks
An overdose is one of the strongest indicators that a substance use disorder has gotten out of control. Despite these symptoms, though, there are treatments available that can restore a person’s health and sobriety even after an overdose.
Cocaine Withdrawal Symptoms
When someone decides to get clean from cocaine or it is no longer available to them, withdrawal occurs, especially if the person has been using for an extended period. It is important to know that cocaine withdrawal, unlike most substances, often causes no visible physical symptoms, such as rashes or vomiting. Symptoms of withdrawal include:
- Aches and general, full-body discomfort
- Agitation and irritability
- Fatigue and muscle weakness
- Increase in appetite
- Nightmares, especially vivid dreams
- Lethargy and slow movements when completing tasks
Even though these symptoms may not seem severe, they represent the brain chemically responding to not having cocaine. As a result, these symptoms may become severe enough to warrant medically assisted withdrawal. This involves a short stay in a hospital or clinic (usually no more than a week). Under a doctor’s care, you may be prescribed medication to ease withdrawal symptoms. Your vital signs will also be monitored by nurses around the clock until the withdrawal symptoms have abated. Medically managed withdrawal is often the first practical step in drug rehabilitation.
Another less intensive form of treatment is medical detoxification (usually referred to as “detox”). It first involves an evaluation by a doctor or other medical professional. Next, stabilizing treatment occurs, so the person is best positioned to go through withdrawal as easily as possible. Next, options for treatment are explored and arranged to help the person attain and maintain sobriety.
There Are Many Options for a Better, Healthier Life
No matter how devastating the effects of cocaine are on the brain, hope is immediately available, and a healthier life is on the horizon. Granite Recovery Centers offer a broad range of treatments and facilities in the Northeastern United States.
Among our many treatment options are medically assisted withdrawal and detox as described above. There are also many alternatives. Residential rehabilitation centers (often referred to as “rehab”) are available 24 hours a day, 365 days a year. During a stay that lasts between two weeks and 60 days, several comprehensive approaches are used, including 12-step programs, one-on-one and group counseling, exercise, meditation, art therapy, and after-rehab care.
If a stay in a peaceful, secluded residential facility is not feasible, there are still other options. Inpatient treatment programs, which usually involve a hospital stay, medically managed withdrawal (if necessary) and therapy-based programs, are available in most major cities when travel is not an option. If work schedules are a concern, intensive outpatient treatment programs are available. These highly discreet programs take place in the evenings and on weekends after regular work hours. Intensive outpatient treatment offers many of the options of residential facilities and inpatient programs. Program lengths are often shorter than the previously mentioned alternatives.
Regardless of how long you have used cocaine, your personal needs or your schedule, places like Granite Recovery Centers are only a phone call away. While cocaine is a powerful drug, finding the right program will put you on the road to sobriety and prove that you can be stronger than any substance. Call us at GRC today to start the journey to a better life.