How Does Cocaine Affect the Brain? Effects on Mental Health
Last Updated Dec 2, 2021
Cocaine affects the brain in a variety of ways. In the long term, it can cause several different parts of the brain to change. In people with a cocaine addiction, it has been shown to essentially “age” a brain, so a person develops issues typically associated with much older adults.
What Does Cocaine Do to the Brain?
Cocaine is a powerful stimulant, which means it speeds up the transmission of messages in the body. More specifically, it acts upon a set of interconnected regions in the brain called the limbic system.
It prevents a neurotransmitter key to the body’s reward system called dopamine to not get recycled as it normally would, which causes a buildup of the neurotransmitter. This is the primary way in which cocaine causes a user to experience a euphoric high.
How Does Cocaine Affect Mood & Emotions?
Cocaine is typically used for its ability to cause a powerful high that can make a person feel energetic, happy, and excited. However, repeated or heavy use can also make a person more likely to experience other negative emotions connected to the manic feelings cocaine can cause, including making some users feel angrier, irrationally nervous, or even fearful and paranoid about things that don’t make logical sense.
Cocaine use will frequently cause users to push their bodies much harder than they realize, and many users experience a “crash” after the drug wears off. A person crashing may experience depression and severe fatigue for potentially several days, as well as a strong craving to do more cocaine.
Can Cocaine Cause Physical Changes to the Brain?
Cocaine can affect a variety of important areas of the brain with repeated use. An animal study showed that tiny protrusions from brain cells called dendritic spines, which are an important part of the memory formation process, are produced at a substantially higher rate in animals injected with cocaine compared to a control group injected with water. After only two hours from receiving their first dose, a significant difference was noticed, meaning cocaine use seems to create strongly reinforced memories related to the euphoric high it causes.
It’s been found that a part of the basal ganglia (and part of the brain involved in motor control and planning) called the caudate nucleus is enlarged in individuals with a history of long-term cocaine use. It’s also been found that there is less gray matter in the frontal cortex of regular cocaine users, an area of the brain responsible for a variety of important functions, including impulse control and decision making.
Additionally, cocaine use has been shown in brain scans to decrease the amount of dopamine 2 (D2) receptors in the brain, which may make a person less sensitive to behavior humans would normally find rewarding.
Does Cocaine ‘Age’ the Brain?
A study involving brain imaging of habitual cocaine users found younger and middle-aged people with cocaine use disorder had brains that looked typical of much older adults.
Users in their 30s and 40s showed signs in their scans more closely associated with adults over 60 years old. Middle-aged cocaine users had a variety of health risks more closely associated with that age group too, showing a much higher rate of memory loss, increased susceptibility to infection, and higher rates of cardiovascular disease than is typical of a non-drug user of the same age.
People who are addicted to cocaine likewise tend to perform worse in tasks involving the prefrontal cortex, issues which elderly adults often also develop.
This study produced some important findings, although it doesn’t have all the answers. Researchers involved in the project also want to study more casual cocaine use — associated with people who use cocaine but aren’t addicted to the drug. They also want to track users for longer periods to more closely map how cocaine use changes the brain of a single individual over time.
Can the Brain Recover From Cocaine Use?
It can be tough to recover from changes to the brain that are the result of chronic drug use, although at least some level of recovery is generally possible with abstinence (and drug abstinence is also important for making sure issues don’t worsen).
A small 2018 study found male military veterans who had used cocaine and then had recovered and remained abstinent from cocaine use saw recovery in neural systems related to reward, craving, and controlling inhibitions, but less significant recovery in neural systems related to decision-making.
In animal studies, it’s been found that stimulating the orbitofrontal cortex can help to restore some adaptive learning capabilities that can be lost with heavy cocaine use. In the future, it’s possible that strengthening OFC activity in humans will be used as part of recovery treatment to help users better improve their insight and awareness of the consequences of drug use, internalizing the issues drugs can cause and resisting their use more effectively.
Cocaine. (April 2016). National Library of Medicine.
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Cocaine May Age the Brain. (April 2012). Science.
Cocaine ‘Rapidly Changes the Brain’. (August 2013). BBC News.
Presumed Structural and Functional Neural Recovery After Long-Term Abstinence From Cocaine in Male Military Veterans. (February 2018). Progress in Neuro-Psychopharmacology & Biological Psychiatry.
What Are Some Ways That Cocaine Changes the Brain? (May 2016). National Institute on Drug Abuse.
Effects of Long-Term Cocaine Self-Administration on Brain Resting-State Functional Connectivity in Nonhuman Primates. (December 2020). Translational Psychiatry.
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