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What Are the Side Effects of Cocaine?

Cocaine is a central nervous system drug used recreationally for its euphoric effects. Because cocaine binds to the reward and gratification sensors in the brain, it creates an affirmative association with the substance. 

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Cocaine comes with a wide variety of side effects and a high risk of addiction.

Key Facts About the Risks of Cocaine 

As cocaine is one of the most commonly used recreational drugs globally today, the risks are oftentimes either ignored, overlooked, or underplayed. People who regularly use cocaine are at increased risk for the following:

  • Overdose
  • Respiratory infections
  • Cardiovascular infections
  • High blood pressure
  • Gastrointestinal disease
  • Stroke

Key Facts

  • Cocaine abuse also comes with nonmedical risks. Cocaine is a Schedule II drug under the Controlled Substances Act, meaning it has an accepted medical use in the United States but is highly addictive. People who have cocaine in their possession, or tools they might use to take cocaine, can face a wide variety of legal consequences, including jail time.
  • Cocaine can also be very expensive, and users typically need a lot to keep the high going. In the United States, cocaine cost about $120 per gram in 2020. People can lose their homes and possessions, as they attempt to keep their drug supply high.
  • Getting help for a cocaine problem isn’t always easy, as drug problems are often subject to stigma. Negative language can force people to hide their difficulties instead of getting help for them. Their troubles can deepen in response.
  • There are also nonmedical risks, such as short attention spans, psychological dependence, neglecting responsibilities, financial problems, and more.
  • According to the 2021 National Survey on Drug Use and Health, close to 15% of Americans have used cocaine at least once. Despite its widespread use, researchers say cocaine was responsible for less than 1% of admissions to treatment programs in 2021.
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What Are the Side Effects of Cocaine? 

Cocaine is dangerous, and users often need help with side effects. Researchers say the rate of emergency room visits caused by cocaine increased from 6.6 visits per 10,000 people in 2008 to 8.9 visits per 10,000 people in 2018.

Even people who don’t experience a sudden cocaine-related side effect can deal with long-term problems that are difficult—if not impossible—to fix.

Here’s what you need to know about cocaine’s side effects:

Long-Term Side Effects 

Long-term side effects of cocaine use include physical and mental damage. The physical side effects include the following:

  • Cardiovascular damage
  • Sinus damage
  • Bloody and runny nose
  • Deviated septum
  • Respiratory damage
  • Brain damage
  • Coma

Mental side effects associated with cocaine use often show up as anxiety, depression, mood swings, inability to solve problems, poor decision-making, psychosis, auditory hallucinations, and an inability to understand information.

Short-Term Side Effects

Short-term side effects associated with cocaine use can also be physical and mental. They include the following: 

  • Dilated pupils
  • Insomnia
  • Nausea
  • Bloody nose
  • Twitching
  • Excessive sweating

Short-term mental effects include paranoia, hostility, euphoria, over-excitement, as well as engaging in drug-seeking behavior.

Cocaine & the Brain

Cocaine works directly on parts of the brain associated with reward. Understanding the brain’s mesolimbic dopamine system is a critical part of learning why cocaine can be so addictive.

A sober brain releases a small amount of the chemical dopamine in response to something rewarding (like a good meal). Another cell removes dopamine to recycle it for further use.

Cocaine works by blocking dopamine recycling. The result is a buildup of the chemical and an inability to remove it. People feel euphoric while on the drug due to this buildup.

When the cocaine dose wears off, cells work hard to clean up excess dopamine. The result is a quick drop in euphoric feelings (or a “crash”) that can make people reach for drugs. If they take more cocaine, the cycle starts all over again.

How You Ingest Cocaine & Its Impact on Risks

The way cocaine is used has an impact on the risk involved. Cocaine is most often either snorted, smoked, or injected.


Studies conducted in the 1990s suggested that snorting cocaine was associated with a lower level of addiction than injection. However, any method of cocaine abuse can be addictive.

Snorting cocaine can also cause extensive damage to the olfactory organs and destroy your sense of smell.


Smoking cocaine is accomplished by applying heat to crack cocaine or freebase cocaine. This method puts individuals at risk for a chronic cough, worsening asthma, respiratory distress, and lung diseases, such as pneumonia.


Liquifying cocaine and injecting it directly into the bloodstream is another method of using cocaine. This method puts individuals at a higher risk for addiction and liver problems, scarred or collapsed veins, skin infections, and contracting HIV/AIDS, hepatitis C, or other blood diseases. 

Injecting cocaine also puts individuals at a higher risk of developing cocaine addiction as well as overdosing.

Cocaine Interactions 

Mixing cocaine with other drugs can come with a variety of consequences and can amplify the negative effects of each drug used. For example, cocaine and alcohol both react within the liver. This puts additional strain on the liver, heart, and other organs.

Cocaine is also often mixed with heroin and/or opioids, which have opposing effects on the central nervous system. This can cause adverse effects like respiratory failure, coma, overdose, and even death.

What Are the Signs of a Cocaine Overdose? 

Signs of cocaine overdose include the following:

  • Difficulty breathing
  • Extreme anxiety, paranoia, agitation, and panic 
  • Elevated heart rate
  • Rise in body temperature or excessive sweating
  • Head or chest pain
  • Hallucinations
  • Nausea or vomiting
  • Seizures
  • Strokes
  • Loss of consciousness

If you spot signs of cocaine overdose, don’t wait. Call 911, and tell the operator where you are, what symptoms you’re seeing, and how much cocaine the person has taken. If the person has taken other drugs, mention that too. Stay with the person and on the phone until help arrives. Follow any instructions the operator gives you while you wait.

If you believe that you or someone you know has been abusing cocaine or has a drug dependency issue, it’s important to seek professional help as soon as possible.

Generally, treatment options include support and supervision during detox, comprehensive therapy, and aftercare support. The best course of action is to use a multidisciplinary approach where different therapeutic approaches are used based on individual needs.

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Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated March 20, 2024
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