Cocaine is a powerful recreational drug that has a wide range of physical and psychoactive effects including intense feelings of euphoria, happiness, and alertness. Cocaine has gained infamy over the years due to its association with popular culture and celebrity use and abuse. Cocaine continues to be a controversial drug due to its powerful effects on the body, its contentious history, and its addictive nature.

Read on to discover some unlikely health benefits and learn more about the dangerous effects of cocaine.

NOTE: Selfhacked does not support the use of cocaine, even though it may have some benefits. We feel the negatives far outweigh any of the positives.

What is Cocaine?

Cocaine (benzoylmethylecgonine) is a well-known illegal stimulant that is widely used all over the world [1, 2].

Cocaine (coca alkaloid) is derived from the leaves of the coca plant (Erythroxylon coca) [34].

In spite of its recent notoriety, cocaine has a documented history of use by the Amara Indians of Peru. This tribe has “used cocaine” for thousands of years by chewing the leaves of the coca plant [5].

This low-level usage appears to have produced few adverse effects, presumably due to the low concentration of the active component in the leaves and the laborious act of extracting cocaine by chewing the coca leaves [5].

However, its use changed after 1859 when the German chemist Albert Niemann purified cocaine [6].

Around the end of 1884, cocaine started gaining publicity due to the interest conveyed by a number of scientists. Sigmund Freud praised the drug in his famous Cocaine Papers describing its therapeutic properties in relieving depression and anxiety [7].

Following Freud’s publications, Carl Koller discovered the anesthetic properties of cocaine on the human eye [8].

Purified cocaine became commercially available when Merck started refining and producing it [5].

Without regulatory restrictions, cocaine was initially sold as both a therapeutic and consumable product [6].

However, the passage of the Harrison Narcotics Act of 1914 in the US banned the distribution of cocaine due to widespread cocaine abuse and addiction [9].

Despite regulatory restrictions, the drug is still sold and used illegally around the world. According to a United Nations report, around 18.3 million people used cocaine in 2014 [10].

Cocaine is a white crystal powder that can be snorted, smoked, or injected [11].

Cocaine is called “crack” when is it smoked (freebase form of cocaine). It’s street names include coke, flake, snow, and powder.

How It Works

Cocaine is highly addictive and produces a feeling of euphoria through the brain’s pleasure center (buildup of dopamine in the limbic system) [12].

Independent of the route of administration (snorted, smoked, or injected), cocaine is rapidly absorbed into the bloodstream and reaches the brain to initiate its psychopharmacological effects [612].

Once in the brain, cocaine blocks the reuptake of the neurotransmitters dopamine, noradrenaline, serotonin, and acetylcholine by presynaptic neurons (mesolimbic and mesocortical areas), which increases their effects on the postsynaptic neurons [613, 14].

More specifically, cocaine blocks the dopamine transporter SLC6A3, which causes a buildup of dopamine and an overactivation of dopamine receiving neurons [12].

Also, by blocking neurotransmitter transporters through a similar mechanism, cocaine increases norepinephrine and serotonin, which has a profound effect on both the brain and the heart [15].

Dopamine reinforces the addictive behaviors in the limbic “pleasure” or “reward” center of the brain (mesolimbic and mesocortical dopaminergic systems) [1617].

The release of dopamine in the brain causes psychoactive changes as increased body movements and mood [18].

These psychoactive changes can lead to uncontrolled writhing movements (cocaine-induced movements or crack dancing) [1920].

The sustained effects of the leftover dopamine, norepinephrine, and serotonin cause narrowing of blood vessels leading to heart complications [2122].

As shown by animal studies involving cocaine, endothelin-1 plays a major role in narrowing the blood vessels (vasoconstriction) in the brain (cerebrum) [23].

Receptor And Transporter Gene Products Affected By Cocaine

Cocaine binds to the following dopamine, serotonin, and norepinephrine transporters and blocks the transport of these neurotransmitters back into the presynaptic terminals enhancing their effects:

  • TAAR1 (Trace amine-associated receptor 1) [24]
  • VMAT2 (Vesicular monoamine transporter 2) [25]
  • DBH (Dopamine β-Hydroxylase) [26]
  • DRD2 (Dopamine Receptor D2) [26]
  • SLC6A3 (Dopamine Transporter) [26]
  • SLC6A4 (Serotonin Transporter) [26]
  • SLC6A2 (Norepinephrine Transporter) [26]

Desired Short-Term Effects Of Cocaine

Cocaine’s appealing short-term psychoactive effects (intense high) include [2728]:

  • Euphoria – a general state of intense happiness or self-confidence
  • Increased energy, alertness, or sociability
  • Inflated self-esteem
  • Decreased fatigue
  • Decreased appetite [29]

3 Medical Uses Of Cocaine

Besides cocaine, the coca leaves contain essential nutrients such as vitamins and minerals and have many health benefits [4].

Chewing coca leaves can treat gut symptoms, environmental stress, hunger, and altitude sickness through brain stimulation and mood elevating properties [30, 31].

Coca leaves also raises the body’s blood glucose level above fasting levels, which can decrease the feeling of hunger [3230].

However, refined cocaine is a very powerful stimulant that has a limited number of health benefits. These health benefits do NOT counteract the addictiveness and side effects of cocaine.

1) Produces Topical Anesthesia For Surgical Procedures

The numbing properties of cocaine make the drug an ideal anesthetic for surgical practices [33].

Cocaine exerts this effect by inhibiting sodium channels, decreasing nerve impulse conduction and neuropathic pain [3435].

Cocaine, when combined with other compounds (tetracaine and adrenaline), can be used as a topical anesthetic for minor facial and scalp lacerations [36].

2) Helps Wound Healing

A topical gel, which combines adrenaline and cocaine is also effective in treating cuts on children without toxic side effects unless the topical anesthetic run off onto mucosal surfaces or into the eye [3738].

3) Might Help With Weight Loss

Cocaine decreases storage and increases the breakdown of fat through its effects on the brain (neuropeptide CART) while maintaining fat appetite [39].

Animal studies have demonstrated that both food reward and cocaine increased dopamine release in the brain (nucleus accumbens) [14, 18].

Also, cocaine produces a feeling of fullness, which is controlled by dopamine actions in different parts of the brain (nucleus accumbens core) [40].

However, given the adverse effects of cocaine consumption, its effects on weight loss are often overlooked.

5 Adverse Side Effects/Risks Of Cocaine

Cocaine is a powerful drug that has both short and long-term effects.

Clinical studies on both humans and animals have shown that cocaine use can damage the heart, brain, liver, kidneys, gut, and blood vessels [41, 4243, 444546, 4748, 49, 50].

Also, if snorted, cocaine can damage nostril tissues and if smoked, the lungs [51, 5253].

How Cocaine Exerts Its Adverse Effects

Cocaine exerts its adverse effects at both cellular and molecular levels. Cocaine increases addictive behavior by maintaining dopamine transmission in the brain (nucleus accumbens and dorsal striatum), creating cravings in addicts [5455].

Mitochondria are the energy generators of the cell. As shown by cell-based studies, cocaine can accumulate inside the cell and damage the functional and structural integrity of mitochondria disrupting cellular energy production and resulting in cell death [56].

Also, animal studies showed that cocaine could produce oxidative stress in cells and alter mitochondrial gene products [57].

In the heart, this oxidative stress leads to toxicity and cell death, as observed in human cocaine overdose [58].

1) Psychological And Mood Disorders

Cocaine can significantly impact the user’s mood and psychological state. Cocaine users have reported a wide range of adverse psychological effects including anxiety, depression, mood swings, paranoia, and panic attacks [59].

Chronic cocaine use can cause symptoms of excited delirium and aggression [60].

Observational research has shown that cocaine users are significantly more likely to develop depression [61] and psychosis [62].

On the flip side, cocaine addiction is also a consequence of depression and other mental health disorders. According to epidemiologists, 53% of adults that have a drug problem also have a coexisting mental health disorder [63].

Although rare, higher doses can cause hallucinations or false sensory perceptions [64].

Abstinence from cocaine use can create withdrawal symptoms like mood disturbances and cravings [65].

2) Can Negatively Impact Sleep

Cocaine can alter and impair chemical and physical balance (homeostasis), wakefulness, and sleep due to chemical changes in the brain [66].

In animals studies, cocaine disrupted normal sleep patterns [67].

More specifically, cocaine can lead to a reduction in REM (rapid eye movement) sleep, which has also been associated with depression. Also, cocaine disrupts the total amount of time spent in REM sleep, REM percent, and REM eye movement density [68].

Cocaine use impairs the normal sleep cycle, while dependence causes associated profound sleep problems [69].

Sustained abstinence in cocaine addicts will produce insomnia and decreased sleep [70].

Consequently, sleep disturbances and insomnia can cause depression and lead to suicide [71].

3) Damages Cognitive Functioning

Long-term cocaine use can negatively impact the cognitive functions of the brain. A preliminary study based on arithmetics and memory showed brain impairment in 20 heavy cocaine abusers [72].

Studies have shown that cocaine users have decreased short-term memory, attention, and concept formation compared to non-users [7374].

Long-term cocaine use worsened cognitive functions including memory, attention, and decision-making. Magnetic resonance imaging (MRI) studies have shown that cocaine deactivates or decreases the activity in many regions of the brain (anterior cingulate, anterior insula, striatum, cingulate gyrus, frontal gyrus, and right prefrontal cortex) [28].

Cocaine reduced memory and learning (neurobehavioral) performance and these effects lasted for up to 4 weeks of abstinence in 56 chronic cocaine users [75].

Cocaine use also compromises an individual’s ability to control drug urges or addictive behavior (impulse control) [76].

4) Causes Respiratory Complications

Smoking “crack” (freebase cocaine) can result in pulmonary complications including asthma, airway injuries, difficulty breathing, wheezing, inflammation, and bleeding of the lungs (pulmonary barotrauma, hypersensitivity pneumonitis, pulmonary hemorrhage, obliterative bronchiolitis, and pulmonary edema) [7778].

The acute respiratory symptoms of smoking cocaine include coughing with sputum, chest pain, shortness of breath, coughing of blood (hemoptysis), and worsening of asthmatic symptoms [78].

Prolonged exposure to cocaine can lead to obstructive pulmonary disease (transient pulmonary infiltrates), airway obstruction, and fever [79].

A case report of a 26-year-old university student showed that sniffing cocaine could also lead to damage and inflammation of the lung (cellulose granuloma) [80].

Other reports indicated that inhalation of (freebase) cocaine could directly damage the pulmonary gas exchange surface [81].

5) Causes Heart Complications

Cocaine use causes several short-term physical effects such as increased blood pressure, constricted blood vessels, and increased heart rate [5782].

By increasing heart rate and blood pressure, cocaine increases the heart’s oxygen demand [83].

When oxygen demand is high, blood vessels normally expand to increase blood flow and oxygen delivery. However, cocaine causes blood vessels to constrict, increasing the overall blood pressure while decreasing the overall oxygen delivered. This can lead to damaging of the blood vessels (atherosclerotic lesions) [84].

Cocaine is also commonly associated with heart complications such as hypertension, irregular heart rates (arrhythmias and tachycardia), reduced blood flow to the heart (myocardial ischemia), heart attacks (myocardial infarction), and sudden heart (cardiac) death [8586].

The risk of an acute heart attack is increased 24 times after cocaine use in relatively low-risk individuals [87].

An autopsy performed on 40 subjects who were positive for cocaine revealed that cocaine use leads to inflammation and damage to the heart muscle (myocarditis) [88].

Intravenous cocaine use can increase the chances of bacterial infections (endocarditis) and also damages the heart [89, 83].

Cocaine abusers also have a higher prevalence for coronary artery aneurysms [90].

Signs of Cocaine Use

Warning signs of chronic cocaine use include:

  • Red or inflammation of the eyes (periorbital and orbital cellulitis) [91]
  • Dilated pupils [92]
  • Runny or bleeding nose with swollen, inflamed mucosa [93]
  • Difficulties standing or sitting [92]
  • Behavioral changes like repetition and ritualistic behaviors [94]
  • Emotional changes [95]
  • Incoherent speech [92]

Overdose Symptoms

Consumption of high doses of cocaine can result in overdose or poisoning. Cocaine overdose results in experiencing an augmentation of its adverse side effects. Symptoms include [96]:

  • Psychosis, agitation, or delirium (acute behavioral toxicity)
  • Long-term toxicity in the form of seizures or stroke
  • Convulsions
  • Heart problems (irregular heart rate and increased blood pressure)
  • Respiratory problems
  • High body temperature (thermoregulatory problems)

What To Take To Reduce Adverse Effects While Under The Influence

Because of cocaine’s effect on transporters in the brain, synaptic dopamine is metabolized and excreted before normal re-uptake can occur [97].

Depletion of dopamine leads to depression, decreased cognitive function, and fatigue. Administration of L-tyrosine helps to increase dopamine concentrations in the brain (L-tyrosine>Dopa>Dopamine) [98].

Tyrosine can come from nutritional supplements [99] or food sources such as chicken, turkey, soy products, or fish.

However, while increasing tyrosine may potentially mitigate some adverse effects of dopamine depletion, such as depression or mood disorders, its efficacy is limited and does not guarantee mitigation of all of cocaine’s adverse effects [100].

Treatment Of Addiction (Cognitive-Behavioral Approach)

There are many different strategies or treatments for cocaine addiction. One approach is through cognitive-behavioral therapy (CBT). CBT utilizes several important tasks to combat cocaine addiction, including [101, 102]:

  • Maintaining motivation to abstain from drug use by placing the user in perspective of gains/losses through drug use (what is important in a user’s life) [103]
  • Teaching effective coping skills [104]
  • Identifying and reducing habits associated with drug use [101]
  • Fostering management and tolerance of withdrawal effects such as depression or anger [105]
  • Building and using effective social supports and environment to decrease the risks of addiction [106]

Want More Targeted Ways to Improve Your Mood?

If you’re interested in natural and more targeted ways of improving your mood, we at SelfHacked recommend checking out this mood wellness report. It gives genetic-based diet, lifestyle and supplement tips that can help improve your mood. The recommendations are personalized based on your genes.

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