Cocaine is the most potent known natural stimulant. It comes from the leaves of the coca bush, but is sold as a fine, white powder. It can be snorted, smoked or injected.

Pure cocaine was first used in the late 19th century for medical purposes. It was used in nose, eye and throat surgeries as an anesthetic. Because cocaine constricts blood vessels, it was also used to limit dangerous bleeding. Cocaine is still sometimes used as a topical anesthetic because it’s fast-acting and effective. Aside from medical uses, it’s illegal to use cocaine in most countries of the world.

When snorted, cocaine powder is inhaled through the nose. It’s absorbed quickly into the bloodstream via the nasal mucosa. When injected, a needle releases it directly into the bloodstream. Users smoke cocaine by inhaling smoke or vapor into the lungs. It’s then absorbed into the bloodstream. All three of these methods produce effects very quickly. They are also extremely risky and cause both short- and long-term effects.

Common Names

  • Cocaine
  • Coke

Street Names

  • Blow
  • C
  • Chalk
  • Coke
  • Flake
  • Marching powder
  • Nose candy
  • Snow
  • Crack (a crystalline form of cocaine, also called freebase cocaine)

Short-Term Effects of Cocaine

Cocaine is a strong central nervous system stimulant that affects both your brain and your body:

  • Causes blood vessels to constrict
  • Increases heart rate, blood pressure and body temperature
  • May cause an erratic heartbeat
  • Causes your brain to release large amounts of a neurotransmitter called dopamine
  • Alters the way your brain processes dopamine
  • Makes the user feel euphoric, energetic and alert
  • Makes you hypersensitive to sounds, sensations and light
  • May make you feel restless, irritable and anxious

Cocaine can make people feel like they’re on top of the world, but some people feel just the opposite. If you take a lot of cocaine, you may behave unpredictably and even become violent.

The euphoria that a cocaine user feels lasts less than an hour. How long the effect lasts depends on how cocaine enters the body. When cocaine is snorted, the effect lasts 15 to 30 minutes. When it’s smoked or injected, the drug is absorbed more quickly. The feeling is more intense, but the effects don’t last as long—as little as 5 to 10 minutes.

People who smoke or inject cocaine are thought to be at greater risk of harm than people who snort it. This may be because these methods cause more intense euphoria and other effects.

Long-Term Cocaine Effects

Some effects of cocaine are related to the method by which people ingest it:


Smoking cocaine can cause:

  • Coughing
  • Shortness of breath
  • Lung damage and bleeding
  • Severe chest pain


This causes:

  • Chronic runny nose
  • Nosebleeds
  • Loss of smell
  • Problems swallowing


This method can lead to infections of your skin and soft tissue. The veins you use can collapse. You’re also at risk of contracting HIV and hepatitis C if you share needles with others.

In the long term, any kind of cocaine abuse leads to dangerous risks and side effects. Some of these are potentially fatal. For instance, because cocaine impairs judgment, all cocaine users have a higher risk of self-destructive behavior, such as unprotected sex.

The most serious risks are to the heart because of the many ways cocaine affects your cardiovascular system. The combination of constricted blood vessels, higher blood pressure and a more rapid heartbeat are highly damaging in the long term. It can lead to:

  • Heart inflammation, which may eventually cause heart failure
  • Higher risk of stroke and heart attack
  • Risk of aortic aneurysm or rupture

Cocaine and Alcohol

People who use both cocaine and alcohol are at even more risk because the body converts them into cocaethylene. This substance affects the brain for longer than cocaine does by itself and causes more potent effects. It’s also toxic to the liver and can cause heart attacks.

Cocaine Contaminants

Cocaine may be mixed with other drugs, like amphetamines or opioids such as fentanyl. This is risky because it means the drug may be more potent than you expect it to be, or it could have unexpected side effects.

Cocaine Overdose

The risk of overdose is higher if you combine cocaine with another drug, but overdose is possible from cocaine alone. Whether cocaine is used by itself or with other drugs, an overdose can be fatal.

Symptoms of cocaine overdose include:

  • Difficulty breathing
  • High blood pressure
  • High body temperature
  • Hallucinations
  • Intense anxiety or agitation

More seriously, it can cause irregular heart rhythm, seizures, heart attack and stroke.

Cocaine Withdrawal Symptoms

When the effects of cocaine wear off, the body crashes almost instantly. This happens because the brain’s dopamine levels return to normal. Along with the crash, users feel a strong craving for more cocaine. They may also feel:

  • Fatigue
  • Anxiety
  • Irritability
  • Agitation
  • Paranoia
  • Anhedonia, or a lack of pleasure – This is linked to the rapid change in dopamine levels. It’s a major reason cocaine is so addictive.

Withdrawing from cocaine doesn’t cause major visible physical symptoms, like withdrawing from heroin or alcohol does, including vomiting, shaking and delusions. Because of this, many people underestimate how addictive cocaine is. Experts know that cravings, irritability, depression and other symptoms of cocaine withdrawal are often worse than the withdrawal symptoms of other drugs.

Cocaine Addiction Treatment

Cocaine addiction treatment is most effective when it’s in an inpatient setting because your ability to relapse is removed. At the moment, no medications are FDA-approved to treat addiction to cocaine, but behavioral therapy can help you stay sober in the long term. For instance, cognitive behavioral therapy (CBT) helps people unlearn the habits that led them to use cocaine. Then they learn new habits that help them stay sober and healthy.

Another kind of therapy is called contingency management. This uses monetary vouchers to reward patients for clear urine tests.

Cocaine is so highly addictive that it’s dangerous from the very first dose. But even a long-term cocaine user can break free from the addiction.

Take the first step to a better life. Call The Ranch today for a free, confidential consultation about treatment options: 18448767680.

Krisi Herron

Medically Reviewed by

Krisi Herron, LCDC

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