The Short & Long Term Effects of Cocaine

Cocaine is a highly addictive stimulant drug that produces many short-term and long-term effects. By better understanding cocaine and its complications, caregivers may be in a better position to begin a conversation with the user about addiction treatment to get the help that they need to get healthy again.

Method of ingestion impacts the effects of cocaine

People use cocaine in different ways. They may inject with a syringe, snort, smoke or eat it. The method used to ingest cocaine affects the time that it takes for it to reach its highest concentration in the user’s bloodstream and the length of time of the drug’s effect;

	Time to reach peak concentration level in the bloodstream	Duration of effect
Smoking or injection	1-5 minutes	5-60 minutes
Eating	60-90 minutes	Up to 180 minutes (3 hours)

Short-term and long-term effects of cocaine on the body’s organs

Cocaine abuse has detrimental effects on many organs within the body. For example, ongoing cocaine abuse can cause structures within the brain to physically change. Organ damage can trigger short-term and long-term effects that impact physical and mental health. Being young and healthy does not protect one from such complications, nor does it reduce the risk of an overdose. 

Short-term effects of cocaine

Brain	Lungs	Stomach and colon	Other
Dizziness Violent behaviour Panic Anxiety Intense happiness Extra energy Overconfidence Paranoia Talkative Restlessness Irritability Decreased appetite	Rapid breathing Difficulty breathing	Nausea and vomiting	Dry mouth Dilated pupils Heightened sense and sensitivity to light, sound and touch Temporary decreased need for sleep Tremors Muscle twitches

Long-term effects of cocaine

Long-term effects and other severe health conditions linked to continuous cocaine use include:

Brain	Heart	Lungs	Stomach and colon	Other
Depression Sleeping problems Mood swings Erratic behaviour Violent behaviour Paranoia  Hallucinations Psychosis Convulsions and seizures Sexual trouble Loss of smell Bleeding in the brain (can be fatal) Addiction	Severely high blood pressure Irregular heartbeat Fast heartbeat Heart disease Heart attack Stroke Cardiotoxicity (can cause sudden death)	Lung damage	Stomach pain Nausea Vomiting Bowel perforation (hole) Bowel decay	Impotence (males may have difficulty getting an erection) Low libido, (men and women) Poor nutrition Changes in appetite  Pregnancy complications  Elevated risk of stillbirth, miscarriage and premature delivery

Specific long-term effects of cocaine are associated explicitly with the way the method of ingesting cocaine; 

Long-term effects of smoking crack (cocaine)	Long-term effects of snorting cocaine (nose and sinus problems)	Long-term effects of injecting cocaine
Severe chest pain Low blood oxygen Difficulty breathing Wheezing when breathing Shortness of breath Breathing failure (stop breathing) Collapses lungs filled with fluid Coughing Coughing up blood from the lungs	Lost sense of smell Frequent nosebleeds Runny nose Red, chapped or runny nose Frequent nose and sinus infections Trouble swallowing Developing a hole in the wall between the nostrils	HIV Hepatitis

Cocaine effects and complications for pregnant women and their baby

Pregnant women and their unborn children can also experience a wide range of short-term and long-term effects and complications due to the use of cocaine. 

Pregnant woman using cocaine	Cocaine side effects and complications in utero (unborn):	Cocaine side effects observed in the child after birth:
Euphoria Decreased appetite Weight loss Malnutrition High blood pressure High pulse rate Heart attack Delirium Panic Aggression Loss of muscle coordination Increased sexual drive Infections (gonorrhea, Chlamydia infections, syphilis, HPC) Insomnia Headaches Convulsions Heart arrest Sudden death Premature birth Fetal death	Impaired brain growth Impaired growth in general Brain structure and function abnormalities Blocked arteries supplying blood and oxygen to the brain  Arm and / or leg defects Urinary tract malformations	Impaired cognition Learning disabilities Impaired language development Impaired motor development  Attention-deficit Prone to substance abuse in adolescence Difficult to calm Hyper alert Heart rate abnormalities

Cocaine and asthma

Certain pre-existing conditions may cause more specific short-term and long-term effects and complications in cocaine users. For example, somebody with asthma who uses cocaine may increase their risk of an asthma attack which could require hospitalization, intubation as well as ventilation. Moreover, a study showed that cocaine users with asthma have a higher likelihood of not using their asthma medications properly, which can put them at risk for uncontrolled asthma.

Cocaine overdose

A cocaine overdose can be lethal. The risk of overdose increases when one adds alcohol and opioids into the mix with cocaine. An overdose can result in seizures, convulsions, respiratory failure, stroke, irregular heartbeat, heart attack or liver failure. Injecting cocaine puts one at risk of getting a skin infection, blood poisoning or infection of the lining of the heart and even death. Sharing needles, pipes or spoons puts one at risk of getting HIV, Hepatitis B or Hepatitis C.

Medical terms and explanation of various cocaine-related complications

Cocaine users can experience life-threatening experiences, which can result in hospitalization. A drug-related hospitalization can be a frightening experience for both the user and the caretaker. A physician or nurse may use medical words to describe cocaine short-term and long-term effects and complications. It can be stressful when you do not understand the meaning of medical terms. Here is a list of some of medical terms and their definitions;

Agonal breathing: Struggling to breathe, gasping for air

Akinesia: Very slow or lack of movement

Akathisia: Inability to stay still

Apnea: Momentarily stopping to breathe

Areflexia: Muscles do not respond

Arrhythmia: Problem with the rate or rhythm of the heartbeat

Bradykinesia: Inability to move the body

Cardiac fibrosis: Scarring of the heart muscle

Cocaine-induced rhabdomyolysis: A syndrome that is caused by the death of muscle tissue which can be toxic in the bloodstream and which can lead to kidney failure

Coronary syndrome: A condition where the blood that is flowing to the heart is either suddenly stopped or severely reduced

Delirium: Severe confusion and reduced awareness of one’s surrounding

Diaphoresis: Excessive sweating

Dyspnea: Difficulty breathing

Dystonia: Muscles contract uncontrollably

Cocaine-induced cardiotoxicity: Sudden death

Cyanosis: Bluish skin

Ectopic beats: Extra or skipped heartbeats

Epistaxis: Nosebleed

Hypertension: High blood pressure

Hyperthermia: Abnormally high body temperature 

Irregular breathing: A substantial increase in breathing rate or a momentary pause (stop) in breathing

Ischemic stroke: A stroke is caused by a blood clot that blocks the inside of a blood vessel in the brain, preventing blood from flowing to the brain.

Myocarditis: Inflammation of the heart muscle

Paranoia: Anxiety or fear make the person believe that somebody wants to harm them

Pruritus: Itch

Renal failure or kidney failure: The kidneys suddenly stop being able to filter and clean the blood. 

Tachydysrhythmia: Fast heart rate with more than 100 beats per minute. 

Tachypnea: Rapid breathing

Vertigo: Dizziness

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References:  

Andreea Hetea et al. Alcohol and Psychoactive Drugs in Pregnancy. MAEDICA – J of Clinical Medicine. 2019; 14(4): 397-401. 

Government of Canada. Substance use. Date modified 2020-04-03. https://www.canada.ca/en/health-canada/services/substance-use/controlled-illegal-drugs/cocaine-crack.html#a1

Hetea, A., Cosconel, C. et al. Alcohol and Psychoactive Drugs in Pregnancy. Maedica – a Journal of Clinical Medicine. 2019;14(4): 397-401.

John R. Richards and Jacqueline K. Le. Cocaïne Toxicity. StatPearls Publishing; January 2020.

Kurt D. and Lubo Zhang. Short- and long-term adverse effects of cocaine abuse during pregnancy on the heart development. Ther Adv Cardiovasc Dis. 2009 February; 3(1):7-16. Doi: 10.1177/1753944708099877.

S-Y.A. Tsai et al. The cellular basis of fetal endoplasmic reticulum stress and oxidative stress in drug-induced neurodevelopmental deficits. Neurobiology of Stress 10 (2019) 100145. pp.12

Sung Tae Kim and Taehwan Park. Review: Acute and Chronic Effects of Cocaine on Cardiovascular Health. International J of Molecular Sciences. 2019, 20, 584.

Underner, M, et al. Asthme et usage de cannabis, de cocaïne ou d’héroïne. Revue des Maladies Respiratoires (2020), https://doi.org/10.1016/j.rmr.2020.06.004