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What Does Cocaine Do to Your Brain?
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What Does Cocaine Do to Your Brain?

Written by Seth Fletcher on January 27, 2024
Medical editor Dr. Chintan Shah
Last update: April 9, 2024

Cocaine derives from the coca plant leaves and is a potent and highly addictive drug. It delivers an intense high when smoked, snorted, or injected and can significantly affect brain cells, even when used only a few times. So, what does cocaine (coke) do to your brain? Cocaine use causes short-term effects, which wear off within days and long-term effects that can be permanent. CCFA explores cocaine addiction and the brain and the effects of cocaine on brain function and mental health.

Key Takeaways

●  Cocaine is a highly addictive drug that can have profound effects on the brain

●  Cocaine abuse can lead to long-term changes in brain structure and function

●  The brain can recover much of the damage sustained from cocaine abuse

●  With the right help, people can recover from cocaine addiction and live meaningful lives

How Does Cocaine Affect the Brain?

The effects of cocaine on the brain occur due to its action on the brain’s chemical processes. Cocaine is a stimulant that acts on the brain’s reward system. When you take cocaine, your brain releases large amounts of dopamine and serotonin, neurotransmitters that regulate pleasure and motivation. These chemicals are responsible for the powerful euphoric effects associated with cocaine use.

Cocaine bypasses the brain’s natural reward mechanism by preventing neurotransmitter uptake. When the high from cocaine wears off, the user feels an unpleasant comedown or “low” and desires more of the drug. If they continue to use the drugs, cocaine effects will cause the user to develop tolerance, a situation where they need more of the drug to obtain the same euphoric sensations.

Cocaine is one of the world’s most addictive drugs, and prolonged use will ultimately lead to dependence and addiction. The signs of cocaine use and addiction may be physical, behavioural, or psychological. A person with a cocaine addiction will experience intense and highly unpleasant withdrawal symptoms when they try to stop or reduce cocaine use.

If you or a loved one is struggling with cocaine use and addiction, the Canadian Centre for Addictions can help. At CCFA, we employ sophisticated addiction recovery strategies in an environment that inspires lasting change. Call 1-855-499-9446 today for addiction support and counselling.

Short-term Effects

The short-term effects of cocaine on the brain include:

Increased Energy and Mental Alertness

Cocaine blocks dopamine reuptake in the brain, meaning that it stays longer than it usually would, causing a feeling of increased energy and mental alertness. Cocaine also increases the level of noradrenaline and adrenaline, two neurotransmitters involved in the body’s flight or fight response.


Cocaine triggers euphoria in the short term by blocking the reuptake of dopamine and serotonin, two neurotransmitters that impact pleasure, motivation, and reward. When released in large amounts, these chemicals elicit a feeling of intense euphoria, which wears off quickly.

Increased sensitivity to stimuli

Cocaine affects how the brain responds to external stimuli by changing the activity of the amygdala and hippocampus, areas of the brain that play a role in processing sensory information and emotional responses. Cocaine also increases the activity in the sympathetic nervous system, which regulates the body’s flight or fight response.

Anxiety and Irritability

By disrupting the brain’s neurotransmitter systems, cocaine can cause anxiety and irritability. Preventing the normal reuptake of dopamine and other neurotransmitters causes an imbalance of these chemicals, leading to anxiety and irritability. It can also do so by triggering an acute stress response.

Panic Attacks

Cocaine triggers the sympathetic nervous system, which regulates the flight or fight response. This response is characterized by rapid breathing, increased heart rate, sweating and other physical symptoms which can lead to panic attacks.

Long Term Effects

Cocaine also produces long-term adverse effects on the brain, including:

Changes to the Brain’s Physical Structure

Cocaine can speed up the loss of grey matter in the prefrontal cortex, the area of the brain responsible for executive functions such as planning, self-control, and decision-making. Studies also reveal that cocaine can shrink the amygdala, the part of the brain involved in emotional regulation. These brain structure changes can have long-term effects on an individual’s ability to function daily.

Changes to the Brain’s Reward System

The brain naturally releases dopamine in response to desirable external events or stimuli. Prolonged cocaine use can interfere with this process, making the brain less responsive to other forms of pleasure like eating, having sex, spending time with loved ones or engaging in one’s hobbies.


Continued cocaine use will make the brain less responsive to the drug over time. As the brain adapts to the presence of cocaine by reducing the number of dopamine receptors, it can lead to tolerance. The brain becomes less sensitive to cocaine, and the user will need more of the drug to get the same effect.

Cognitive Decline

Studies show that individuals who repeatedly use cocaine exhibit cognitive deficits related to attention, memory, and executive functioning.

Premature Brain Aging

Your brain loses grey matter as you age; this natural process takes decades and does not necessarily affect your memory. However, chronic cocaine use can speed up grey matter loss and lead to memory issues or increase the risk of dementia.


Regular cocaine use can increase levels of cortisol, the body’s stress hormone. It can also cause the brain stress receptors to become more sensitive, leading to feelings of dissatisfaction and negativity when the drug is withdrawn.

Increased Sensitivity

In some cases, prolonged cocaine use can cause the brain to become more sensitive to the drug’s toxic effects at lower doses. Increased cocaine sensitivity can also lead to a higher risk of cocaine overdose and death.

Brain Disorders and Psychological Effects

Long-term cocaine use increases users’ risk of conditions like Parkinson’s disease, brain hemorrhage, seizures, aneurysms, and strokes. They may also be more likely to have neurological issues like paranoia, psychosis, and panic attacks.

Can Cocaine’s Effects on the Brain Be Physical

Certain questions may arise around this topic - does cocaine kill brain cells, and does it cause brain damage? Undoubtedly, cocaine’s effects on brain chemistry are not only psychological; they can also be physical. Studies show that continued cocaine use affects the size of brain regions, such as the hippocampus, which is involved in learning and memory. Cocaine use has also been associated with changes in the striatum, a part of the brain that plays a role in motivation and reward. Chronic cocaine use has also been linked to reduced white matter in the brain, which can affect communication between different brain regions.

The physical effects of cocaine use on other organ systems can also affect the brain. Damaged veins and linings due to cocaine abuse can restrict blood flow to the brain, potentially leading to headaches, blood clots, strokes, and seizures.

Can the Effects of Cocaine on the Brain be Reversed?

While the effects of cocaine on the brain may be long-lasting, it may be possible to reverse some of the damage sustained from chronic cocaine use. The amount of recovery possible may be affected by individual brain chemistry and the duration and frequency of cocaine use.

Structural changes caused by chronic cocaine use, such as a decrease in the size of the hippocampus, can be reversed after a period of abstinence. This study found that moderate cocaine effects on brain function are at least partially reversible if recovery begins within one year.

Another study also links withdrawal to many long-term effects of cocaine use, suggesting that abstinence from cocaine for at least five months can reverse much of the brain damage caused by the drug. It should be noted that in some cases, the brain may never fully recover from cocaine use, and some damage may be permanent.

Treatment Options for Cocaine Addiction

There are a variety of options for drug addiction treatment. The best treatment is one tailored to the specific needs of the person requiring drug addiction treatment. Treatment for cocaine addiction includes one or a combination of the following approaches.

Medical Detox

Medically supervised detox is the first step in cocaine addiction treatment. It helps to get all traces of the substance out of the individual’s system while managing cocaine withdrawal symptoms in a safe environment. Medical detox may last a few days to weeks, depending on the severity of the addiction.

Inpatient Rehab

Individuals with severe addiction cases may need to spend time in a treatment facility while undergoing personalized round-the-clock treatment. CCFA offers patient-oriented inpatient treatment to clients with severe cocaine addiction.

Cognitive Behavioural Therapy

Cognitive behavioural therapy (CBT) is a popular form of drug addiction treatment that helps people identify negative thoughts and beliefs that may be contributing to their addiction. CBT helps people with cocaine addiction to recognize and challenge these negative thought patterns while replacing them with more positive and helpful ones. CBT sessions may be performed individually or in a group setting.

Support Groups

Support Groups like Narcotics Anonymous and SMART Recovery provide a space for people to share their experiences and receive support from others who have been through similar situations. The 12-step approach to recovery has been effective in helping many people overcome addiction.

Aftercare Treatment

Overcoming cocaine addiction is challenging, and relapses after treatment are common. Aftercare treatment helps patients stay in touch with their treatment and keeps them on the path to sobriety when they face challenges. At CCFA, we offer several supportive services to help individuals maintain their sobriety after completing their treatment program.

When to Seek Professional Help

Cocaine is an extremely powerful drug, and even occasional use can be harmful to your brain. It’s crucial to seek professional help for cocaine use if you notice the following:

●  You use larger amounts of cocaine than intended

●  Trying and failing to reduce or stop cocaine use

●  Spending much time using cocaine or trying to recover from the effects of cocaine use

●  Continued cocaine use despite obvious physical or mental health issues

●  You continue to use cocaine even when it’s affecting your work, school, or other activities

●  Giving up important or once enjoyable activities to use cocaine

●  Continued cocaine use even when it’s affecting relationships with friends and loved ones

●  You use cocaine in dangerous situations like driving or operating hazardous machinery

●  Having intense cravings for cocaine whenever you stop using

●  Experiencing withdrawal symptoms when you cut back or stop cocaine use


Cocaine has a significant impact on the brain. The rush of dopamine elicits intense feelings that make you want to use the drug again. Over time, cocaine use changes the brain’s structure and function, leading to addiction and other adverse health consequences. The brain’s plasticity means it can heal over time, and with proper treatment, you can recover from addiction and live a healthy, fulfilling life.

If you or a loved one is struggling with cocaine addiction, the Canadian Centre for Addiction can help. Our team of qualified addiction experts helps people understand how cocaine affects the brain and the healthier coping strategies available by engaging them in one-on-one counselling with certified counsellors, psychiatrists, and mental health professionals. Call 1-855-499-9446 to learn more about our cocaine addiction treatment programs.


What organ is affected by cocaine the most?

Cocaine can affect several organs in the body, but it is most damaging to the brain. The brain controls a person’s thoughts, feelings, and behaviours, and cocaine use can alter its function. Cocaine affects the brain’s neurotransmitters and can lead to loss of grey matter over time.

How is cocaine addiction diagnosed?

Cocaine addiction is a stimulant use disorder diagnosed using criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders, Edition 5 (DSM-5), a guide used by healthcare professionals for diagnosing substance use and other mental health disorders. Your healthcare provider will inquire about your current usage and health history to determine addiction.

Is your brain affected after using cocaine once?

A single use of cocaine is unlikely to cause any significant effect on your brain. However, it is crucial to note that using cocaine even once affects the reward system, making it more likely for you to use cocaine again.

What happens if you mix alcohol and cocaine?

Mixing alcohol and cocaine is dangerous and potentially life-threatening. Alcohol is a depressant that slows down brain activity, while cocaine is a stimulant that increases brain activity. Combining both substances produces cocaethylene, a stronger metabolite than either alcohol or cocaine. Cocaethylene is toxic to the body’s organs and increases the risk of certain health complications, such as a potential overdose.

What are some cocaine-related mental disorders?

Cocaine-related mental health disorders are mental disorders induced by cocaine use. They include:
● Depression
● Anxiety
● Psychosis
● Post-acute withdrawal syndrome (PAWS)

Certified Addiction Counsellor

Seth brings many years of professional experience working the front lines of addiction in both the government and privatized sectors.

Dr. Chintan is a Board Certified Family Physician with an interest in holistic and preventative care as well as healthcare systems. Credentialed Physician with both American & Canadian Board of Family Medicine. Adjunct Professor in the Department of Family Medicine at the Schulich School of Medicine & Dentistry. Telemedicine clinician.

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