What Cocaine Does to Your Body and Mind: Short-Term and Long-Term Effects

Cocaine is a stimulant. It speeds up the messages travelling between the brain and the body, and that speed is what people are buying: energy, confidence, talkativeness, the sense that the night is going somewhere. In this article I want to describe what it actually does, first in the hours after using and then over the years, in plain language, because knowing what is really happening makes it easier to make sense of what you are experiencing.

The first hour or two

Shortly after use, cocaine raises the level of dopamine in the brain, the chemical involved in pleasure and motivation. People typically feel euphoric, confident and wide awake, and conversation feels easy. Heart rate and blood pressure rise and appetite fades. For a while, everything feels sharper.

That same speed carries the risk. Cocaine makes the heart work harder and narrows the blood vessels, and taking too much can cause a heart attack or a stroke. The risks grow with the amount used and how often it is used.

The comedown

What goes up, must come down. In the hours and days that follow, many people feel low, anxious, tired and irritable, and sleep is often poor. Cravings can be strong, and the quickest way to switch them off is to use again, which is how one night out quietly becomes a pattern. Regular use can leave people run down and depressed, which is the opposite of what they were looking for when they started.

What repeated use does to the body

The heart carries much of the long-term cost. Regular cocaine use is linked with dependence, heart damage, and problems with blood pressure and heartbeat. That risk does not switch off between sessions; it builds with every weekend that ends the same way.

Snorting damages the nose. The lining inside can become inflamed and then damaged, and in serious cases the wall between the nostrils wears through. That damage does not need to reach crisis point before it is worth taking seriously.

Around this sit quieter changes: broken sleep, weight loss as appetite stays away, and a body that seems to pick up every bug going round.

What repeated use does to the mind

Anxiety, paranoia and low mood are among the most common mental health effects for people who use cocaine regularly. And a circle forms that is hard to see from inside: cocaine lifts the mood for an hour or two, the comedown takes more than it gave, and using again feels like the obvious answer.

Mixing cocaine with alcohol

This combination is common on nights out, and many people do not know it carries its own risk. When both are in the body, the liver produces a substance called cocaethylene. It lasts longer in the body and is more toxic than either substance on its own, putting extra strain on the heart and other organs, including the liver. Mixing also makes it easier to drink past the point where you would normally stop.

Crack cocaine

Crack is cocaine in a form that is smoked. It reaches the brain within seconds, and the effects are intense and short-lived, so people use again and again to hold on to the feeling. If your picture of cocaine is powder on a Friday night, it is worth knowing that crack works on the same brain system, only faster.

What helps

Stopping does not undo everything overnight, but it stops the damage accumulating, and many effects improve once use ends. A GP or local drug and alcohol service can assess what is happening and discuss treatment, and FRANK can help you find local services. Therapy gives that work somewhere proper to go: a regular hour to look at what the cocaine is doing for you, the triggers that start a craving, the shame that keeps it secret, and what you would rather do with your money and your evenings.

If someone has chest pain, a seizure, collapses or has difficulty breathing after using cocaine, call 999 immediately.