Cocaine is a potent stimulant drug that is most notorious as a substance of abuse, although it is listed by the Drug Enforcement Administration (DEA) as a Schedule II drug. Cocaine can be found either as a whitish, off-white, or tan powder, or it can be found in brown, yellow, or off-white rocks, which is crack cocaine.
The drug is highly addictive, and abusing it in any form can lead to long-lasting harm to the brain and body. Long-term use of cocaine affects various body systems.
- Brain: A study conducted at UC San Francisco’s Ernest Gallo Clinic and Research Center found that using cocaine even once can rewire the brain’s decision-making ability; this problem can quickly lead to abuse issues, cravings, and addiction. Changes in behavior stem from changes in brain structure in the reward center, as dopamine floods the brain, telling the individual that they are being rewarded for something good. Cocaine releases substantial amounts of dopamine for several hours; as the drug wears off, the person crashes, often feeling fatigued and depressed. They may seek out more cocaine immediately in order to avoid the comedown effects, which can lead them on a cocaine binge; a cocaine binge may cause overdose, physical dependence, and long-term health problems.Even just fulfilling cravings for cocaine may lead to addiction, which is characterized by compulsive behaviors to acquire and consume substances. This type of behavior is often beyond the individual’s power to control. Abstinence and therapy may help the person slowly “rewire” their brain back to a normal state over time.Chronic abuse of cocaine can lead to permanent anxiety, paranoia, delusions, and even hallucinations due to changes in how the brain processes dopamine. The person may struggle with depression, insomnia, mood swings, and a lower tolerance to environmental or emotional stress. The individual is likely to experience problems with motivation, cognition, memory, impulsivity, and judgment.
The structure of the brain may change to put the person at risk for seizures, involuntary muscle twitches, shaking, or other physical ailments. People who abuse cocaine or crack for a long time are more likely to develop dementia or Parkinson’s disease compared to the general population.
- Cardiovascular system: Cocaine increases adrenaline, which speeds up the heart, opens blood vessels, and increases blood pressure; consistently forcing this experience on the body can lead to weakening of the heart muscles, damage to blood vessels, and permanently raised blood pressure. In the short-term, this can induce a heart attack or stroke in people who are at risk of this; however, on a long-term basis, the consistent stress will put the person at risk of a heart attack, pulmonary embolism, cardiac arrest, or stroke.People who abuse cocaine age their heart considerably. A person who chronically abuses cocaine at age 30 is, per cardiologists, likely to have a heart function like that of a 60-year-old person. Cardiomyopathy, or the weakening of the heart muscles, is more likely to occur early in people who chronically abuse cocaine; they are also more likely to have cholesterol harden arteries, making a heart attack highly likely.
- Lungs: Smoking crack cocaine damages the lungs, but snorting cocaine also puts the person at risk of upper respiratory infections because it damages the mucous membranes throughout the nose, throat, and lungs. People who abuse cocaine or crack cocaine are at greater risk for tuberculosis and pneumonia as well as lung cancer.Abusing cocaine in any form may also trigger asthma or make the condition worse. Changes in how the body processes oxygen through breathing can also cause long-lasting damage to other organ systems.
- Nose and mouth: People who snort cocaine are notoriously at high risk of perforating their nasal septum, or the thin piece of tissue and cartilage separating the nostrils. If the septum is perforated, a hole develops; this can become infected or grow larger, leading to continuous damage to the cartilage of the face and eventual collapse of the nose.Damage to the cartilage of the nose and infection may spread to the upper palate, or the roof of the mouth. This bone and tissue separates the nasal passages from the mouth, and it can become damaged due to cocaine ingestion; the thin mucous membranes can rot away, exposing bone, which becomes damaged. This bone, too, can disintegrate and develop a hole.
- Skin: The skin is the largest organ of the body, and it detects when small environmental disturbances, like poisonous plants or insects, are invading a person’s space. However, a person who abuses cocaine – and especially, in this instance, crack cocaine – is at risk of developing hallucinations, especially in a category called formication. This type of hallucination involves thinking that insects or small creatures are crawling all over the body. This leads to picking at the skin, obsessive scratching, or compulsive grooming that can, ultimately, damage the skin.
- Gastrointestinal system: Snorting cocaine leads to swallowing a small amount of it, which can cause bowel decay. In some rare cases, a person may eat cocaine, which can also damage the entire digestive system. Smoking crack or abusing powdered cocaine also changes blood pressure and constricts blood vessels, cutting off oxygen supply to the gut. This can cause ulcers to develop and may lead to perforations in the stomach or intestines.Changes in appetite associated with cocaine abuse can cause malnutrition, from failing to eat or eating poor-quality food. Long-term, this can cause indigestion, acid reflux, bowel problems, chronic constipation or diarrhea, and more.
- Kidney failure: A person who abuses cocaine can damage their kidneys either through developing high blood pressure caused by substance abuse or by elevating their body temperature to dangerous levels. This causes the breakdown of skeletal muscles, releasing toxins into the blood that the kidneys cannot filter out. This severe condition is called rhabdomyolysis.
- Transmittable diseases: People who inject drugs intravenously or intramuscularly may share needles; this increases the risk of transmitting blood-borne infections, especially viruses. Those who inject cocaine are at risk of contracting HIV and hepatitis C.When a person is intoxicated on cocaine, their decision-making ability is reduced, but their sociability and sexual interest have likely increased. This makes the individual more likely to participate in risky sexual behaviors, which can cause them to contract a sexually transmitted infection.
- Drug abuse during pregnancy: Women who struggle with addiction to cocaine or crack cocaine and who become pregnant put their children at risk for birth defects. Prenatal exposure to cocaine changes the structure of the child’s brain, especially the location of dopamine receptors.Women who ingested relatively small amounts of cocaine during pregnancy could still cause harm to their children. Researchers found that these children often developed a condition similar to attention deficit hyperactivity disorder (ADHD) that was not responsive to stimulant medications like Ritalin or Adderall. Pregnant women who struggle with severe addiction to large amounts of cocaine or crack cocaine may give birth to children with what is colloquially called crack baby syndrome, which consists of emotional problems, retarded mental development, or other cognitive deficits.Prenatal cocaine exposure can also damage the heart and the autonomic nervous system that controls it. This can lead to a lifetime of heart disease, poor heart function, or early death.