Effects of Cocaine on the Brain: Learn more

Cocaine belongs to a group of addictive substances known as drugs. It stimulates the nervous system to create feelings of euphoria. The body eventually craves more of the drug, and the cycle of addiction is born. Familiarizing yourself with the physical and psychological changes caused by cocaine proves that although the effects are initially pleasurable, there are deadly repercussions as cocaine affects the way the human brain thinks, feels, and behaves. Find out the effects of cocaine on the brain and much more.

Effects of Cocaine on the Brain
Effects of Cocaine on the Brain

Effects of cocaine on the brain: What is Cocaine?

Crack, coke, rock, snow—all are slang terms for cocaine: an addictive schedule 2 drug used as a stimulant. Cocaine is a derivative of the coca plant. This substance received its names from the white powder crystals extracted from the plant’s leaves. Substances like talc, corn starch, sugar, and procaine or amphetamines are often combined with the cocaine powder.

Cocaine is introduced to the body in a few ways. The most common manner of getting cocaine into the bloodstream is through nasal tissue. Users sniff the white powder up their nose. The drug can also be ingested or rubbed on the gums to absorb in the sensitive mucosal areas. However, it is absorbed at a faster rate by inhaling the powder or dissolving it in water for injection into the veins.

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Cocaine is a dangerously addictive drug. While smaller doses produce a high at first, larger amounts are needed to provide the desired effect with consecutive doses. As use increases, so do the potentially deadly symptoms.

Effects of cocaine on the brain: Risk Factors

According to the National Survey on Drug Use and Health, cocaine is the 2nd most popular recreational drug. All ages and genders have reported the incidence of cocaine use. For example, “nearly 4.7 million Americans aged 12 or older reported using cocaine in the past year” (MacLaren, 2017). However, there are certain risk factors that make some susceptible. Keep in mind that having multiple risk factors does not necessarily guarantee a cocaine addiction.

Effects of cocaine on the brain: Environment

The type of environment people lives in immensely impacts the risk of cocaine use. 

Environmental factors include:

  • Substance abuse in family or among peer groups—Humans learn from exposure. The behaviors others exhibit in our presence are viewed as “normal.” For example, a child growing up around a parent who abuses drugs assumes the behavior is acceptable. Regardless of age, there is also a strong desire to be liked by peers. If peers are partaking in cocaine use, the peer pressure fuels decisions one would not otherwise make.
  • Pop culture—The younger generation is especially influenced by drug use in the media, as culture regularly depicts drugs as glamorous and adolescents want to fit in even more so than adults.
  • History of physical, sexual, emotional abuse or trauma—Stress as a result of abuse leads many to resort to cocaine in order to distract from the underlying trauma.  
  • Poverty—Both the poor and the wealthy can become addicted to cocaine. However, those with a lower socioeconomic status tend to turn to addictive substances to more frequently. Experts have not established a correlation between actual finances and cocaine abuse, but agree the risk is related to factors such as neglect during childhood and a lack of education in poverty settings.

Effects of cocaine on the brain: Psychological Factors

The risk for cocaine use is not solely due to the influence of others. Various psychological components usually contribute.

  • StressChronic stress is a prime reason many fall victim to substance abuse. Studies reflect a positive correlation between those experiencing stress and cocaine use. Addiction serves as motivation and a coping strategy from the stress.
  • PersonalityImpulsivity, aggressiveness, and anxiety are personality traits that increase the chance of cocaine addiction. Those who are impulsive make rash decisions and may not consider the dangers and those who are aggressive show little self-control.
  • Depression—Depression is another motivation for drug use. Cocaine is known to boost mood. In cases of depression where someone is unusually sad for weeks at a time, cocaine seems like an easy fix for depression patients.
  • Existing psychological disorders—Similar to depression, other psychological disorders are associated with impulsive behaviors that can lead to poor decision making and eventually drug use. 

Effects of cocaine on the brain: Genetics

Genes are units that comprise human DNA. The body’s cellular activities are directed by genes. Sequences of DNA controls physical characteristics like the color of our hair and eyes. It also controls how the body functions physically and psychologically. DNA occasionally contains errors called mutations. When DNA becomes mutated, it impacts the function of cells. That is why genetic disease exists. While science has pinpointed exact mutations for illnesses, drug abuse can be linked to genes. Cocaine abuse specifically is associated with mutations in the gene DRD2, but there are others. Genetic predisposition accounts for a significant portion of cocaine risk.

Effects of cocaine on the brain: Gateway Drugs

Gateway drugs are substances that can lead to the use of more addictive drugs. Alcohol, nicotine, or marijuana are gateway drugs. A study at Columbia University found that mice used cocaine in increased amount and frequency after exposure to alcohol. Additionally, survey results report that almost all adult cocaine users have previously experimented with marijuana.

Effects of cocaine on the brain: Symptoms

As cocaine is absorbed systemically, the chemicals reach every bodily system. That means the effects are multi-system too. While some symptoms like headaches are minor, they escalate as addiction takes hold and the dose of cocaine to produce a high increases.

  • Light, noise, and touch sensitivity
  • Convulsions and seizures
  • Headaches
  • Sexual dysfunction
  • Trouble sleeping
  • Decreased appetite
  • Respiratory failure
  • Stroke
  • Cerebral hemorrhage
  • Heart attack
  • Birth defects
  • HIV (if injected)
  • Hepatitis (if injected)
  • Bowel decay (if ingested)
  • Loss of smell (if snorted)
  • Nose bleeds (if snorted)
  • Runny nose (if snorted)
  • Difficulty swallowing (if snorted)

Physical Effects of Cocaine on the Brain

Despite lung, cardiac, and gastrointestinal involvement, cocaine predominately affects the brain because of its influence on the central nervous system. The central nervous system is comprised of neurons, which are tiny cells that communicate through chemicals in the brain called neurotransmitters. Neurons signal the release of neurotransmitters that tell the body how to function and aids in overcoming stressful stimuli. Cocaine interferes with the way the brains neurons communicate by altering the brain’s neurotransmitter levels.

Effects of cocaine on the brain: Neurotransmitters

Although there are many neurotransmitters, dopamine and GABA are the two altered from cocaine use. The neurotransmitter, dopamine, oversees the body’s pleasure and reward system. Cocaine acts on dopamine by signaling a sudden release of dopamine in the area between neurons (synapses) and tricking the brain’s pleasure response. The abundance of dopamine is why users feel euphoria upon exposure. Normally a second neurotransmitter known as GABA counteracts the raised dopamine levels. However, the process is unsuccessful because cocaine blocks its release. Continual use of cocaine overwhelms the nervous system. Eventually, neurons in the brain can no longer communicate when the drug induces a rush of dopamine. The dopamine receptors are damaged.  

Effects of cocaine on the brain: Movement Disorders

Dopamine plays a role in numerous bodily processes. Movement is one of them! Movement disorders are characterized by neurological conditions that disrupt appropriate voluntary and involuntary movements.

Examples include:

  • Tremors—rhythmic shaking of hands, feet, head, or limbs
  • Tics and Tourette syndrome—repetitive, jerky movements or vocal sounds
  • Dystonia—involuntary, repetitive twisting of muscles throughout the body or in one area
  • Akathisia—restless sensation in legs and inability to stay still
  • Tardive dyskinesia—repetitive movements (i.e. eye blinking, tremors, grimacing)
  • Transient chorea—a combination of intermittent slow movements, muscle contractures, rigidity, and involuntary jerking

Cocaine is linked to movement disorders for a variety of reasons. The most common cause is from a lack of or rapid metabolism of dopamine as the receptors are compromised. Unnatural movements are also caused by cocaine brain damage after a stroke or hemorrhage. Medical professionals note that chronic or occasional use of cocaine exacerbates preexisting neurological movement disorders.

Effects of cocaine on the brain: Loss of Gray Matter

The human brain is made up of white and gray matter with cocaine use primarily affecting the latter. Gray matter is home to the brain’s communicators—neurons. The purpose of gray matter is to interpret information. As we age into older adulthood, the sections of the brain comprised of gray matter decrease. Reduction of gray matter is connected to cognitive impairments, memory problems, and dementia.

The loss of gray matter is a normal fact of life as we age, but cocaine hastens its decline. The University of Cambridge conducted an interesting study that demonstrated 1.69 millimeters of gray matter loss in the average adult per year and double that number for cocaine users (Pappas, 2012). High doses of cocaine kill off brain cells.

Psychological Effects of Cocaine on the Brain

The physical, biological processes disrupted by cocaine use a user’s psyche. The act of cocaine on the brain communication rewires the traditional manner the brain functions. Whether mood unpredictability, full-blown mental health disorders, or drastic changes in behavior, the psychological consequences of cocaine are catastrophic.

Cocaine Causes Stress, Anxiety, and Depression
Cocaine Causes Stress, Anxiety, and Depression

Effects of cocaine on the brain: Impaired Social Processing

To combat loneliness, social isolation can instigate cocaine use. However, cocaine’s direct effect on social processing amplifies social problems. In response to drug stimuli, long term cocaine users have strong activations in the areas of the brain that are responsible for reward. Those same users show a reduction for stimuli that typically increases brain activation in non-users (i.e. sex, money, relationships, etc.). Experts agree that the social repercussions of cocaine are emotional. The nervous system fails to recognize rewards from social interaction. Users accurately detect abnormal social interactions but do not receive the emotion or “rewards” from their relationships. The absence of reward only encourages their need for the drug and creates scant interest in human interactions.

Effects of cocaine on the brain: Depression  

The initial flood of dopamine within the body with cocaine use generates feelings of euphoria. Energy levels are enhanced, and feelings of happiness soon follow because dopamine regulates emotion. The high is short-lived. Depression, or unexplained sadness, hits as dopamine levels return to baseline. Depressive episodes are brief for users who use cocaine sparingly, yet heavy users can develop chronic depression requiring intensive mental health treatment.

Effects of cocaine on the brain: Paranoia, Anxiety, and Panic Attacks

Cortisol is a stress hormone and neurotransmitter in the brain. When exposed to stress, cortisol communicates to the body which functions to undergo to expedite healing. This might entail raising blood glucose, elevating heart rate, and boosting blood pressure for energy. Cocaine triggers the release of cortisol. As the body continually perceives it is under stress, the user becomes paranoid.

68% to 84% of cocaine users suffer from paranoia: irrational, untrue thoughts and feelings. Users believe they are threatened and that “everyone is out to get them.” Paranoia lasts hours and no convincing can denounce the untrue beliefs. Anxiety and panic are secondary to the paranoia, as users worry over false dangers.

Effects of cocaine on the brain: Cocaine Induced Psychosis

Chronic cocaine use or users who take excessive amounts of the drug are prone to cocaine-induced psychosis. Psychosis is a detachment of reality. Paranoia is the first sign. Hallucinations, delirium, agitation, and talking incoherently are common as the psychosis progresses. The effects of cocaine-induced psychosis are prolonged. Instead of hours, the symptoms last days to weeks. Symptoms stop with the cessation of drug use.

Effects of cocaine on the brain: Schizophrenia

It is challenging for mental health professionals to differentiate cocaine-induced psychosis symptoms from schizophrenia. Thus, 40% of addicts diagnosed with schizophrenia as a comorbidity. Schizophrenia presents with the disconnection of reality or psychosis, erratic behavior, concentration or memory problems, and anxiety.

Behavioral Effects of Cocaine on the Brain

The effects of cocaine on the brain’s mood regulation and emotional processing are distressing for both the user, as well as the user’s friends and family. Distress is heightened when thoughts stemming from emotional dysregulation are acted on. Aside from the risk of suicide from secondary depression and psychosis, other unfortunate behaviors ensue with cocaine use.

Effects of cocaine on the brain: Hyperactivity

Cocaine increases energy, while simultaneously interfering with attention. The substance is the perfect combination for breeding hyperactivity. Users experience a surge of energy, but the hyperactivity is not pleasant. The sensation of hyperactivity is described as “crawling out of your own skin” or a restlessness that does not go away.

Effects of cocaine on the brain: Decision Making

Because cocaine is a stimulant, users wrestle to contain their restless energy. Unfortunately, it usually leads to poor decisions with a deficit in impulse inhibition.

  • Violence—More than half of cocaine abusers partake in violence after use. Examples of violence range from verbal abuse, fist fights, and even murder.  
  • Hallucination behaviors—Hallucinations are seeing things that are not there. These visuals influence behavioral decisions like running a traffic light or walking to a person who is not really there.
  • Risk taking—Cocaine is related to egocentrism and narcissism, both of which produce over confidence. With impulsivity, users are liable to take risks (i.e. jumping off a building, etc.) they would not take if not under the influence.

Effects of cocaine on the brain: Withdrawal

Due to its addictive nature, cocaine has rapid withdrawal rates. The brain undergoes a series of transformations when it is deprived of a drug it is dependent on. Just like cocaine use interferes with the brains neurotransmitter levels, cocaine withdrawal causes additional changes in the brain. Withdrawal symptoms are temporary as the nervous system works to restore equilibrium and to repair the damage from cocaine abuse. The symptoms manifest physically and emotionally.

  • Depression
  • Anxiety
  • Cravings
  • Insomnia
  • Fatigue
  • Irritability
  • Mental fatigue
  • Concentration issues
  • Poor Memory
  • Paranoia

Anti-addiction medications, support groups, and individual psychotherapy are resources to support the withdrawal process.

Cocaine withdrawal is unpleasant, but battling the symptoms is the beginning of courageously overcoming addiction. If you or someone you know is struggling with cocaine addiction, do not hesitate to reach out to a professional.


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Liebschutz, J., Savetsky, J. B., Saitz, R., Horton, N. J., Lloyd-Travaglini, C., & Samet, J. H. (2002). The relationship between sexual and physical abuse and substance abuse consequences. Journal of substance abuse treatment, 22(3), 121-8.

MacLaren, E. (2017, October 25). Cocaine history and statistics. Retrieved from

Pappas, S. (2012, April 24). Cocaine Eats Up Brain Twice as Fast as Normal Aging. Retrieved from https://www.livescience.com/19867-cocaine-ages-brain-shrink.html

Verdejo-Garcia A. (2014). Social cognition in cocaine addiction. Proceedings of the National Academy of Sciences of the United States of America, 111(7), 2406-7.

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