Woman holding nose after snorting cocaine

The drug cocaine (chemical name: benzoylmethylecgonine) is classified as a central nervous system stimulant. Cocaine is processed from the coca plant and has been traditionally used by natives in areas where the plant is indigenous as a stimulant.

Cocaine actually retains some medical uses in the United States, primarily as a topical anesthetic. This results in its current status from the United States Drug Enforcement Administration as a Schedule II controlled substance. The substances classified under this categorization are considered by the government to have some medical uses, but they are extremely dangerous and serious potential drugs of abuse.

Cocaine is primarily abused in powder form; most often, it is snorted, but it can also be taken orally, injected, or smoked (particularly the crack form of cocaine). Cocaine abuse became very prevalent in the latter half of the 20th century but has dropped off due to the rise of other drugs of abuse, such as prescription opioid drugs, benzodiazepines, and illicit opioids like heroin. However, cocaine still remains a major drug of abuse, and the long-term effects of abusing the drug can have serious ramifications.

Factors That Influence the Effects of Cocaine

There are numerous research studies that have documented the potential long-term effects of cocaine abuse. It can never be stated with any specific probability that any potential long-term effect will occur in any single individual; however, certain changes in an individual’s system will occur with continued use of cocaine, and a person will also be at an increased risk to develop many different types of complications as a result of abusing a powerful stimulant substance like cocaine.

Exactly what ramifications any specific person will experience and how these will develop depend on numerous personal vulnerabilities and how these vulnerabilities interact with the person’s experience. For instance, the potential to develop specific short-term and long-term symptoms as a result of cocaine abuse will depend on the following:

  • Genetic makeup
  • Use of any other drugs along with cocaine
  • The length of time cocaine has been abused
  • The amount of cocaine normally used
  • Outside factors, such as stress, crime, malnutrition, etc.
  • Infectious diseases, such as tuberculosis, HIV, etc.
  • Other specific factors and even random influences

What Happens with Long-Term Cocaine Use?

There are some things that will definitely occur to some extent in individuals who abuse cocaine on a regular basis for lengthy periods.

  • Cocaine use alters neural pathways in the brain. The exact extent to which these pathways are altered depends on the above factors.
  • One of the ramifications of the alteration of brain pathways is increased sensitivity to the effects of perceived stress.
  • Another ramification as a result of altered brain pathways is that people experience a decrease in their ability to derive pleasure from sources that typically give pleasure, like personal relationships.

The results of these effects in many people is that they begin to use cocaine or other substances as a replacement for normal outlets that satisfy basic needs, such as engaging in healthy personal relationships, finding meaning in life, motivation to accomplish goals, etc. Instead, they substitute the use of cocaine to satisfy many of these basic needs. The actual level to which an individual will substitute their use of cocaine for many of these basic drives and needs will depend on many of the factors mentioned earlier, such as genetic makeup, experience, level of drug abuse, etc. Certainly, alterations in the pathways of the brain that occur as a result with frequent abuse of cocaine will also make a person more vulnerable to:

  • Cognitive problems, such as issues with attention, concentration, memory, judgment, and complex problem-solving
  • Emotional problems, such as anxiety, depression, vulnerability to stress, and even potential issues with psychosis
  • Polysubstance abuse that can manifest itself as an effort to counteract the stimulating effects of cocaine (e.g., the use of central nervous system depressants, such as alcohol or narcotic medications) or the use of other drugs to enhance the effects of cocaine.

Because cocaine is eliminated from the system very rapidly and its effects are very transient, chronic use of cocaine often results in individuals attempting to maintain the stimulating effects of the drug by bingeing on it. Bingeing on cocaine can lead to an exacerbation of the above issues and will result in increased tolerance in all individuals.

Tolerance refers to the need to use more of a drug to get the effects that were once felt with lower amounts of the drug. The level of tolerance that one develop depends on the factors mentioned above.; however, tolerance always results in an individual needing more of the drug to get the desired effects. The development of tolerance to cocaine exacerbates all of the potential negative effects that occur with long-term use of the drug.

The development of tolerance also increases the probability that an individual will develop withdrawal effects when they stop using cocaine. Not everyone will develop a diagnosable withdrawal syndrome as a result of chronic cocaine abuse; however, nearly everyone who chronically abuses the drug will develop some level of negative symptoms, such as depression, apathy, cravings, feeling down, lethargy, increased appetite, increased need for sleep, etc., once they stop using the drug. Many individuals who chronically abuse cocaine will use more cocaine to deal with the symptoms, and this leads to a significant potential to develop a formal substance use disorder (addiction) to cocaine.

Issues with Escalating Use

As a person’s intake of cocaine increases, there is an increased probability that other serious physical effects may occur. These include:

  • High blood pressure
  • Irregular heartbeat
  • Heart attack or other forms of heart disease
  • Stroke
  • Liver damage (cirrhosis, hepatitis, etc.)
  • Problems with the kidneys
  • Respiratory issues
  • Contraction of infectious diseases, including HIV, tuberculosis, etc.
  • Neurological problems, such as movement disorders (e.g., Parkinsonian symptoms)

Neurological issues result from the changes that occur in the brain with chronic cocaine use. Issues in other organ systems are complications that occur due to the toxicity of cocaine. The method by which one uses cocaine can seriously increase the probability that one will develop any of the above issues, such that people who inject or smoke the drug are more likely to develop the above issues than people who snort it; however, the probability of any of these issues is increased with chronic use of cocaine.

Because cocaine is an extremely corrosive drug, individuals who chronically abuse it will often experience:

  • Significant problems with dentition, including an increased risk of developing cavities and tooth loss
  • Issues with the nose as a result of snorting cocaine that can include damage to the nasal septum, infections, and a loss of smell
  • Respiratory damage as a result of smoking cocaine
  • Collapsed veins and scarring of the veins and arteries as a result of injecting the drug

The types of detrimental issues that may occur with social functioning as a result of cocaine abuse are potentially numerous. Individuals who chronically abuse cocaine will experience some level of:

  • Lost productivity in their occupation or educational goals
  • Distress or dysfunction in personal relationships.
  • Personal distress associated with their abuse of the drug
  • Exposure to potential legal entanglements as a result of possession and use of cocaine

The level of personal emotional distress that occurs to any single individual as a result of cocaine abuse will vary. However, there are serious possibilities that can occur in an individual’s personal, professional, and legal situation regarding their use of cocaine. These include:

  • Estrangement from important family members, such as parents, children, spouses, etc.
  • A potential loss of parental rights
  • Divorce
  • Loss of valued friends
  • Issues with one’s chosen career that can include a loss of employment and a failure to find suitable employment
  • A disruption in education, such that one does not attain their desired level of education
  • Potential sanctions from the legal system that can include fines and incarceration

Long-term abuse of cocaine will inevitably result in some of these issues. Moreover, some individuals turn to criminal activities to finance their use of cocaine. The probability that chronic abuse of cocaine will affect a person’s personal and professional relationships in some manner is nearly 100 percent; however, the seriousness of these effects will vary from individual to individual.

Long-Term Cocaine Use and Pregnancy

Pregnant women wearing white shirt Vintage tone.

Chronic abuse of cocaine has serious ramifications for expectant mothers. Estimates of cocaine-exposed infants suggests that these numbers have dropped off, but the issue is still a serious concern. Cocaine use during pregnancy can affect the later development of the child, although the issues associated with the so-called crack baby syndrome originally described in the literature may be a gross exaggeration.

Research suggests that cocaine use during pregnancy results in health issues for the mother, such as potential seizures, migraine headaches, and damage to the uterus that may affect the development of the child. Premature birth probability is increased, and this can lead to severe issues with the development of the child, including problems with social skills and intellectual abilities.

Issues with self-regulation, such as ADHD and other issues, are increased in children exposed to cocaine in the womb. There may be also increased probability of later issues with depression and suicidality in children who were exposed to cocaine during pregnancy.

The Potential for Relapse

Finally, individuals who formally abuse cocaine are at an increased risk for relapse even if they have spent many years in treatment, have years of abstinence, and have made a commitment to no longer use cocaine. This is because these individuals have a higher vulnerability to cues related to their past cocaine use.

Treatment for chronic cocaine abuse should be comprehensive and include the use of medications for the early control of cravings and withdrawal, therapy to initiate lifestyle changes, social support from peers in recovery and family members, and a long-term commitment to abstinence from drugs and alcohol. Those in recovery from cocaine abuse should not engage in any form of drug abuse or alcohol use, as this can increase their vulnerability to relapse.