How Cocaine Affects the Brain

How Cocaine Affects the Brain

05 Jan How Cocaine Affects the Brain

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Hollywood parties, beautiful people, cartel shootouts and crazed addicts, these are the strange and eclectic images we conjure when we hear the word: Cocaine. It has been the subject of songs, films and television shows. It has wormed its way into the heart of American pop culture and laid roots in our collective psyche as the drug of the rich, the famous and the notorious. Our obsession with this singular substance has changed the world in countless ways, but most of us know very little about it other than its depiction in the media. As a Schedule II narcotic its trade has been illegal since the early 1920s, and has been the main focus of the United States’ War on Drugs.

Countless people have died in the numerous gang wars and cartel feuds that have broken out over its sale and distribution, while many more have fallen prey to its addictive nature. If this is the case, then why does it retain its popular facade? Surely the human price is far too high to account for its continued use and star-studded status. This reasonable, yet overly idealistic assumption does not take into account the money involved, or, most importantly, the underlying reason for the drug’s fame in the first place. Cocaine is what it has become, not because of pop culture or Pablo Escobar, but because of the effects it has on our brains…the good, the bad, and the ugly.

How Cocaine Affects the Brain

What is Cocaine?

Cocaine’s damaging relationship with humanity has its seemingly benign roots in the mountains of South America. Centuries ago, Patagonia travelers used the leaves of the coca plant as a stimulant to allow them to traverse the Andes in record time. The mildly energizing effect of the leaves combined with lime juice left the user capable of prolonging physical activity for extended periods of time (mitigating the risk of succumbing to frostbite or freezing to death overnight in the harsh environs of the Andes). When European explorers arrived in Peru they were gifted with gold, livestock and, strangely enough, the leaves of the coca plant. Delighted with the leaves’ stimulating effects, they soon introduced the coca leaf to their native countries, heralding it as one of the many cure-alls available at the time (these also included opium). The medical community soon adopted cocaine as both a numbing agent for surgeries and a cure for depression.

The famed psychoanalyst Sigmund Freud was a huge proponent of the drug’s “virtues”, claiming it as “magical” and extrapolating upon its many “benefits”. By 1886 cocaine was being used as an active ingredient in Coca-Cola, though this practice would end nearly 30 years later it helped to cement Coke’s lasting hegemony. By 1922, the government of the United States had become aware of cocaine’s less shining qualities (it was causing 5,000 overdose deaths a year) and officially banned the substance. 50 years later, the cartels of Columbia began to traffic the drug in what is now a multi-billion dollar industry.

Immediate Effects on the Brain

Cocaine is a powerful nervous system stimulant that hijacks the pleasure and reward centers of the brain. When ingested, the user will often experience a sense of euphoria within a relatively short period of time. This, coupled with the stimulating effect, is what has made the drug so popular for so long. But the chemistry behind this temporary feeling of euphoria is incredibly damaging to the brain and nervous system. Cocaine acts as a neurotransmitter inhibitor, keeping the brain’s messengers from fulfilling their function by pinning them into place so that their message is repeated over and over again. The neurotransmitter dopamine, for example, (cocaine’s main victim) is usually released when the brain is experiencing some sort of pleasure. Be it the taste of chocolate cake, a cool drink on a hot day, or sexual climax, dopamine is in charge of telling your body that everything is going incredibly right in that moment.

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Once the message is sent the dopamine molecule is then recycled back into its transmitting neutron to be rebuilt and reused. Cocaine, however, blocks this return and forces the dopamine to continue transmitting until it is entirely used up. The result is a euphoric high followed by a corresponding low. Once all the dopamine is depleted, there is nothing to take its place and so the brain will no longer be able to maintain regular levels. This is why the comedown from cocaine is so harsh—the dopamine has gone and all pleasure with it. Cocaine’s fame rests solely on the shoulders of its immediate effect on the brain: the high, the dopamine overload. But if more people paid attention to the comedown and the lasting effects cocaine has on the brain’s chemistry then our romance with this drug would die, to be replaced with horror.

Long-term Effects on the Brain

Cocaine’s long-term effects on the brain are exclusively damaging. There are no benefits to long-term use and exposure, only the fostering of physical dependence and, thus, addiction. The fact is, after cocaine is ingested (whether by insufflation, injection or inhalation) it begins to change the way our brain chemistry works. By blocking our dopamine chemicals and using them up, cocaine is replacing and degrading the natural process of the nervous system. Dopamine is not an infinite resource, constantly available for deployment. It takes time to produce and the right circumstances to trigger its transportation to the synapses of the brain. Cocaine interferes with this natural process, as well as with the deployment of two other key neurotransmitters, norepinephrine (the neurotransmitter responsible for fight or flight response) and serotonin (responsible for mood). The depletion of these essential neurotransmitters can lead, not only to suboptimal brain function, but also to numerous mental conditions that adversely affect our way of life.

Depression: The consistent depletion of serotonin and dopamine in our brain can lead to depression (characterized by a consistent lowness of mood). Just like the short-term comedowns that cocaine is known for, long-term abuse of the drug can lead to a lasting low that affects every aspect of our lives. Those who suffer from depression will have a lessened appetite for sensory experience, interpersonal communication and physical activity (their reduced levels of serotonin no longer allowing them to feel heightened amounts of pleasure over anything but the shortest periods of time). Lethargy and sluggishness will be the unintended physical side effects, as will an increased desire to sleep and to either eat too much or too little. This mental disorder is exceedingly dangerous as it is the leading cause of suicide due to this consistent lack of basic enjoyment. The potential for self-harm, coupled with a consistent devolution of the natural processes of our brain chemistry, makes this one of cocaine’s most hazardous effects on the brain.

Anxiety:  Because cocaine hijacks our neurotransmitters and blocks their return, we can feel the noticeable effects of their absence days, or even weeks, after the fact. Anxiety and panic disorders, the result of extreme neural over-activity, will often be the result. As our brains attempt to function post cocaine use, many of the natural chemical processes will be kicked into overdrive to make up for the lack of neurotransmitters in the system. Anxiety, characterized by rapid heartbeat and extreme nervousness, is the inevitable result of such over-activity. Cocaine will often give us a hyper-confident sense of self. Anxiety is the inverse of this suffusion of confidence. We will second-guess our speech patterns, grow extremely wary in social situations and display a notable lack of confidence in everyday life that would otherwise be reserved for our deepest, darkest moments. This is not because we are suddenly different people, but because the chemical imbalance in our brains due to the use of cocaine has sabotaged our ability to feel the pleasure and excitement that we once felt in even the smallest, most unimportant interpersonal interactions.

Fatigue and Insomnia: Because of its stimulating properties, cocaine use obviously affects our ability to sleep, but this does not necessarily end once the drug is out of our systems. The extreme neural activity that takes place while under the influence of cocaine can leave its victims sapped of energy, while also keeping them incapable of rest. This is due to, once again, the deficiency in neurotransmitters that is the direct result of cocaine use. Our brains rely on these neurotransmitters for information. They tell us when to sleep and how to be awake. Such rudimentary functions go haywire when cocaine is introduced into the brain’s chemical makeup, causing long bouts of wakefulness combined with utter exhaustion.

How Cocaine Affects the Brain

Poor decisionmaking: Cocaine affects the brain, not only by blocking our neurotransmitters, but also by halting and degrading the natural processes that control our decision making ability. The orbitofrontal cortex (OFC) is the brain’s hub for making decisions, and cocaine use affects its proper function almost immediately. This can lead to a whole plethora of momentary bad decisions (as would be expected), but may also result in long-term degradation of function. The danger of this cannot be overstated as it is our decision making capability that keeps us alive and well in a world full of dangers. Interestingly enough, those with OFC’s functioning at high levels have been found to be distinctly wary of drug use, while others are almost preternaturally aware of cocaine’s damaging effects and potential for loss of brain function.

Paranoia: The stimulating effect of cocaine comes with a distinctive downside. Harnessing that newfound energy is not up to our conscious minds, but lies in a realm beyond our control. Thus, many people who abuse cocaine are found to focus on the weird, surreal, or theoretic. Paranoia, the nagging feeling of suspicion and threat, is the result of the brain’s oversaturation of the neurotransmitter norepinephrine. This fight or flight messenger, when released in bulk, can and will bring the cocaine user into a heightened state of paranoia. Undue fear of people, things and situations is the result of this imbalance. Once cocaine has left the system, the body will still have a distinct deficit of norepinephrine and will thus be incapable of sending its fight or flight responses. This can lead to prolonged paranoia as the brain’s threat assessment capabilities will be severely hampered and will thus register even the smallest of threats as either benign or intensely malignant (and be rendered equally incapable of reacting correctly to either scenario).

Psychosis: The culmination and combination of many of the above effects, psychosis represents a loss of touch with reality due to a breakdown of the central nervous system’s normal functions. Considering how cocaine affects our neurotransmitters and their reception it should be no surprise that psychosis is in the cards for those who abuse cocaine long-term. Psychosis is a blanket term for the frantic and bizarre behaviors brought about by erratic brain function. It can manifest post-cocaine use due to the extreme stress and real damage that the drug causes in the neural pathways of the brain. Hallucinations, delusions and extreme paranoia are the result of this disorder and can represent the first salvo in the appearance of schizophrenia or bipolar type 1 disorder.

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Cocaine affects the brain in a host of dramatically dangerous ways. The momentary focus and feeling of euphoria is replaced by confusion, depression, anxiety and fear. The fact is there are no benefits to cocaine use. Once heralded as a cure-all, a magic brew, a secret ingredient, cocaine has been unmasked as the perpetrator of extreme mental anguish. Its affects on our brain are lasting and exceedingly damaging. Its effects on our world have been overwhelming violent and negative. This drug, shrouded in stardust, does not deserve the accolades or positive attention that is so often heaped upon it by the media. It is a highly addictive, life-threatening substance that can and will destroy otherwise healthy human minds. If you or a loved one is battling cocaine abuse or addiction do not hesitate to seek help. There are medical and substance abuse professionals out there right now waiting for your call. Cocaine’s effect on the brain should not be underestimated or ignored. The danger this drug poses is real.


When an individual makes the decision to stop using and/or abusing this drug, he or she will likely go through a cocaine withdrawal. During the withdrawal condition, a person can face both physical and mental health complications. For starters, and possibly the biggest risk factors are cardiac issues. During cocaine withdrawal, a person has an increased chance of developing an arrhythmia or infarction, which is commonly known as a heart attack. Seizures are also common during this time.

When a person decides to stop using cocaine, he or she should seek out professional medical assistance. If a doctor or nurse is involved in the process, then it will be less likely for something damaging to occur.

Mental health concerns that are often associated with cocaine withdrawal include depression, suicidal thoughts, aggression, paranoia, and even violent acts. Again, due to these conditions, it is best to experience all withdrawal symptoms at a  drug detox or treatment center, as these venues have a variety of tools and techniques to keep individuals completely safe after their cocaine usage.

Cocaine withdrawal symptoms often include the following example:

  • Lack of energy
  • Lack of motivation
  • Anxiety
  • Irritability
  • Fatigue
  • Depression
  • Lack of Concentration
  • Mood Swings
  • Paranoia
  • Cravings

If you are caught possessing cocaine, you could face a variety of penalties, depending on the amount, your specific location, and your intent. Intent refers to whether you planned to sell or use the drug yourself. The Georgia legal system, in particular, is extremely hard on drug offenders, especially when the drug in question is cocaine. Therefore, when cocaine is found, the punishment is often quite severe.

Cocaine is a Schedule II drug, meaning it is in the same category as methamphetamine, crack cocaine, morphine, opium, and methadone. The law in Georgia is rather clear: It is illegal to have any connection with cocaine, whether the intent is to purchase, possess, or use.

For a cocaine conviction to stick in Georgia, the State must prove that an individual is guilty beyond a reasonable doubt of possessing cocaine. The State must show the accused actually had the cocaine in his or her possession during the time of the arrest for an “actual possession” charge to hold.


As with any type of drug use, even alcohol, there is a difference between abusing the drug and becoming addicted to the drug. It is necessary to understand both concepts, as one can lead into the other.

When a person regularly uses cocaine (or, again, any drug), he or she will likely become used to it, even build up a tolerance for it. Once this tolerance has been established, the individual will have to consume higher and higher doses in order to experience a high. This is considered abuse. When a person continues to increase their intake of any sort of drug on a regular basis, abuse is or has occurred.

Addiction takes the problem even further, creating the possibility of even more dangerous consequences.

If someone is addicted to cocaine, then, in a sense, he or she needs the drug, or think he or she needs the drug, to function. Cocaine is no longer a recreational drug, but a drug that is used and abused daily—likely several times a day. This drug addiction will then consume the user’s life, resulting in a lack of interest in other life events, such as school, friend, family, career, health, and other responsibilities. Not only does this person lose interest, but they also will not care that they are self-destructing.

Remember, addiction is a disease. When an individual tries to fight the disease, he or she may experience withdrawal symptoms from drugs, such as drowsiness, fatigue, increased appetite, depression, mood swings, nightmares, and more.


In order to know if a person is either abusing or addicted to cocaine, it will be necessary to recognize the signs—and there are many. Though recreational use does not necessarily mean abuse or addiction is taking place, remember, this drug is highly addictive and dangerous. Therefore, if a problem has not occurred yet, it does not mean that it will not. Further, if you notice a friend or loved one experimenting with the illegal drug, it will be best to stop the problem before it becomes one.

Once cocaine is consumed, it does not take long to affect the body. However, this also means that the high does not last all that long either. Particularly, the high has been known to last between 5 to 30 minutes, depending on how much of the drug is consumed and over what kind of time period.

When a person has become exposed to cocaine, he or she may become more talkative and energetic, have a boost in confidence, lack of appetite, and avoid sleep. Though, following the high, a crash period almost always takes place.

Other common signs that a person may be using or abusing cocaine can include the following:

    • A white powder or residue stain on or around the nose and/or mouth
    • If the drug has been injected, needle marks on the arms or other body parts
    • Burn marks, usually on hands and/or lips, indicating the drug has been smoked
    • Any types of drug paraphernalia on their person or in their personal effects (i.e. pipe, spoon, syringe)
    • A drastic change in mood, weight, sleeping and eating patterns, and levels of energy
    • Any kind of uncharacteristic, high-risk behavior
    • Dilated pupils
    • Frequent nosebleeds
    • Financial difficulties

If you recognize that someone may be using or abusing cocaine, what do you do? Or, more importantly, what can you do?

For starters, you do not want to be too confrontational. When a person is on drugs, specifically cocaine, their mood will become elevated. Therefore, you never really know how this person will react. The last thing you want to do is get into a physical altercation or any sort of fight, really. Stay calm, relaxed, even spoken, and simply offer your help. If the person declines, then walk away. Remember, in order for a person to get proper help, they have to want it.


If you or someone you know has become addicted to cocaine, or feel as if an addiction could occur, then it is important to seek treatment. The silver lining to the dangerous drug epidemic that continues to hold tight to society, is that many different treatment options are available. However, you, or the person with the drug problem, has to want to get help. Without an acknowledgment of the addiction and the will to beat it, no treatment center will be successful.

When the conscious decision is made to quit cocaine, withdraw is likely to happen. As previously mentioned, cocaine is a highly addictive drug, therefore, getting off of it will be all the more difficult. You must understand that detox will be part of the process. Though difficult, it is not impossible—if you want to get better, you can.

First, you will need to find a facility that can address your specific needs. You are not searching for group assistance, but a facility that can simply put, cater to you and your needs. You will want to visit different options, ask questions, meet the staff, read reviews, and if possible, talk with patients who have the first-hand experience.

It is likely that each rehab facility will offer something different, whether it be a treatment plan or outpatient care. Again, you need to choose the best option for your needs. Depending on your addiction, and how much you currently depend on cocaine, you may need an inpatient program.

Whichever way you decide to go, understand this: Regardless of the nature of your addiction—if you are new to the drug or have been using it regularly for a while—there are tools and various options to get you back on track with your life to help you live completely drug-free.


“Cocaine.” NIDA. 13 July 2018. 14 Mar. 2019.

“What Are the Effects of Cocaine on the Brain?” American Addiction Centers. 14 Mar. 2019.

Nestler, Eric. “The Neurobiology of Cocaine Addiction.” NCBI Dec. 2015. 14 Mar. 2019.

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