In the public mind, cocaine is most often thought of as the expensive, trendy drug of the 1980s and 1990s. This powerful stimulant is so firmly ingrained in popular culture that it can take center stage in a movie that brings millions to the box office (e.g., Blow starring Johnny Depp). Despite the glitz and glamour sometimes associated with cocaine use, the spotlight needs to shine on the many hazardous effects it can bring to users.
Health Consequences of Cocaine Abuse
How does cocaine affect your body? When people think about cocaine, they often focus on the impact of this drug on the brain. But when cocaine is consumed, it travels from its point of entry (nasal passage or vein) through the blood. In this way, cocaine can have a negative impact on all the tissues and organs through which it passes en route to the brain. It should therefore come as no surprise that cocaine abuse is associated with many deleterious health consequences that affect the:
- What does cocaine do to your heart? After cocaine use, the person’s heart rate and blood increase while arteries constrict and consequently decrease the flow of blood to the heart. As a result, cocaine users are vulnerable to heart conditions, including heart disease, heart attack, and heart arrhythmia (an abnormal, potentially fatal heart rhythm).
- Can cocaine damage your kidneys? Through a process known as rhabdomyolysis, a person who uses cocaine may experience kidney failure. Individuals who have high blood pressure are consequently vulnerable to kidney damage. When those same individuals use cocaine, they can accelerate the risk of long-term kidney damage.
- What does cocaine do to your brain? As cocaine can cause blood vessels to constrict, blood supply to the brain can be limited and cause a stroke (irrespective of a person’s age or absence of pre-existing conditions). Cocaine use can also lead to seizures. Known as a cocaine-induced psychosis, in some cases, people will experience severe psychoactive effects that are akin to the symptoms of schizophrenia (such as hallucinations that are tactile, visual, and/or audible).
- Can cocaine cause ulcers (intestines)? Since cocaine constricts blood vessels, flow of blood to the gut can be impaired. Due to an inadequate level of oxygen reaching the intestines, ulcers can develop as well as perforations of the stomach and intestines.
- What does cocaine do to your nose? Over time, snorting cocaine can damage a person’s sinuses and cause nasal perforation that in turn leads to breathing troubles.
- Does cocaine cause impotence (sexual impairment)? In males and females, chronic use of cocaine can lead to sexual dysfunction.
A consideration of the health consequences cocaine has on the body can help individuals to develop an expanded understanding of the true impact of this drug. Most often, individuals associate cocaine use with its short-term health effects that include providing the person with a burst of energy, increased alertness, making the person feel invincible, and/or inducing restlessness, anxiety, or paranoia. But the body’s immediate reaction to cocaine, as manifested in these side effects, is only a narrow part of the overall picture. A closer look at the impact of cocaine on the brain, nose, and veins can provide people with a much fuller understanding of the extensive impact cocaine use can have.
Impact on the Brain
At the outset, it is necessary to highlight that one of the most common dangers associated with cocaine use is addiction. As cocaine is highly addictive (in part because it is fast acting), there can be a relatively short road from physical dependence to addiction. When people are physically dependent on cocaine, they will experience tolerance, which in turn will motivate them to consume more of this stimulant in order to achieve the familiar high. Should individuals stop using cocaine, or significantly reduce the familiar amount of consumption, withdrawal symptoms will manifest.
Physical dependence is a component of addiction. When individuals are addicted to cocaine, in addition to building tolerance and being prone to withdrawal symptoms, they will manifest behavioral symptoms, such as a preoccupation with cocaine use even when use disrupts important obligations and relationships. Further, once individuals experience addiction, their brain structure may change in a way that they are now more susceptible to a relapse. Treatment is an effective way to avoid relapse and build a healthy, drug-free life.
Research on the long-term effects of cocaine on the brain shows that the brain’s reward system can become damaged. Individuals use cocaine for its euphoric effects. The brain is designed to condition people to engage in survival-based behavior, such as eating and reproducing. For instance, when a person eats, there is a ping of pleasure.
Using cocaine and other drugs can be thought of as turning a ping of pleasure into a rush of euphoria. Using drugs essentially hijacks the brain’s rewards system and sends it into overdrive.
The brain is not designed to continually provide people with intense pleasure. Over time, flooding the brain with dopamine – a pleasure-inducing neurotransmitter and a main player in the reward system – overworks the reward complex and causes a decrease in the dopamine-sensitive receptors. One result is that the person may not be able to experience pleasure, not even a natural ping, and this outcome is known as anhedonia (the clinical state of not being able to experience pleasure). In short, using cocaine interferes with the brain’s natural reward system, which can lead to brain damage. Typically, with treatment, the brain will heal itself, but it can take up to two years, and some faculties may not be returned to their prior operating levels.
As the National Institute on Drug Abuse notes, individuals consume cocaine in different ways. As cocaine is sold in powder form, it can be snorted or mixed with water and injected. The way in which a person regularly uses cocaine will directly affect that entry point (i.e., have distinct effects on the nasal complex for those who snort the drug and on the veins for those who inject it). The impact cocaine can have on the nose and veins bears further discussion.
Cocaine’s Impact on the Nose
As noted earlier, cocaine use constricts blood cells. When this happens in the nose, diminished oxygen is sent to the tissues in the septum, causing cells in the lining to die. At this point, the structure of the nose is compromised, and the cartilage cannot be adequately supported. As a result, a hole in the septum develops, which is called a septal perforation. In turn, the nose can collapse. In addition to constricting a person’s air supply, a collapsed nose (a “saddle nose”) can be a cosmetic concern for affected individuals.
In some instances, side effects of snorting cocaine can arise directly from septal perforation or from the use itself. The following are some of the negative side effects that are directly related to snorting cocaine:
- Chronic nasal infections
- Nose whistling
- Social isolation
- Loss of smell
- Lowered self-esteem
If a person stops using cocaine, the blood vessels can recover and blood flow to nasal tissues and other tissues will improve over time. However, a septal perforation will not heal itself, and medical intervention is necessary. In fact, over time, the hole will expand and increase the affected person’s susceptibility to nasal infections and cause changes to the person’s voice. At this point, a nasal reconstruction operation may be necessary. This operation can restore both the structure of the nose (remove the “saddle nose” appearance) as well as improve oxygen flow.
Impact of Intravenous Cocaine Use
When people use cocaine intravenously, they may inject it into the vein, known as mainlining it; under the skin, known as skin-popping; or directly into a muscle, known as muscling. Individuals who opt for any one of these methods most often do so in order to intensify a high and experience it as quickly as possible. Those who use cocaine intravenously may experience psychoactive effects as soon as 15-30 seconds later; snorting can take 3-5 minutes to deliver the desired high. As states do not uniformly provide intravenous drug users with free access to sterile syringes, there is a high risk of needle sharing, a practice that only exacerbates the dangers associated with this method of drug use.
When cocaine is injected directly into a vein, a host of negative effects may emerge:
- Vein infection that can lead to blockages can occur.
- After repeated injections, especially with unsanitary needles or with poor technique, veins can collapse.
- When vein constriction leads to scar tissue in the vein, permanent blockages and blood clotting can occur.
- Vein damage directly reduces the flow of blood to tissues, which renders them susceptible to infection and undermines their ability to repair themselves.
- A risk of gangrene (an infection due to the death of tissues) is present.
The infectious diseases that can be spread through needle sharing include HIV and hepatitis B, C, A, and E (A and E are the least commonly communicated types). According to the advocacy site Avert, outside of Sub-Saharan Africa, approximately 30 percent of all new HIV infections around the world are due to intravenous drug use. The hepatitis B virus can cause a serious liver infection that can lead to liver cancer, cirrhosis (permanent scarring of the liver), or liver failure.
Hepatitis C also affects liver health. One of the most dangerous aspects of Hepatitis C is that a carrier may not be symptomatic, which makes it harder to detect the virus and can give the virus more time to grow and harm the liver. As the virus causes the liver to become inflamed, it cannot properly function, which can lead to liver cancer, cirrhosis, or liver failure.
According to the National Institute on Drug Abuse, in the US, approximately 800,000 to 1.4 million Americans are living with hepatitis B, while 2.7-3.9 million are thought to be infected with hepatitis C. Among intravenous drug users, one study concluded that each person who is infected with hepatitis C will likely infect approximately 20 other people, most often within the first three years of carrying the virus. In 2013, it was expected that liver disease due to a hepatitis virus would lead to the death of 22,000 Americans.
Individuals who use cocaine intravenously face a higher risk than the general population of exposure to Staphylococcus aureus (S. aureus). This bacterium can lead to conditions such as endocarditis (involving damage to heart valves) and bacteremia (informally known as blood poisoning/bacteria in the blood). Intravenous cocaine use can also lead to musculoskeletal infections. This type of infection arises when viruses embed in a person’s bones and cause conditions, such as osteomyelitis and septic arthritis. A common symptom is pain in the sternoclavicular joint (located between the sternum and clavicle), knee, or spine.
Preventing Cocaine Abuse
Education about the negative health effects of drugs can help to prevent initiation into cocaine use as well as encourage people who abuse cocaine to seek treatment. In a drug treatment context, some rehab centers offer psychoeducation, which is an educational curriculum coupled with therapy. A main goal of psychoeducation is to help individuals understand the impact of drug abuse on the body, mind, and spirit. Education, be it for the person who is experiencing drug abuse or concerned loved ones, remains one of the most fundamental and effective approaches to preventing, stemming, and healing substance abuse.
At present, participation in a structured rehab program is the most advisable course of treatment for cocaine addiction treatment.
The rehab process commences with a supervised medical detox. After detox, a recovering person enters the abstinence maintenance phase of treatment. Therapy, both individual and group, is the mainstay of this phase of treatment. Depending on the rehab center, additional services may be offered onsite, including recovery group meetings, family therapy, and educational classes. Individuals with health conditions related to their cocaine use or otherwise will likely receive treatment at an appropriate medical facility.
Cocaine abuse causes serious physical health issues; however, the damage is often reversible once the abuse stops. Recovery is possible with comprehensive treatment. With comprehensive care, individuals can leave cocaine use in their past and move toward a better future.