Cocaine: How it Affects Mental and Physical Health in the Long Term

Produced from the leaves of the coca bush, cocaine is one of the most powerful of all the naturally occurring stimulants. Often referred to as the party drug, cocaine can give users an addictive boost while socialising, making them feel more confident – and almost invincible.

Unfortunately, cocaine can also lead to aggression, paranoia, and bizarre behaviour, giving users a very unpleasant experience. But the effects of cocaine last far longer, affecting the mental and physical well-being of the individual.

Below is a description of the darker side of cocaine use, and the long-term problems that it causes.

Long-Term Effects

Regular use of cocaine creates a tolerance so that increasingly high doses, or greater frequency, are required to achieve the same high. This is because the reward pathway in the brain becomes desensitised.

Simultaneously, the stress receptors become more sensitive. This means that when users aren’t taking cocaine, they feel more anxious, unhappy, and negative. These chemical responses are one of the reasons why the level of cocaine consumption often increases over time. This is often done unconsciously with users not realising that their consumption is creeping upwards.

Continuing to use cocaine in the long-term can result in very significant effects on both the body and mind:


The heart/cardiovascular:

  • Increased risk of blood clots
  • Increased risk of heart attack, stroke, pulmonary embolism, and deep vein thrombosis
  • Inflammation and death of heart tissue
  • Aortic rupture
  • Angina
  • Permanently high blood pressure
  • Difficulty with the heart contracting

The brain:

  • Reduction of oxygen to the brain due to constriction of blood vessels
  • Increased risk of aneurysms and brain damage
  • Shrinking of the brain (cerebral atrophy)
  • Inflammation of the blood vessels in the spinal column and/or brain (cerebral vasculitis)
  • Seizures
  • Strokes

The mouth and nose:

  • Damage to soft tissues of the nose and nasal passage
  • Collapse of septum and holes in the roof of the mouth
  • Loss of sense of smell
  • Difficulty swallowing
  • Persistent irritation of the nasal passage


  • Destruction of oxygen-carrying cells
  • Difficulty with oxygen entering the bloodstream
  • Increased risk of pneumonia, asthma, and acute respiratory distress

Digestive system:

  • Reduced blood flow to the stomach and intestines, causing ulcers and tears
  • Increased risk of ischemic colitis (injury/inflammation of the colon)

The above is just some of the main physical effects but there are many more that steadily start to appear with long term use including liver damage, kidney toxicity and depending on the route of administration, infectious diseases. Years of cocaine use can also lead to sexual dysfunction and movement disorders such as Parkinson’s at a young age.

Even if you don’t notice any physical ill-effects, ongoing cocaine use will be causing invisible damage in the body which could be too late to rectify by the time it’s obvious.


The physical effects on the body are huge, but even for individuals with no history of mental health difficulties, the psychological effects can be enormous too.

The way that cocaine affects the pleasure centres of the brain, and the functioning of neural connections can cause very severe short-term reactions, which may include unexpected suicidal thoughts, plus other effects which remain in the long term.

These could include:

  • Panic attacks
  • Depression/anxiety
  • Paranoia
  • Aggression
  • Psychosis
  • Agitation
  • Restlessness
  • Hallucinations
  • Ongoing suicidal thoughts
  • Impaired thinking

The Contamination of Cocaine

As can be seen from the above, cocaine can cause a huge range of long-term problems, both physical and mental. However, there are additional complications which arise from the fillers that cocaine is cut with.

The big issue is that the fillers which are used can vary hugely, and some are more problematic than others.

Additional psychoactive ingredients may be cut with the cocaine. This increases the likelihood of addiction and produces more potent effects. These could include amphetamines, caffeine, and crystal meth, but also – and more worryingly – fentanyl.

Similar to morphine but up to 100 times stronger than heroin, fentanyl is a synthetic opioid analgesic. Fentanyl is one of the leading causes of overdose deaths, even when taken in tiny amounts.

Conversely the cocaine may be weaker than expected, with either cheap numbing agents added to mimic the effect of cocaine and make it appear higher quality, or a range of inert white powders. These could be relatively harmless such as flour, talc or baking powder, or less pleasant substances such as asbestos or tyramine, which causes migraines and can be dangerous for anyone taking MAOI medication.

In the worst-case scenario, toxic ingredients may be mixed in with the cocaine. This could include strychnine and arsenic, both of which can cause death.

Get Help to Prevent Long-Term Damage

Far from being the fun party drug that it’s often portrayed as, cocaine destroys both the body and mind with ongoing use. Users eventually end up finding it difficult to socialise, may find it hard to form relationships and trust others and experience sexual dysfunction.

A lifestyle and wellness coach can provide critical support in changing habits and patterns of thinking, helping individuals to continue to refrain from cocaine use even after years of abuse. It’s never too late to prevent further damage but getting help now really is vital.

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