What Does Cocaine Do to Your Brain?

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Cocaine is a powerful drug that can lead to dependency, overdose, and death. Because people feel an intense high immediately, it creates a desire to have more. In 2020, 5.2 million people aged 12 and older reported using cocaine in the past 12 months.

Cocaine use has significant short and long-term effects. Taking small amounts of cocaine makes the user feel alert, awake, more talkative, and confident. They might experience a reduced appetite and need for sleep.

The long-term effects of chronic cocaine use can be severe. Adverse effects include anxiety, panic attacks, reduced blood flow to the gastrointestinal tract, significant weight loss, malnourishment, permanent damage to the heart and cardiovascular system, increased risk of stroke, permanent damage to the nasal passageways, and a sharp decline in cognitive functioning.

Guardian Recovery will examine cocaine’s effect on the brain, whether cocaine can cause brain damage, and how you can seek treatment for yourself or someone you love who has a cocaine use disorder.

If you or someone you love has been suffering at the hands of a cocaine use disorder, Guardian Recovery is available to help. We are dedicated to providing the most comprehensive and individualized medically monitored detox program. To learn more about our programs, contact us today.

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How Does Cocaine Affect Brain Function?

Like many substances, cocaine has long-term effects on the brain. Studies show that cocaine creates glutamate, an excitatory neurotransmitter. This type of neurotransmitter stimulates a nerve cell, making the chemical message move from nerve cell to nerve cell, not stopping. Glutamate is essential for proper brain function.

Glutamate is also necessary for producing GABA, another neurotransmitter responsible for sleep, deep relaxation, anxiety regulation, and muscle function.

Effects of Cocaine Use on the Brain

Cocaine impacts the brain’s reward center by flooding the brain with dopamine. This is the neurotransmitter related to people’s euphoric high when using cocaine. Too much dopamine damages the way the brain and body function. It is also linked with competitiveness, aggression, and poor impulse control.

Additionally, cocaine changes the way the brain adapts to stress. Stress is what contributes to relapse with cocaine use, and many times, people with cocaine use disorders also have a comorbidity of post-traumatic stress disorder. Cocaine elevates stress hormones in the brain and also leads to dependence as the brain seeks out cocaine when triggered by stressors in the environment.

Physical Effects & Brain Structure Changes

Research has shown that structural changes in many brain regions have occurred with chronic cocaine use. Specific structural changes included a decrease in gray matter density and reduced performance on testing that measured memory and cognition. Additional structural changes included a persistent indication of relapse and addiction in the brain after prolonged abstinence.

Brain Cells & Grey Matter

Gray matter comprises 10% of the brain and holds 10 billion to 50 billion neurons. The responsibility of these neurons is to process information through axon signaling through white matter. Grey matter in the central nervous system helps individuals control movement, memory, and emotion.

As mentioned, cocaine use decreased gray matter density, impacting memory and cognition. The good news is that research has determined increased gray matter in individuals abstaining from cocaine for more than 35 weeks. This is hopeful news for individuals seeking treatment for cocaine use and experiencing the adverse effects of chronic use on memory and cognition.

Psychological Effects

Unfortunately, because cocaine impacts dopamine, GABA, and the structural components of the brain, there are psychological effects that occur from cocaine use. Psychiatric symptoms include agitation, paranoia, hallucinations, delusions, violence, and suicidal and homicidal ideation. Additionally, if a person is already diagnosed with a comorbid mental health disorder, cocaine can exacerbate the symptoms of the co-occurring mood disorder.

Research has found paranoia in 68-84% of patients using cocaine. 55% of people were found to have engaged in violent behaviors, and homicide occurred in 31% of patients who used cocaine. Suicide has appeared in 18-22% of cases. Finally, many people diagnosed with a comorbid psychological disorder were found to have cocaine dependence.

Emotional & Mood Effects

As mentioned, cocaine has an immediate high; however, it only lasts 15-30 minutes. This leads to frequent use and can unintentionally lead to an overdose and a sudden low in behaviors as one person is coming off the high. When a person starts to come down from a high, they may experience withdrawal symptoms quickly.

This experience of coming down from a cocaine high is called a cocaine crash. Here are the common symptoms one may experience when they have hit a cocaine crash.

Symptoms of a cocaine crash include: 

  • Agitation.
  • Irritability.
  • Restlessness.
  • Increased blood pressure.
  • Increased body temperature.
  • Intense cravings.
  • Mood swings.
  • Exhaustion.
  • Depression.
  • Suicidal thoughts.
  • Increased appetite.

There can be severe consequences if continued cocaine use occurs or if a person attempts to detox without medical assistance. If you need help detoxing cocaine from your body, Guardian Recovery can help.

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Brain Dopamine & Serotonin Levels

Cocaine floods the brain with dopamine and disrupts serotonin and norepinephrine regulation which leads to the addictive qualities of the drug. Disrupting the regulation of these neurotransmitters causes sharp spikes of dopamine in the brain’s reward center. This sharp dopamine spike contributes to the intense high people may experience when using the drug. This also leads to the adverse risks of dependence, overdose, and death.

Short-Term & Long-Term Effects on the Brain

Short-term effects of cocaine use include restricted blood vessels, dilated pupils, increased body temperature, heart rate, and blood pressure. Large amounts of cocaine can lead to erratic or even violent behavior. Additionally, a person may experience tremors and muscle twitching.

Severe medical complications can occur with cocaine use. Examples include cardiovascular effects, headaches, seizures, strokes, and coma. In rare instances, sudden or unexpected death can occur.

Regularly snorting cocaine can lead to long-term nose damage, including nosebleeds, problems with swallowing, hoarseness, and chronic runny nose. Smoking crack cocaine damages the lungs and can worsen asthma. People who inject cocaine have puncture marks called tracks and are at risk of contracting infectious diseases like HIV and hepatitis C. They also may experience allergic reactions, either to the drug itself or to additives in cocaine, which can result in death in severe cases.

Cocaine has substantial effects on the heart and cardiovascular system. Cocaine use is linked with an increased risk of stroke.

As mentioned, the brain also is negatively impacted by long-term cocaine use. Examples include Parkinson’s disease and cognitive impairments of memory, judgment, impulse, and motor functioning.

Can Cocaine Use Cause Permanent Brain Damage?

Primarily, the type of brain damage caused by cocaine can be short-term and be reversed if abstaining from cocaine use for at least 35 weeks. However, some complications can lead to permanent brain damage. For example, a person is at a high risk of developing a stroke from cocaine use. If a person suffers from a stroke and loses oxygen for a sustained time, severe and irreversible brain damage can occur.

Cocaine Brain Damage & Brain Scans

Brain scans have shown decreases in grey matter, brain regions responsible for relapse and addiction have been disturbed even after abstinence, and surprisingly, even white matter is affected by cocaine. White matter communicates and sends messages through the central nervous system and coordinates messages with grey matter. Unfortunately, we have found through research and imaging that the brain is severely impacted by cocaine use, and there is no guarantee that all brain damage can be reversed through abstinence.

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At Guardian Recovery, we remain dedicated to providing our clients with a comprehensive program of cocaine detox — one that focuses on much more than physical stabilization. In addition to emphasizing physical recovery, we tackle mental, emotional, and spiritual well-being. While we prioritize a safe and pain-free cocaine withdrawal, we offer individualgroup, and family therapy sessions, case management services, relapse prevention training, and aftercare planning.

Contact us today if you or your loved one is ready to begin an entirely new way of life and commit to long-term recovery. As soon as you call, we start developing a plan of action that begins with an initial pre-assessment. This assessment helps us determine which level of care is the most appropriate for each unique case. We identify potential coverage options if our medically monitored detox program is a good fit. We work closely with most major regional and national insurance providers. Contact us today for a free, no-obligation insurance benefit check.


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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

  1. https://nida.nih.gov/publications/research-reports/cocaine/what-scope-cocaine-use-in-united-states
  2. https://nida.nih.gov/publications/research-reports/cocaine/what-are-some-ways-cocaine-changes-brain
  3. https://nida.nih.gov/publications/research-reports/cocaine/how-does-cocaine-produce-its-effects
  4. https://nida.nih.gov/news-events/nida-notes/2021/08/chronic-cocaine-use-changes-brain-structure-cognitive-function-rhesus-monkeys
  5. https://www.ncbi.nlm.nih.gov/books/NBK553239/#:~:text=The%20grey%20matter%20has%20a,movement%2C%20memory%2C%20and%20emotions.
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3601087/
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC181074/
  8. https://nida.nih.gov/news-events/nida-notes/2019/02/disruption-serotonin-contributes-to-cocaines-effects#:~:text=Cocaine%20blocks%20the%20transporters%20for,drug’s%20reinforcing%20and%20addicting%20effects.
  9. https://nida.nih.gov/publications/research-reports/cocaine/what-are-short-term-effects-cocaine-use
  10. https://nida.nih.gov/publications/research-reports/cocaine/what-are-long-term-effects-cocaine-use
  11. https://www.nature.com/articles/s41398-021-01367-x

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Reviewed professionally for accuracy by:

Ryan Soave


Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

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Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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