Effects & Risks of Cocaine & Crack

An overdose of cocaine can be lethal. Death may occur as a result of an abnormal heartbeat (arrhythmia), stroke, seizures or respiratory arrest (breathing stops). There is no specific antidote that can reverse the effects of the drug. If you think that a person has overdosed, contact emergency services immediately.

Health Hazards & Long-Term Effects

Taking large amounts of cocaine for a long time can have many unwanted effects. People using cocaine may become depressed, have mood swings, or become restless and excitable. Their behaviour may be erratic, bizarre, or violent. Some people become psychotic and can experience:

• Paranoia – smoking crack cocaine can produce particularly aggressive paranoid behaviour in users.
• Hallucinations
• Delusions

Heavy users may have trouble sleeping, may change between feelings of intense hunger and a lack of interest in food. Cocaine users often develop social problems. They may become preoccupied with buying, preparing, and using the drug. School and job performance may suffer.

Cocaine-related deaths are often a result of cardiac arrest or seizures followed by respiratory arrest.

Watch “How Does Cocaine Affect The Brain?” (How Drugs Work, BBC Three) on YouTube

Other medical complications include:

• high blood pressure
• irregular heartbeat
• impotence (sexual dysfunction)
• Smoking crack cocaine can cause chest pain and breathing difficulties (crack lung)
• Sharing drug supplies, such as needles, pipes, straws, and spoons, can spread viruses. These include HIV, hepatitis B, and hepatitis C
• Prolonged cocaine snorting can result in ulceration of the mucous membrane of the nose and can damage the nasal septum enough to cause it to collapse

Risks of use with other substances

Using cocaine with other drugs, particularly opiates such as fentanyl, either at the same time or consecutively, is associated with an increased risk of overdose.The increased availability of cocaine in the illegal drug supply and the drug’s co-use with opioids are contributing to increased rates of cocaine-related deaths in Canada.¹

When people mix cocaine and alcohol, they are compounding the danger each drug poses and unknowingly causing a complex chemical interaction within their bodies. Researchers have found that the human liver combines cocaine and alcohol to manufacture a third substance, cocaethylene, which intensifies cocaine’s euphoric effects and possibly increases the risk of sudden death.

Is Cocaine Addictive?

Yes, cocaine is addictive. With repeated use, tolerance to the effects of cocaine can develop. Regular cocaine users can also develop psychological dependence which is characterized by intense cravings for the drug even when the user knows there are significant consequences.

Withdrawal from cocaine use – Regular users of cocaine who suddenly stop using the drug may experience the following withdrawal symptoms:

• exhaustion
• extended and restless sleep
• hunger
• irritability
• suicidal thoughts
• intense craving for the drug

Some individuals in withdrawal may be at risk for experiencing debilitating depression, which can include suicidal thoughts, causing them to relapse to alleviate overwhelmingly negative thoughts and feelings.

Can cocaine/crack cocaine harm a developing fetus and newborn babies?

Cocaine use during pregnancy may increase the risk of miscarriage and premature delivery. Babies may be born underweight. Babies born to cocaine users may:

• be irritable
• feed poorly
• not sleep well for several weeks after they are born