How Does Cocaine Impact the Brain?

Posted on May 20, 2022

man experiencing the effects of cocaine

Cocaine is a powerful stimulant that results in increased energy and alertness and feelings of restlessness, grouchiness, anxiety, panic, and paranoia. It is derived from the dried leaves of the coca plant grown in South America. Cocaine can change the way the human brain functions, changing the decision-making process and how the brain responds to stress, among other functions.

Understanding Neurotransmitters

The brain’s cells are called neurons. They communicate via neurotransmitters that pass between synapses (tiny gaps between neurons).

The neurotransmitters attach to the cell across the synapse. The intended message is shared and then the neurotransmitter moves back into the synapse to return to the cell it came from initially. At this point, the neurotransmitter will be recycled for later use.

Cocaine and Dopamine

Cocaine affects multiple parts of the brain, but one of the most significant is how the drug disrupts the natural functioning of the neurotransmitter dopamine. Dopamine plays an important role in how the brain rewards and reinforces behaviors.

Cocaine blocks dopamine from cells. This causes the neurotransmitter to build up in the synapses between cells. The burst of energy and happiness associated with cocaine results from this buildup of dopamine between neurons. Other common short-term effects of cocaine include:

  • Mental alertness
  • Extreme sensitivity to sight, sound, and touch
  • Irritability and restlessness
  • Paranoia
  • High body temperature
  • Upset stomach

Short-term Effects of Cocaine

The effects of cocaine are felt immediately. The initial feelings of happiness and energy can last for minutes or even hours. How long the reaction is felt will depend on how the drug was taken. Faster absorption of the drug — for instance, when smoked — leads to a more intense but shorter-lived high. When snorted, cocaine’s effect is felt more slowly and will last longer.

In addition to the feelings cocaine causes in the brain, it also produces a physical reaction. This can include:

  • Constricted blood vessels
  • Dilated pupils
  • Increased body temperature
  • Increased heart rate
  • Elevated blood pressure
  • Tremors
  • Vertigo
  • Muscle twitches

Long-Term Brain Changes Because of Cocaine

Repeated, regular use of cocaine can result in adaptations in the brain. The pathways between neurotransmitters become less sensitive to natural effects because of the drug. The circuits in the brain that involve stress increase their sensitivity. Additionally, as an individual’s brain expects more significant amounts of dopamine, things the person used to enjoy or find pleasure from become less interesting or rewarding.

The result is a range of adverse effects when the person is not using cocaine. The withdrawal symptoms include increased displeasure and negative moods. Because of these effects, many users of cocaine shift their focus to finding the drug instead of seeking pleasure from more natural reward-inducing things like food or relationships.

Animal studies have shown that chronic cocaine use elevates stress hormones in the brain and decreases functioning in the part of the brain where decision-making occurs (the orbitofrontal cortex). A person may also experience side effects like:

  • Loss of smell
  • Problems swallowing
  • Nose bleeds
  • Cough
  • Lung problems

Death from Cocaine

The physical side effects of cocaine use can be severe and are often linked to the heart. Side effects of cocaine include:

  • Disturbances in heart rhythm
  • Heart attacks
  • Neurological effects, including headaches, seizures, strokes, and coma
  • Gastrointestinal complications, including abdominal pain and nausea

Taking cocaine with alcohol is dangerous because it can increase the effect cocaine has on the heart. A person can experience sudden death from cardiac arrest or seizures, even upon their first use of cocaine. Combining cocaine and heroin is dangerous because cocaine’s stimulating effects offset the more sedating effects of heroin. This can result in a person taking more heroin than usual without realizing it and increasing the risk of overdose.

Cocaine Addiction Treatment

No medications are currently approved to help in the treatment of cocaine addiction. Help comes in the form of behavioral therapies.

One form of behavioral therapy that has been shown to help those with cocaine addiction is contingency management (CM). This treatment is also referred to as motivational incentives, which offers a voucher or prize-based system to reward people trying to abstain from cocaine use.

Another form of behavioral therapy — cognitive behavioral therapy (CBT) — appears effective in helping to prevent relapse. CBT teaches the person the skills they need to achieve long-term abstinence from cocaine by recognizing the situations where they are most likely to use it and how to avoid them.

A licensed mental health and substance abuse intensive outpatient program (IOP) in Scottsdale, Arizona, Rising Phoenix was created to offer a safe, welcoming, and nurturing environment where clients are not judged, but embraced, throughout their recovery process.

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