Because of cocaine’s effects on blood vessels and the heart, severe internal damage can occur. Learn how cocaine can cause internal bleeding and what to do if internal bleeding is suspected.

Cocaine use is known to harm many aspects of a person’s health. Not all damage from cocaine use is visible. Much of the physical damage caused by cocaine is on the inside of the body. Cocaine users might not even know that their bodies are injured. One of the types of damage cocaine can cause is internal bleeding, or bleeding on the inside of the body. Cocaine can cause internal bleeding in many different organs. Doctors recognize that cocaine can cause bleeding in the brain, stomach, intestines, lungs and spleen.

Article at a Glance:

When considering how cocaine use can cause internal bleeding, keep the following key points in mind:

  • Cocaine use can cause bleeding in many different parts of the body, including the brain, lungs, GI tract and spleen
  • Drug interactions between cocaine and drugs that increase bleeding risk may also contribute to internal bleeding
  • Internal bleeding is serious and can be fatal
  • Emergency medical attention should be sought if internal bleeding is suspected

Cocaine and Bleeding in the Brain

Bleeding in the brain is a potentially deadly effect of cocaine use. Not only does cocaine use increase the risk of brain bleeds and strokes, but brain bleeds from cocaine use are often more serious than other kinds of brain bleeds. 

People with brain bleeds from cocaine use were almost three times more likely to die from the bleed than people whose bleeds were not linked to cocaine. In addition, even when cocaine users survived their brain bleed, the outcome was often poor. Cocaine users were less likely to have recovered fully by the time of their hospital discharge people with other brain bleeds. Signs of brain bleeding include sudden-onset:

  • Weakness on one side of the body
  • Confusion or problems with speech
  • Loss of vision
  • Severe headache
  • Balance problems

Cocaine and Bleeding in the Stomach or Intestines

Cocaine can cause severe damage to the gastrointestinal (GI) tract. This damage includes not only bleeding but holes in the GI tract and the death of parts of the intestine. Doctors think that cocaine causes this damage by harming the blood vessels. Symptoms of GI damage can start anywhere from one hour to 48 hours after cocaine use. Symptoms of GI bleeding and damage from cocaine include:

  • Abdominal pain
  • Nausea or vomiting
  • Bloody diarrhea

Cocaine and Bleeding in the Lungs

Cocaine use is linked to bleeding in the lungs. This type of bleeding may be common with cocaine use and can be fatal. A study of people who died from cocaine overdose showed that more than 70% of them had some degree of lung bleeding. Signs of bleeding in the lungs from cocaine use include:

  • Coughing up blood
  • Shortness of breath

Cocaine and Bleeding in the Spleen

In rare cases, cocaine use can cause the spleen to rupture. Cocaine has a dramatic effect on the spleen and can cause the organ to temporarily shrink by 20%. Doctors think that cocaine may cause bleeding in the spleen because of blood pressure changes or because of blood vessel damage. Symptoms of a ruptured spleen include:

  • Pain on the left side of the abdomen
  • Pain in the left shoulder
  • Confusion
  • Dizziness

How Does Cocaine Cause Internal Bleeding?

Most people recognize cocaine as a drug that affects a person mentally. Cocaine is a widely-known stimulant that causes people to act energetically. Beyond the damage that snorting and injecting cocaine can cause, it’s important to know how cocaine causes internal damage as well. When cocaine is consumed it stimulates the sympathetic nervous system (related to the “fight-or-flight” response that people experience) which limits blood flow and causes the heart to work harder. Such changes in blood flow can have negative effects within the body. These effects include:

  • Rapid spikes in blood pressure
  • Burst aneurysms, which are weak bulging parts of an artery
  • Inflammation and damage to blood vessels

Drug Interactions with Cocaine that Increase Bleeding Risk

Cocaine can also increase the risk of bleeding because of drug interactions. If someone takes certain drugs like blood thinners, using cocaine can be harmful. Cocaine stops the body from breaking down blood thinners, so it lasts longer than it should and increases the risk of bleeding. 

Similarly, cocaine has an interaction with some non-steroidal anti-inflammatory drugs (NSAIDs). Bleeding risk also increases when NSAIDs are mixed with cocaine. Just like with blood thinners, cocaine use leads to a higher bleeding risk by stopping the body from breaking down NSAIDs. NSAIDs include drugs like:

  • Ibuprofen
  • Meloxicam
  • Naproxen

How to Treat Internal Bleeding from Cocaine Use

Internal bleeding is a medical emergency that can lead to death. If you suspect that you or a loved one has internal bleeding, for any reason, you should seek emergency medical attention right away. Internal bleeding cannot be treated at home. Delaying treatment can be fatal.

If you or a loved one struggle with cocaine use, The Recovery Village can help. Call to speak with a representative to learn how addiction treatment can help people reach their recovery goals. You deserve a healthier future, call today.

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Editor – Thomas Christiansen
With over a decade of content experience, Tom produces and edits research articles, news and blog posts produced for Advanced Recovery Systems. Read more
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Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more

Martin-Schild, Sheyrl; et al. “Intracerebral Hemorrhage in Cocaine Users.” Stroke, April 2010. Accessed June 14, 2019.

U.S. National Library of Medicine. “Hemorrhagic Stroke.” April 3, 2019. Accessed June 14, 2019.

Underner, M; Perriot, J; Wallaert, B; et al. “Alveolar Hemorrhage and Cocaine Use.” Revue des Maladies Respiratoires, February 2018. Accessed June 14, 2019.

Tiwari, Alok; Moghal, Mohammed; Meleagros, Luke. “Life Threatening Abdominal Complications[…]lowing Cocaine Abuse.” Journal of the Royal Society of Medicine, February 2006. Accessed June 14, 2019.

Ghimire, Subash; Liu, Joy; Evans, Samuel; Dushay, Kevin. “Cocaine-induced Diffuse Alveolar Hemorrh[…]ew of the Literature.” Rhode Island Medical Journal, August 1, 2016. Accessed June 14, 2019.

Khan, Aysha; Casaubon, Jesse; Regan, John; Monroe, Leonora. “Cocaine-induced Splenic Rupture.” Journal of Surgical Case Reports, March 22, 2017. Accessed June 14, 2019.

Canadian Institutes of Health Research. “Cocaine.” June 18, 2019.  Accessed June 18, 2019.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.