Cocaine has both short-term and long-term effects on the brain, including paranoia, Parkinson’s disease, stroke and more.

With cocaine being the second-most illegally trafficked drug across the globe, it’s important to understand how cocaine affects those who use it, including the possible dangers and effects cocaine has on the brain in both the long and short term.

How does cocaine affect the brain—does cocaine kill brain cells? Can it lead to the development of neurological disease later on in life? Thanks to multiple studies and ongoing medical research, these questions have some answers.

What Is Cocaine?

Cocaine is a potent and addictive stimulant drug derived from the coca leaf. It can be snorted, injected or smoked to achieve a euphoric high — a result of the drug’s hyper-stimulating effect on the brain’s dopamine levels. When used repeatedly, cocaine side effects can cause severe health problems in addition to the development of physical and mental dependence.

Cocaine is commonly taken recreationally, either by snorting, smoking, or injecting it into the bloodstream. When cocaine is purchased from an unknown source, it is always possible that the drug isn’t pure cocaine—a situation that presents its own risks.

The Dangers of Mixing Cocaine with Other Drugs

There are many risks associated with cocaine use in general, but combining cocaine with other substances is especially dangerous. The risk of overdose is heightened when you take multiple substances together, and there’s also a risk of dangerous or fatal drug interactions.

Cocaine can be cut with a variety of substances, from non-drug substances like laundry detergent to drugs like fentanyl and levamisole. By cutting drugs with other substances, drug dealers can make more money by selling smaller amounts of the intended drug and larger amounts of “filler”.

For the person purchasing the drugs, the stimulatory effects of cocaine may be prolonged by a longer half-life of another substance taken at the same time.

How Does Cocaine Affect the Brain?

In order to determine how cocaine affects the brain overall, it’s important to consider both the long-term and short-term effects of this drug.

When someone uses cocaine, the brain begins releasing extra dopamine, a feel-good brain chemical responsible for the feelings of a high or euphoria. Cocaine prevents the breakdown of dopamine, leading to a buildup of large amounts of it in the brain. The sudden flood of dopamine changes how the brain and body function.

The effects of cocaine become apparent quickly once someone takes it, but these effects are short-lived. They typically end within a few minutes to an hour after the drug is taken.

In the short term, people often use cocaine for the high it produces, causing feelings of euphoria, boosts in energy and mental alertness, and sensitivity to light and sound. Irritability, paranoia or violent behavior may also occur in the short term.

Physical Health Risks of Short-term Cocaine Use

There are other short-term health risks of using cocaine:

  • Nausea
  • High blood pressure
  • High body temperature
  • Rapid heart rate
  • Seizures
  • Heart attack
  • Stroke

Though it is rare, sudden death can occur either when cocaine is used or shortly afterward.

Long Term Effects of Cocaine on the Brain

Cocaine also has lasting adverse effects on the brain over the long term. Extended cocaine use can contribute to:

  • Severe paranoia
  • Hallucinations
  • Seizures and seizure disorders
  • Parkinson’s disease
  • Intracerebral hemorrhage

In general, research suggests that many cognitive functions can be adversely affected by cocaine use in the long term. These functions include motor skills, decision-making skills and memory.

Does Cocaine Kill Brain Cells?

As a person ages, their brain experiences a gradual reduction in gray matter. Over time, the loss of gray matter in the brain, brainstem and spinal cord can lead to natural complications related to aging, such as changes in memory and cognition.

However, people with a cocaine use disorder can lose a significantly greater amount of gray matter, and at a more rapid pace, than someone with no history of a substance use disorder.

Cocaine can also cause autophagy, where brain cells die in response to the neurological stress and neurotoxicity that occur from cocaine use.

It is possible that cocaine can kill brain cells both in the short- and long-term stages of cocaine use. However, there are many other toxic effects associated with a brain on cocaine. Every time someone repeatedly exposes their brain to cocaine, there is a possibility of dangerous or even fatal side effects.

Don’t Wait — Help Is Here

If you or a loved one are concerned about a cocaine use disorder, it’s time to seek professional help. The Recovery Village provides care to those struggling with cocaine use through evidence-based addiction treatment and therapy. Reach out to one of our knowledgeable representatives today to learn how you can start on your path to recovery.

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Editor – Erica Weiman
Erica Weiman graduated from Pace University in 2014 with a master's in Publishing and has been writing and editing ever since. Read more
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Medically Reviewed By – Dr. Conor Sheehy, PharmD, BCPS, CACP
Dr. Sheehy completed his BS in Molecular Biology at the University of Idaho and went on to complete his Doctor of Pharmacy (PharmD) at the University of Washington in Seattle. Read more

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Food and Drug Administration (FDA). “Librium Package Insert.” July 2005. Accessed November 9, 2021.

Griffin, Charles, et al. “Benzodiazepine Pharmacology and Centr[…]Mediated Effects.” The Ochsner Journal, 2013. Accessed November 9, 2021.

Hallare, Jericho; Gerriets, Valerie. “Half-Life.” StatPearls, August 23, 2021. Accessed November 9, 2021.


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.