Yes, cocaine causes vasoconstriction, which is why cocaine can be prescribed legally in the United States. Vasoconstriction is when the blood vessels (arteries or veins) tighten.

The body constricts blood vessels naturally for many reasons. If a person is cold, the capillaries in their hands and feet constrict to save heat. When a person is not eating, the veins that deliver oxygen to their stomach constrict.

Vasoconstriction is one of the ways the body directs energy and fuel to different parts of the body.

Cocaine’s Legal Uses

Cocaine is classified as a Schedule II controlled substance by the Drug Enforcement Administration (DEA). This classification means that cocaine has a high abuse potential, but it can be prescribed for medical uses.

Cocaine is used as a topical anesthetic in the mucous membranes of the oral, laryngeal and nasal cavities. Cocaine is unique as a topical anesthetic because it can be used off-label to stop nosebleeds and makes cauterization and packing a wound easier.

Most other topical anesthetics do not function similarly, and some do the opposite (vasodilate or relax). Therefore other topical anesthetics might make bleeding worse, and they must be combined with a second drug to constrict the area.

Despite its legal status, physicians rarely prescribe cocaine except in hospital emergency departments.

Damage From Vasoconstriction

Too much vasoconstriction harms different tissues and organs. Prolonged vasoconstriction strangles cells of oxygen, and they cannot produce the energy that they need. Without energy, cells start to die.

When the body constricts naturally, it has safety mechanisms in place to stop constriction from happening for too long. So, if the body is cold, blood vessels constrict, but not for so long that the skin and muscle in the hands start to die.

Cocaine causes the body to ignore those safety mechanisms, and the blood vessels continue to constrict even when it is dangerous to do so. Prolonged vasoconstriction causes ischemia (reduced blood flow) and is dangerous in different ways for organs of the body.


Heart ischemia causes different problems depending on which cells are affected. Oxygen starvation leads to different types of heart damage:

  • Arteries and veins feeding the heart: Myocardial Infarction (heart attack)
  • Heart muscle cells: Angina (chest tightness)
  • Pacemaker cells: Arrhythmias (sudden cardiac death)

Cocaine commonly affects the heart and this is one of the primary reasons for going to the hospital after cocaine abuse.

Gastrointestinal Tract

When the cells of the gastrointestinal tract (GI) tract die, the main symptom is extreme pain. An ischemic bowel does not absorb the nutrients of food very well. The bowel may stop moving food along the GI tract and it may become stuck or lay undigested.


Kidneys filter different toxins out of the bloodstream. If capillaries supplying blood to the kidneys constrict for too long, kidney cells start to die. Cocaine can cause kidney damage. Kidney damage from cocaine is usually reversible, but sometimes the damage can be permanent.


Skin without enough circulation turns blue and becomes cold. When ischemia is very bad, the skin may start to turn black and die. This is an uncommon side effect of cocaine use.

Key Points: Cocaine and Vasoconstriction

Keep the following key points in mind about cocaine and vasoconstriction:

  • Cocaine constricts (tightens) blood vessels
  • Cocaine can be prescribed in a hospital for cuts to the face and head
  • Vasoconstriction reduces blood flow to parts of the body
  • Reduced blood flow can kill cells and damage organs
  • Sometimes organs cannot be repaired once they are damaged
  • The only way to prevent damage from vasoconstriction is to stop using cocaine

Cocaine damages the body by reducing blood flow and cutting off the oxygen supply to the body. The only way to prevent this damage is to stop abusing cocaine. Rehab is an important first step for those seeking help.

If you suspect a loved one is abusing cocaine or any other dangerous substance, helping them find support and treatment can save their life. Contact The Recovery Village to get in touch with a representative who can help you or your loved one with understanding how treatment addresses addiction and any co-occurring mental health disorders.

Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a 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 provider.

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