Cocaine use impacts physical, emotional and behavioral health. Signs, symptoms, and side effects of cocaine, both short- and long-term, can help you identify someone struggling with a cocaine addiction.

Cocaine (often referred to as “coke” or misspelled as “cocain”) is a stimulant drug that impacts multiple organs in the body, leading to a wide variety of side effects and symptoms. Understanding how cocaine affects a person can help you understand the many risks involved with its use. It can also help you identify signs that a friend or loved one may be using the drug.

Article at a Glance:

  • Physical signs and symptoms of cocaine can include twitching, dilated pupils, sniffing and a runny nose.
  • Cocaine can cause short-term effects like high blood pressure and increased heart rate. These effects can lead to heart attacks, strokes and other medical emergencies.
  • Cocaine can cause long-term damage to the body and mind.
  • Cocaine’s drug effects long-term can vary depending on how it’s used, such as snorting, smoking, or injecting.

Short-Term Effects of Cocaine on the Body

Because cocaine is a stimulant, it can have a variety of short- and long-term effects on both the body and the mind. The drug’s short-term effects often start immediately after use and subside within a half-hour. Smoking or injecting cocaine leads to a fast, strong high that lasts for up to ten minutes. Conversely, snorting cocaine leads to a slower, weaker high that lasts for up to 30 minutes.

Psychological Effects of Cocaine on the Brain

Some of the short-term effects of cocaine on the brain include:

  • Alertness
  • Euphoria
  • Energetic feelings
  • Extreme sensitivity to sight, sound and touch
  • Irritability
  • Paranoia
  • Restlessness

Physical Effects of Cocaine on the Body

Cocaine’s short-term physical effects on the body include:

  • Constricted blood vessels
  • Large pupils
  • Nausea
  • Increased body temperature
  • Increased blood pressure
  • Fast heartbeat
  • Irregular heart rate
  • Tremors
  • Muscle twitches

Some of cocaine’s physical effects can lead to medical emergencies like:

  • Heart attack
  • Ruptured arteries
  • Miscarriage
  • Seizures
  • Stroke
  • Bleeding in the brain

Cocaine Overdose Signs and Symptoms

Cocaine tolerance develops quickly. When this occurs, a person constantly needs to take larger amounts to feel the same familiar effects. Though no amount of cocaine is “safe” to take, the drug can be more dangerous in larger doses and put you at risk of an overdose.

Regardless, anyone who uses cocaine is at risk for an overdose. An overdose is a medical emergency that requires immediate treatment. You will not get in trouble for saving someone’s life by seeking medical attention for their overdose.

Symptoms of a cocaine overdose can include:

  • High blood pressure
  • Changes in mental status
  • Seizures
  • Chest pain
  • Shortness of breath
  • Bloody nose
  • Headache
  • Paranoia
  • High body temperature
  • Extreme sweating
  • Severe agitation, restlessness or confusion
  • Itching
  • Vision problems, including blurry vision or complete vision loss
  • Diarrhea, vomiting or abdominal pain
  • Delirium

If you notice one or more signs of a potential overdose, contact 911 immediately.

Long-Term Health Effects of Cocaine Abuse

In addition to short-term health effects, cocaine can also cause long-term health issues. These long-term health concerns can be both physical and psychological in nature.

Long-Term Physical Effects of Cocaine Use

Long-term physical health effects may include:

  • Permanent blood vessel damage
  • High blood pressure
  • Liver damage
  • Kidney problems
  • Malnutrition
  • Severe tooth decay
  • Sexual problems, including infertility in both men and women

Long-Term Psychological Effects of Cocaine Use

Long-term psychological effects may include

  • Paranoia
  • Severe depression
  • Anxiety
  • Aggression
  • Psychosis and hallucinations
  • Irritability
  • Confusion and Disorientation

Long-term cocaine use also affects general cognitive abilities, including

  • Attention
  • Impulse control
  • Memory
  • Decision-making
  • Motor function

Long-term effects can also vary depending on how the person is abusing cocaine. Snorting, smoking, injecting and taking cocaine orally can all have different long-term consequences.


Over time, snorting cocaine can lead to health problems like:

  • Loss of smell
  • Nosebleeds
  • Chronic runny nose
  • Problems with swallowing


Over the long term, chronically smoking cocaine can lead to lung issues like:

  • Chronic cough
  • Asthma
  • Problems keeping enough oxygen in your blood
  • Lung infections, such as pneumonia


Over time, injecting cocaine can increase your risk for health concerns like:

  • HIV, hepatitis C and other bloodborne diseases
  • Skin and soft tissue infections
  • Scarring
  • Collapsed veins

Ingesting Orally

It’s uncommon for cocaine to be used orally because it takes longer to get high via this route. However, oral cocaine use can still cause dangerous, long-term side effects, such as severe bowel decay caused by reduced blood flow to the intestines.

Signs and Symptoms of Cocaine Abuse

The signs of cocaine abuse are similar to the signs of other drug use. The first signs and symptoms of cocaine use may seem minor, but they can escalate as a person’s addiction continues to develop.

Signs that your loved one is abusing cocaine may include:

  • Strange and unusual behavior
  • Keeping secrets or giving suspicious answers to questions
  • Leaving early, showing up late or missing obligations entirely
  • Increased impulsivity
  • Financial troubles
  • White stains on clothes, belongings or skin

Cocaine is not cheap. In order to fund a cocaine habit or addiction, many people must go to extreme lengths to pay for the next binge. This can mean repeatedly asking for money, stealing from friends or family members, taking on extra jobs, taking out loans, selling their possessions or beginning to sell drugs themselves.

It’s not uncommon for people with cocaine addiction to empty their savings accounts or retirement funds to pay for their drug use. As cocaine use progresses, it can result in a series of life-altering outcomes that should be red flags and prompt immediate attention. These include:

  • Quitting or getting kicked out of school
  • Leaving or getting fired from a job
  • Bankruptcy or serious debt
  • Lost friendships and relationships
  • Trouble with the law

A common thread among those who use cocaine is the unpredictable and extreme changes in mood. A loved one who develops a cocaine addiction can become distant and unrecognizable from the person you used to know. This can make it difficult to address their behavior or confront the situation that’s unfolding. The more these symptoms pile up, though, the more urgent the problem becomes.

If you suspect someone you love is struggling with cocaine use, The Recovery Village is here to help you find the appropriate care for your loved one. Contact us today to learn more about cocaine addiction treatment programs that can work well for your loved one’s needs.

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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
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Editor – Jonathan Strum
Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more

Egred, M., Davis, G.K. “Cocaine and the heart.” British Medical Journal (BMJ), 2005. Accessed September 6, 2021.

National Institute on Drug Abuse. “What are the long-term effects of cocaine use?” May 2016. Accessed September 6, 2021.

National Institute on Drug Abuse. “Health Consequences of Drug Misuse: Mental Health Effects.” June 2020. Accessed September 6, 2021.

National Institute on Drug Abuse. “Cocaine DrugFacts.” April 2021. Accessed September 6, 2021.

Richards, John R.; Le, Jacqueline K. “Cocaine Toxicity.” StatPearls, July 19, 2021. Accessed September 6, 2021.

Cleveland Clinic. “Cocaine (Crack) Addiction.” October 11, 2019. Accessed September 10, 2021.

Drug Enforcement Administration. “Drugs of Abuse.” April 2020. Accessed September 6, 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.