What Are the Long-Term Effects of Cocaine Use?

Cocaine is a powerfully addictive drug. Thus, it is unlikely that an individual will be able to reliably predict or control the extent to which he or she will continue to want or use the drug. And, if addiction takes hold, the risk for relapse is high even following long periods of abstinence.

Recent studies have shown that during periods of abstinence, the memory of the cocaine experience or exposure to cues associated with drug use can trigger tremendous craving and relapse to drug use. With repeated exposure to cocaine, the brain starts to adapt, and the reward pathway becomes less sensitive to natural reinforcers and to the drug itself.

Tolerance may develop — this means that higher doses and/or more frequent use of cocaine is needed to register the same level of pleasure experienced during initial use. At the same time, users can also become more sensitive (sensitization) to cocaine’s anxietyproducing, convulsant, and other toxic effects.

Users take cocaine in “binges,” during which the cocaine is used repeatedly and at increasingly higher doses. This can lead to increased irritability, restlessness, and paranoia — even a fullblown paranoid psychosis, in which the individual loses touch with reality and experiences auditory hallucinations. With increasing dosages or frequency of use, the risk of adverse psychological or physiological effects increases.