With repeated exposure to cocaine, the brain starts to adapt so that the reward pathway becomes less sensitive to natural reinforcers10,18 (see "What Are Some Ways that Cocaine Changes the Brain?"). At the same time, circuits involved in stress become increasingly sensitive, leading to increased displeasure and negative moods when not taking the drug, which are signs of withdrawal. These combined effects make the user more likely to focus on seeking the drug instead of relationships, food, or other natural rewards.
Crack Cocaine Long Term Effects Brainl
With regular use, tolerance may develop so that higher doses, more frequent use of cocaine, or both are needed to produce the same level of pleasure and relief from withdrawal experienced initially.10,18 At the same time, users can also develop sensitization, in which less cocaine is needed to produce anxiety, convulsions, or other toxic effects.7 Tolerance to cocaine reward and sensitization to cocaine toxicity can increase the risk of overdose in a regular user.
Users take cocaine in binges, in which cocaine is used repeatedly and at increasingly higher doses. This can lead to increased irritability, restlessness, panic attacks, paranoia, and even a full-blown psychosis, in which the individual loses touch with reality and experiences auditory hallucinations.2 With increasing doses or higher frequency of use, the risk of adverse psychological or physiological effects increases.2,7 Animal research suggests that binging on cocaine during adolescence enhances sensitivity to the rewarding effects of cocaine and MDMA (Ecstasy or Molly).19 Thus, binge use of cocaine during adolescence may further increase vulnerability to continued use of the drug among some people.
Specific routes of cocaine administration can produce their own adverse effects. Regularly snorting cocaine can lead to loss of sense of smell, nosebleeds, problems with swallowing, hoarseness, and an overall irritation of the nasal septum leading to a chronically inflamed, runny nose.15 Smoking crack cocaine damages the lungs and can worsen asthma.2,3 People who inject cocaine have puncture marks called tracks, most commonly in their forearms,7 and they are at risk of contracting infectious diseases like HIV and hepatitis C (see "Why Are Cocaine Users at Risk for Contracting HIV and Hepatitis?"). They also may experience allergic reactions, either to the drug itself or to additives in cocaine, which in severe cases can result in death.
Cocaine damages many other organs in the body. It reduces blood flow in the gastrointestinal tract, which can lead to tears and ulcerations.7 Many chronic cocaine users lose their appetite and experience significant weight loss and malnourishment. Cocaine has significant and well-recognized toxic effects on the heart and cardiovascular system.7,16,20 Chest pain that feels like a heart attack is common and sends many cocaine users to the emergency room.7,20 Cocaine use is linked with increased risk of stroke,16 as well as inflammation of the heart muscle, deterioration of the ability of the heart to contract, and aortic ruptures.20
Former cocaine users are at high risk for relapse, even following long periods of abstinence. Research indicates that during periods of abstinence, the memory of the cocaine experience or exposure to cues associated with drug use can trigger strong cravings, which can lead to relapse.21
Damage to the nose and mouth: Snorting cocaine causes direct damage to the mucous membranes in the nose. With drier environments and less blood flow, the soft tissues in the nose will become damaged and eventually die. This will expose the cartilage lining between nasal cavities, which is the septum. Once the septal cartilage is exposed, it too will die, creating a hole. Many people who struggle with cocaine abuse develop septal perforations, which can cause a collapse of the nose structure, and, eventually, breathing problems. Sometimes, this issue can be corrected with plastic surgery but not always. A similar process can occur in the upper palate of the mouth. Palatal perforations are not as common as septal perforations, but they can occur through long-term abuse.
Negative Effects on the Brain: Consistent constricting of blood vessels can reduce the amount of oxygen the brain receives, which can cause brain damage. It also increases the risk of aneurysm due to damage to the vascular walls feeding the brain. Further brain damage from cocaine or crack cocaine can include:
Gastrointestinal damage: With reduced blood flow throughout the body, several organ systems can be indirectly damaged over time, including the stomach and intestines. Short-term side effects from cocaine abuse include stomach pain, reduced appetite, nausea, vomiting, and constipation; over time, these side effects will become more permanent, indicating necrotic bowel or death of important tissues in the gastrointestinal system. People who struggle with cocaine abuse are also more likely to get ulcers due to changes in the pH of the stomach. In addition, cocaine abuse can lead to the development of ischemic colitis, which is inflammation and injury of the large intestine; this can cause serious digestive problems and even lead to death.
Liver damage: Long-term cocaine abuse means higher risk of overdose, and cocaine overdose can lead to liver injury, as the body is flooded with toxins that the liver cannot filter out. While most damage to the liver resolves if the person recovers from the overdose or if they get help ending their cocaine addiction, there have been instances of death due to acute liver damage. Chronic liver damage is less likely, unless the person mixed cocaine and alcohol, which can cause the liver to produce cocaethylene, which increases the depressive effects of alcohol, increases aggression, stresses the heart, and damages the liver.
Kidney damage: Chronic cocaine abuse can damage the kidneys in two ways. First, permanently increased blood pressure leads to kidney damage due to loss of blood flow. While many organ systems are damaged through lack of oxygen and high blood pressure, the kidneys are especially susceptible. Second, long-term cocaine abuse causes rhabdomyolysis, or the destruction of skeletal muscles; as these muscles die, toxins are released into the body, and they flood the liver and kidneys. Kidney failure is a late-stage result of rhabdomyolysis.
Infectious diseases: People who struggle with cocaine and crack cocaine addiction are more likely to contract several infectious diseases, including HIV and hepatitis. Sometimes, this is because of needle-sharing; however, more often, the intense stimulant contributes to poor decision-making, increased risk-taking, and enhanced sexual drive, which can lead to risky sexual encounters. Additionally, cocaine abuse impairs the immune system, so diseases spread rapidly through the body.
Both cocaine and crack cocaine can cause brain damage, even when used only a few times. Damage to brain structures can trigger addiction, which is a disease involving the reward circuits and dopamine systems. Abusing this potent drug can cause other kinds of long-term damage as well.
Both freebase (crack) and powdered cocaine can cause long-term damage to mental health, which appears in the form of mood or emotional disturbances. Because the drug directly interferes with dopamine being reabsorbed by neurons, one of the symptoms of a cocaine comedown is serious depression.
One of the most serious long-term effects from cocaine abuse is damage to the cardiovascular system. This can lead to damage to many other organ systems, including the brain. A few ways cocaine damages the structure of the brain are outlined below:1
There are many different drugs that can make you paranoid, the most common types being stimulants and hallucinogens. When it comes to stimulants, crack cocaine and methamphetamine are notoriously known to cause paranoia.
People who binge on crack cocaine, have co-occurring mental health conditions, or have been using the drug for an extended amount of time are more susceptible to experiencing paranoia while high. Sadly, drug-induced paranoia can lead people to harm themselves, others, or suffer immensely emotionally.
In the long term, repeated crack cocaine exposure causes changes in neural pathways. Over time, brain circuits that are involved in stress, pleasure, and mood become increasingly sensitive. Without the drug, people who are addicted exhibit signs of withdrawal. Moreover, tolerance to crack cocaine can increase the risk of overdose. In addition, smoking crack damages the lungs, nose, and other bodily functions.
Many users take crack cocaine in binges where they use the drug frequently and at high doses. In such cases, users may experience increased restlessness, irritability, panic attacks, paranoia, and psychosis. The longer people use crack cocaine, the more likely they are to experience paranoia, drug-induced psychosis, and other psychological and physiological effects.[2]
Drug-induced psychosis, on the other hand, is another long-term effect of crack cocaine abuse that involves a combination of paranoia and hallucinations. Although drug-induced psychosis can occur after using a large amount of any drug, stimulant-induced psychosis is most common. Psychosis consisting of delusions and hallucinations has been reported in approximately 29-53% of chronic crack cocaine users and is more common with intravenous and intranasal use.[1]
Psychosis is extremely dangerous, especially in crack cocaine users because violence is often connected with cocaine abuse. One study found that of a group of patients with cocaine-induced psychiatric symptoms:[1]
Paranoia caused by crack cocaine may last anywhere from a few hours to weeks, months, or even years if users continue taking the drug. Even those who have detoxed may experience paranoia while their brain beings to adjust to functioning without the drug. The length of time drug-induced paranoia typically depends on how long a person used crack cocaine, their mental health, and whether or not they mixed the drug with any other substances. 2ff7e9595c
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