According to data from the 2019 National Survey on Drug Use and Health about 2 million Americans reported using cocaine within the last 30 days and 5.5 million reported using the drug within the last year.
As worrying as these numbers sound, this only places the US in 5th place when it comes to cocaine use rates, behind Austria, Spain, and….the UK.
According to a recent study, the UK had the second highest rate of cocaine use globally, only behind Australia.
As the number of cocaine-related deaths in the UK rises, we at PCP believe that understanding the long-term consequences of cocaine use goes a long way in preventing abuse and preventing relapse.
Statistics on Cocaine Abuse
● The proportion of cocaine abuse among individuals between 16 – 59 in the UK has remained relatively steady, according to the latest 2023 report. However, the drug does seem to be becoming more popular among the 16 – 24 years age group.
● Unfortunately, the number of cocaine-related deaths in England and Wales has seen a steady rise over the last decade, with 857 deaths in 2022, compared to 139 deaths in 2012.
● Another worrying trend is the rise in the use of crack cocaine, an alternative form of the powdered drug with similar properties.
● Government research suggests that increasing the purity of crack cocaine and a fall in the purity of heroin may be a driving force behind the increased adoption of the drug within the UK.
● Cocaine abuse was found to be most prevalent amongst individuals making £50,000 and above, though the vast majority of cocaine users fall below this benchmark.
How Does Cocaine Affect the Brain?
Cocaine is a commonly abused illicit substance which falls under the class of drugs called stimulants. This is a general term used to refer to substances which increase mental or physical activity.
Cocaine can be snorted, smoked or injected. The drug rapidly enters the bloodstream and the effects can be felt almost instantly.
Cocaine affects several chemical substances within the brain, most famously dopamine – known as the happy hormone. Cocaine causes the brain to release massive amounts of dopamine and prevents the brain from getting rid of dopamine once it has been released, causing it to accumulate within the brain
The short-term effects include increased mental alertness, a feeling of euphoria, becoming more talkative and energized, and increased sensitivity to sensations.
However, it can also lead to adverse effects such as headaches, paranoia, anxiety, panic attacks, aggressive behaviour, seizures, strokes and even coma.
The short-term effects of cocaine use can last for minutes to hours, although complete recovery may take as long as days. Aside from these temporary effects, long-term cocaine abuse has several chronic effects on brain chemistry as well.
Long-Term Effects of Cocaine on the Brain
Chronic cocaine use causes several changes to brain chemistry and structure. It can lead to the development of mental health disorders such as addiction and substance use disorder, highlighting the importance of seeking help from a doctor or mental health professional for those struggling with cocaine use.
These changes in brain chemistry and structure can profoundly impact a person’s physical and mental health, leading to serious side effects and diminishing their overall quality of life.
Changes to the Reward System
The reward system (called the mesolimbic system) is a term used to refer to different parts of the brain that work together to control the way we physically and mentally process the concept of ‘reward’.
Reward refers to when the brain associates a diverse range of activities, substances, and situations with positive feelings. As simple as this sounds, this is a complex and not fully understood process that involves multiple parts, some of which are affected by cocaine use.
Effects on the nucleus accumbens.
The nucleus accumbens is the part of the reward system responsible for creating pleasurable feelings during certain activities. This part of the brain is activated by dopamine which explains why cocaine creates a strong feeling of euphoria when consumed.
Scientists believe that this process evolved to encourage us to perform activities which were beneficial to survival. This usually includes activities like eating calorie-dense food, drinking water when thirsty or having an orgasm.
Unfortunately, the ability of cocaine to mimic this natural process creates a dangerous feedback loop which encourages more cocaine use.
Also, research has shown that cocaine releases more dopamine than other healthy pleasurable activities like eating, exercise and sex. Eventually, addicts lose interest in other activities and can only find pleasure in further consumption of the drug.
Effects on the memory centers
The rewards system is also closely linked to the primary memory centres of the brain – the hippocampus and amygdala. This partly explains why simply remembering pleasurable experiences encourages re-creating this activity.
This mechanism is also very important when understanding drug cravings and addiction. Over time, cocaine abusers learn to associate certain sensations and activities with cocaine use and the feeling of euphoria created.
This is why the sight of cocaine-related paraphernalia, specific locations and even people can stimulate the powerful compulsion to consume the drug.
Eventually, this progresses from being activated only by drug-related paraphernalia to near-constant compulsion to seek out drugs or drug-related activities.
Effects on the frontal cortex
The frontal cortex is a part of the reward system associated with higher cognitive functions like decision-making and self-control.
One of its important functions is inhibiting the immediate urge to seek out pleasurable activities to avoid potential consequences. For example, convincing yourself to cut down on food to avoid becoming overweight.
In chronic cocaine abusers, this function is severely impaired. This dysfunction is one of the key features of addiction – the inability to stop consuming the drug despite its negative consequences.
It also partly explains the compulsive nature, poor planning and sub-par decision-making of drug addicts. This is why drug use is associated with crime, poor financial decision-making and an inability to maintain stable relationships.
Tolerance
Tolerance means when an individual needs to take larger amounts of a substance to achieve the same effects. In terms of illicit drug use, this typically means achieving a state of euphoria.
Tolerance usually occurs when psychoactive drugs are taken over a long period, taken often or in dangerously high amounts.
There are several psychological and physical explanations for the phenomenon of tolerance. However, in a nutshell, the brain simply becomes less sensitive to the dopamine released by the brain when cocaine is consumed.
This encourages users to consume continuously higher amounts of cocaine to achieve the same effect, increasing the risk of overdose and other harmful consequences.
Chronic cocaine abusers also develop tolerance to dopamine release during normally pleasurable activities. Not only does this cause them to lose interest in such activities, but it also means they have a low threshold for boredom and tend to seek out drugs when not mentally stimulated.
Fortunately, this effect is reversible. Sustained abstinence eventually increases the brain’s sensitivity to normal levels of dopamine release.
Withdrawal
Drug withdrawal is a complex phenomenon, and how it happens is not fully understood. It involves several unpleasant physical and psychological symptoms which occur when drug use is suddenly stopped.
Researchers believe chronic use of psychoactive substances like cocaine leads to changes in brain biochemistry. Suddenly, discontinuing these drugs creates a temporary imbalance, which manifests as withdrawal.
Generally speaking, cocaine withdrawal can last between hours to days. However, this can vary from person to person.
The acute withdrawal phase (commonly called the “crash”) typically lasts for one to two weeks. Many chronic users experience intense cravings, nausea, mood changes, insomnia, agitation, anxiety, fatigue, depression, hallucinations, and even an increased risk of suicide.
However, some individuals develop a more prolonged form of withdrawal known as post-acute withdrawal syndrome (PAWS). During PAWS individuals experienced protracted withdrawal symptoms typically lasting longer than the two weeks of acute withdrawal.
Most of the symptoms of PAWS are psychological rather than physical. These include chronic fatigue, poor concentration, depression and continued cravings.
Cognitive decline
Cognitive decline is a common consequence of long-term cocaine abuse. A study showed that up to 30% of dependent users show some degree of impairments in working memory, attention deficits, empathy, decision-making, and other forms of executive function.
Fortunately, research suggests that these effects are reversible. Users who stopped taking cocaine were able to regain almost normal function. This is likely due to the ability of the brain to heal and reorganize after injury, called neuroplasticity.
Researchers are still not sure of the exact cause of this decline in brain function. However, cocaine is directly toxic to the brain, causing widespread inflammation and oxidative stress. Prolonged use can shrink important parts of the brain, a process called atrophy.
Brain atrophy is a normal part of the ageing process. However, this process occurs twice as fast in cocaine users, especially in the parts of the brain associated with cognitive function and memory.
Risk of neuropsychiatric disorders
The relationship between cocaine use and anxiety disorders is well documented. The stimulant effects of the drug and withdrawal can worsen anxiety and PTSD symptoms and lead to panic attacks.
Chronic cocaine use can also lead to depression by disrupting brain chemistry, as well as other associated consequences like financial problems, broken social relationships and health challenges. Chronic cocaine use is also a risk factor for suicide, with 9 to 20% of suicide cases involving cocaine use days before the event. Additionally, chronic cocaine use can contribute to the development of mental health disorders such as addiction and substance use disorder.
Studies also show that up to 53% of cocaine users experience psychotic symptoms like delusions and hallucinations. Most of these symptoms are transient and disappear when the drug is discontinued. However, some users experience further psychotic episodes for weeks to months.
Sleep difficulties
Sleep difficulties like insomnia are common with cocaine abusers. Cocaine is a stimulant and may cause users to stay awake for long periods, eventually disrupting their natural sleep-wake cycle and creating erratic sleep schedules.
Cocaine use also worsens sleep apnea. This is because the stimulant causes the airways to narrow, increasing the risk of apneic episodes.
The sleep difficulties, combined with the other neurological effects of chronic cocaine use, can cause irregular sleep patterns and nightmares, making it difficult to achieve restful sleep.
Other Health Dangers of Cocaine Use
Aside from the neurological effects, there are several other long-term health effects of cocaine use. Smoking cocaine can lead to serious respiratory problems such as acute respiratory distress, chronic cough, and a higher risk of infections like pneumonia and tuberculosis.
Cardiovascular System
Chronic cocaine use can lead to severe cardiovascular issues, including heart attacks, arrhythmias, and heart failure. Additionally, there is a significant risk of cocaine overdose, which can result in acute liver damage and rhabdomyolysis, potentially leading to kidney failure. Cocaine use also causes higher blood pressure. This can result in permanently increased blood pressure, leading to kidney damage due to loss of blood flow and kidney failure as a late-stage result of rhabdomyolysis.
Gastrointestinal System
Cocaine use can cause severe damage to the gastrointestinal system, including stomach ulcers. Reduced blood flow to the gastrointestinal tract can result in issues like ulcers, tissue damage, and inflammation. Chronic use can also lead to significant harm by reducing blood flow to various parts of the body, such as the stomach, intestines, nose, and mouth. This reduced blood flow can result in issues like ulcers, tissue damage, and inflammation in the gastrointestinal tract, as well as damage to the nasal tissues and cartilage, potentially leading to serious conditions like palatal perforation and septal perforations.
Heart disease and high blood pressure
Cocaine has several direct and indirect toxic effects on the heart and blood vessels. This can lead to higher blood pressure, an irregular heartbeat, heart attacks, clogged arteries, and heart failure. Chronic use can result in permanently increased blood pressure, which further exacerbates cardiovascular issues and can lead to severe complications.
Gastric issues
Weight loss and malnutrition are common among chronic cocaine abusers for several reasons. One is the reduced appetite due to less interest in food. Cocaine also causes stomach ulcers, which, in rare situations, can eat a hole through the stomach, a potentially life-threatening situation. Additionally, reduced blood flow to the gastrointestinal tract can result in issues like ulcers, tissue damage, and inflammation.
Respiratory issues
Snorting cocaine can also lead to several nasal problems. This could range from nosebleeds, sinus problems, loss of smell, frequent sniffing and runny nose, and even a hole in the nasal septum.
Cocaine use can also cause worsening asthma symptoms, shortness of breath, wheezing, coughing out blood, chest pain and bleeding into the lungs. Additionally, smoking cocaine can lead to serious respiratory problems such as acute respiratory distress, chronic cough, and a higher risk of infections like pneumonia and tuberculosis.
Risk of contracting blood-borne infections
Cocaine increases your risk of contracting blood-borne infections like hepatitis and HIV. This is because cocaine abusers are more likely to participate in activities such as IV drug use and risky sexual behaviour.
Seek Help at PCP
The neurological impact of long-term cocaine use is complicated and affects different parts of the brain. Understanding these impacts is crucial for developing effective treatment and intervention strategies. Crack cocaine addiction also poses significant risks, including increased likelihood of contracting infectious diseases such as HIV and hepatitis, and the potential for overdose.
Addressing the underlying neurological changes can aid in creating more comprehensive and compassionate approaches to addiction recovery, emphasizing the importance of both medical and psychological support in overcoming addiction. Cocaine is an illegal drug in the U.S., classified as a Schedule II substance, and its use outside of specific medical purposes is considered illegal.
If you or someone you know is struggling with cocaine addiction, it’s important to seek help immediately. Reach out to healthcare professionals, addiction specialists, or local support groups. Addressing substance abuse is crucial for long-term recovery and overall well-being.
Remember, recovery is possible, and taking the first step towards getting help can make all the difference. Don’t wait – contact PCP today and begin the journey to reclaiming your life.
