By Ioana Cozma

Last updated: 10 February 2024 & medically reviewed by Morgan Blair

Cocaine is an illegal and highly addictive drug that profoundly impacts your health. This guide explains what cocaine does to your heart, physical appearance, and mental health.

Key takeaways:

  • Cocaine is a central nervous system (CNS) stimulant producing short-term euphoric effects.

  • In the long term, cocaine leads to tooth decay, hair loss, heart issues, and bloating.

  • Cocaine causes mental health problems and impairs your brain functioning.

Cocaine Effects on Health

What are the effects of cocaine use?

Cocaine stimulates the central nervous system, increasing dopamine production – a neurotransmitter that creates feelings of gratification and pleasure.[1]

Dopamine is connected with other neurotransmitters and hormones that stimulate your brain, such as adrenaline and cortisol.

That’s why, at first, cocaine makes you feel:

  • Euphoric

  • Confident

  • Alert

  • Talkative

  • Reckless

  • Sexually aroused[1]

Physical effects include:

  • Increased heart rate and blood pressure

  • Dilated pupils

  • Increased body temperature

  • Dry mouth and nose

  • Increased urination[1]

However, these extreme highs are typically followed by extreme lows. Excessively stimulating these neurotransmitters leads to difficulties in experiencing the highs.

Cocaine withdrawal exacerbates negative side effects, leading to:

  • Agitation

  • Irritability

  • Sadness

Constantly putting your brain and body in a stimulative state will greatly impact your health.

Cocaine effects at a glance

Cocaine effects




  • Euphoria

  • Confidence

  • Alertness

  • Risk-taking behavior

  • Sexual arousal

  • Agitation

  • Irritability

  • Upset

  • Unpredictability

  • Paranoia

  • Anxiety

  • Depression

  • Mood swings

  • Exhaustion


  • Increased heart rate and blood pressure

  • Dilated pupils

  • Increased body temperature

  • Dry mouth and nose

  • Increased urination

  • Chest pain

  • Malnourishment

  • Heart disease

  • Kidney damage

  • blood clots

  • Seizures and convulsions

What does cocaine do to your heart?

Cocaine affects the heart in a variety of damaging ways. This is because cocaine:

  • Stimulates the nervous system: This causes an increase in heart rate and blood pressure in the short term.

  • Blocks sodium and potassium channels: This leads to depressed cardiovascular profiles, meaning a decreased ability of the heart and blood vessels to pump blood effectively.[2]

Studies show that most cocaine users take cocaine on binges, consuming the drug in high amounts periodically which places additional strain on the heart.[3] These factors enhance the risk of:

  • Heart attack[4]

  • Cardiac arrest

  • Structural heart damage[5]

  • Abnormal heart rhythms, such as atrial fibrillation[6]

  • Increased systolic blood pressure[5]

  • Coronary artery disease[7]

  • Myocardial infarction[8]

  • Congestive heart failure[9]

  • Stroke

  • Death

Cocaine's effect on the nose

Cocaine has several effects on the nose, including:

  • Constriction of blood vessels: Cocaine constricts the blood vessels in the nasal mucosa, decreasing the blood flow to your nasal tissues causing your nasal tissues to become swollen and irritated. Therefore, people may experience regular runny nose, nasal congestion, and sneezing.

  • Nasal tissue damage: Long-term cocaine use damages the nasal tissues, causing nose perforation, especially when inhaling the drug. The effects include perforated or deviated septum and a loss of smell.

  • Loss of smell: Cocaine abuse diminishes the sense of smell because it damages blood vessels and brain areas.

Cocaine's effect on physical appearance

Coke bloat

Using cocaine causes “coke bloat,” meaning extreme swelling in the facial area.

Coke bloat causes range from increased blood pressure to fluid retention, leading to an accumulation of lymphatic fluid.

The depressed heart profile also increases swelling around the eyes and cheeks.

Swollen abdomen

A 2019 study shows that cocaine can inflame the abdomen’s inner lining, leading to peritonitis.[10]

The ensuing complications entail bowel necrosis, loss of the mucosal epithelium, and intestinal ischemia.

Cocaine eyes

Cocaine eyes look bloodshot because cocaine abuse expands blood vessels and blood pressure. That’s what causes the redness on the sclera (the white of the eye).

The condition also entails dilated pupils. Cocaine stimulates your nervous system, releasing endorphins and other chemicals that make your pupils expand.[11] Pupil expansion results in your eyes absorbing more light than usual, leading to eye pain.

Weight loss

Cocaine causes weight loss because:

  • You burn calories faster: Cocaine triggers cortisol and adrenaline release, hormones that increase your metabolic rate. That means you burn calories faster even when you are at rest.

  • Your appetite decreases: Cocaine has been shown to reduce circulating leptin[12] – a hormone that makes you feel hungry. Decreasing this hormone also means you feel less hungry.

  • Cocaine may affect fat metabolization: Some studies show that cocaine leads to profound metabolic alterations in fat regulation.[12] Regular cocaine use reduces your body’s fat stores because it changes how your body burns fat.

Skin changes

Cocaine produces major skin changes:

  • Necrosis, or death of skin cells

  • Hardening of the skin

  • Black palms, aka “crack hands”

  • Chronic skin ulcers

  • Pustulosis, meaning pus-filled skin areas

  • Bleeding red spots called Schonlein-Henoch vasculitis

  • Swollen and red veins called Buerger’s disease

  • Skin eruptions[13]

How cocaine is produced and what it is cut with produces physical changes too. For example, cocaine mixed with the cattle dewormer levamisole can lead to necrosis, effectively leaving rotting sores on the skin.[14]

Hair loss

Cocaine-induced hair loss is also tied to what cocaine does to your heart and body:

  • It reduces blood flow to the hair follicles: Because cocaine constricts blood vessels, your scalp receives less nourishment. That means it cannot sustain new or existing hair cells.

  • It increases cortisol production: This stress hormone damages the hair growth cycle, leading to alopecia.

  • It leads to nutritional deficiencies: Cocaine inhibits your appetite and blocks potassium and sodium channels. That lowers your levels of vitamins and minerals, which are essential for hair health.

Cocaine's effects on oral hygiene

Cocaine use leads to:

  • Loss of enamel: The cause is constantly exposing your teeth to acid cocaine powder, especially if you take it in powder form.

  • Palatal perforation: Cocaine use determines cell necrosis and vasoconstriction, which lead to palatal perforation, the decay of the roof of the mouth. Losing supportive bone tissue in the mouth increases the risk of tooth loss and disease.

  • Gum damage: Cocaine makes you grind your teeth, swells your periodontal tissue in the gums, and slows saliva production. These issues cause mechanical damage and increased oral bacteria, damaging your gums and teeth.

Cocaine and mental health

Cocaine affects mental health through:

  • Changes in mood and behavior: Cocaine builds euphoria and energy. It also causes irritability, paranoia, and aggression. These mood changes damage interpersonal relationships, leading to social isolation.

  • Mental health issues, such as depression and anxiety: These mental health problems result from excessively stimulating your nervous system. They also become more prominent in the first stages of rehab.

  • Cognitive problems: Cocaine impairs your attention, working memory, and decision-making process. These long-term issues persist long after stopping cocaine use.

Can the body heal after prolonged cocaine abuse?

Yes, you can heal after prolonged cocaine abuse, but you may need professional cocaine addiction treatment in order to remove the drug from your system fully.

Be prepared for intense withdrawal symptoms such as depression, fatigue, and cravings, which may lead to relapse. You may also need medical treatment for any underlying medical conditions caused by cocaine and therapy groups or individual psychotherapy for support.