Person with cocaine addiction looking out of window

Cocaine is classified as a class A drug in the UK, meaning it is considered one of the most dangerous substances due to its addictiveness. Despite this, it is commonly used as a recreational drug. In 2020, cocaine was the second most widely used illegal drug in England and Wales, with 2.6% of people aged 16-49 estimated to have used the drug over the previous year. Only cannabis was used more. Cocaine can also be taken in a freebase crystalline form (crack cocaine) that can be even more harmful.

Coca leaves have been used for their stimulant effect for thousands of years. The purified and processed chemical known as cocaine hydrochloride was first isolated from the plant more than a century ago. It was initially used in tonics and elixirs, as well as painkillers. Research and experience showed, however, that cocaine is a powerfully addictive drug that can change the way the brain functions.

How does cocaine affect the brain?

Cocaine is a powerful central nervous system stimulant and local anaesthetic. It provides a brief but intense high and works primarily by increasing levels of the neurotransmitters dopamine and adrenaline in the brain, along with a smaller spiking of serotonin.

Dopamine is a chemical messenger that is well-known as the ‘feel-good hormone’ and is heavily involved in the pleasure and reward pathways in the brain. It is associated with feelings of euphoria, bliss, motivation, and concentration but also plays a role in functions including movement, sleep, learning, mood and memory.

Adrenaline is a chemical messenger that is mainly associated with the body’s ‘fight or flight’ response and serotonin is another ‘happy chemical’ that affects mood and emotions, as well as bodily functions including appetite and digestion.

When cocaine is taken, the floods of these chemicals produce a range of physical and psychological effects – many of which can be intensely pleasurable in the short term, and lead to cocaine addiction.

The psychology of cocaine addiction

Cocaine tends to be a relatively quick-acting drug, typically producing an intense high within minutes of using it. These may kick in within 5-30 minutes but they are also short-lived, generally lasting for around 20-40 minutes. The comparatively short duration of the high can lead many users to want to use the drug again very quickly to recreate or extend the feelings it provides.

These effects can include intense euphoria and feelings of excitement, confidence, talkativeness, outgoingness, energy and alertness or wakefulness. There can also be negative effects such as panic and paranoia, as well as physical impacts such as increased sweating and nausea.

In general though, the intensity of the perceived positive effects tends to outweigh any negative effects. This can create a psychological process known as positive reinforcement. Taking cocaine becomes associated with all those pleasurable feelings, which can start to produce cravings and psychological addiction.

In the longer term, cocaine can have a number of unwanted psychological effects, including depression, anxiety and addictive behaviour.

The physical effects of cocaine

Cocaine use can produce a number of physical effects on the body. Some of these, like appetite suppression and an increased sex drive, might also be seen as desirable by some people.

Others are certainly less desirable. Short-term physiological effects of cocaine use can include constricted blood vessels, dilated pupils and a sharp rise in body temperature. Some users might also experience effects such as tremors, vertigo and muscle twitches. Cocaine use can cause abdominal pain and nausea and neurological effects including headaches and, at the most serious end of the scale, seizures, strokes and coma.

The stimulant effect of the drug can also have an effect on the cardiovascular system, affecting heart rhythm and blood pressure and potentially leading to a heart attack. The most common causes of cocaine-related deaths are heart attacks and seizures. Cocaine is often cut or mixed with other drugs, or taken at the same time as alcohol and other drugs, which can make it even more dangerous.

Repeated use of cocaine can also quickly lead to the user building up a tolerance to the drug. Their system adjusts to the chemicals being released and adjusts, meaning the user needs to use more and more to get the same effect.

What makes cocaine so addictive?

The addictiveness of cocaine is down to a combination of factors. It primarily starts with people chasing the short-lived high from using the drug as they attempt to recreate the euphoria and other pleasurable feelings they experience. As they develop a tolerance to cocaine, they need to use more and more of it for the same effects, essentially getting stuck in a vicious cycle.

The user can become reliant on cocaine as continued use essentially rewires the brain and the way it deals with areas such as pleasure and reward. Eventually, other things that used to bring pleasure or satisfaction can start to lose their sparkle as finding and using more cocaine becomes more important than friends, hobbies, work and even loved ones and families.

Another factor can be dependency and withdrawal. Withdrawal symptoms tend to be more psychological than physical when compared to drugs like opioids (heroin) or alcohol, but they can still be intense, unpleasant and potentially dangerous.

Cocaine withdrawal symptoms can include:
• Anxiety
• Irritability and mood swings
• Depression
• Lack of concentration
• Slowed thoughts and movements
• Fatigue, insomnia or increased sleeping
• Paranoia

Seeking help for cocaine addiction

Breaking free of any drug is never easy but seeking help for cocaine addiction is always a positive step forward. Denial and defensiveness often go hand-in-hand with addiction, so admitting you need help is a massive step towards recovery.

Treatment for cocaine addiction can take a number of different forms. Support groups such as Narcotics Anonymous (NA) can be valuable for many people. Counselling and outpatient treatment programmes through local drug and alcohol services can also help. Residential cocaine rehab provides the most comprehensive addiction treatment programmes, combining detox and withdrawal management with therapies and other treatments to deal with every aspect of addiction.

If you are worried about your cocaine use or that of a loved one, get in touch today to find out how we can help.