The Effects and Risks

Cocaine suppresses feelings of hunger and sleep. Due to a lack of (healthy) food, severe weight loss and general debilitation can occur. Vitamin and nutrient deficiencies can lead to symptoms such as cracked lips, hair loss, pale skin, and reduced resistance to infections. Dehydration can cause the skin to become slack. Severe sleep deprivation can result in disorientation and overall exhaustion.

Using base coke affects the lungs by inhaling coke fumes, combustion products, ammonia, hot air, and tiny particles of ash or metal. Prolonged use can lead to acute asthma attacks, pneumonia, and high blood pressure in the lung vessels. It can even cause a collapsed lung.

Inhaling these harmful substances often triggers an inflammatory reaction in the lungs, leading to coughing, mucus, and shortness of breath.

Inflammation can result in scar tissue in the alveoli (emphysema), making the exchange of oxygen and carbon dioxide more difficult. The more damaged alveoli there are, the less gas exchange occurs, leading to increased breathing difficulties.

Using methadone and/or heroin in addition to coke increases the risk of pneumonia. Opiates suppress the cough reflex, allowing mucus and inhaled particles to remain in the lungs longer.

A collective term for chronic lung problems is COPD, which stands for Chronic Obstructive Pulmonary Disease. COPD is often irreversible, but further damage and deterioration can be prevented by quitting smoking, drastically reducing usage, or choosing a less harmful smoking technique. For instance, with base coke, consider using a longer pipe or smoking on foil.

Inhalation medication and smoking coke require extra attention. Drugs like Ventolin open the airways, reducing breathlessness. However, smoking immediately after using inhalation medication allows harmful substances to penetrate deeper into the lungs, increasing long-term lung damage and complaints. It’s better to wait at least half an hour after using inhalation medication before smoking.

Using cocaine can increase the risk of infectious diseases. Sharing snorting straws or a base pipe can transmit infections such as herpes or mononucleosis. There are also indications of a risk of hepatitis (B or C) transmission, especially if you have cracked lips. Only a small amount of blood, invisible to the naked eye, is needed to transmit hepatitis B and C. Therefore, the advice is not to share paraphernalia.

This issue mainly affects snorters. Snorting can cause painful inflammation of the nasal mucosa, leading to nosebleeds. To stop a nosebleed, first blow your nose thoroughly. Then pinch your nose just below the bridge and lean forward.

Years of snorting cocaine can damage the nasal septum. Cocaine erodes the nasal bone. Therefore, rinse the nose with lukewarm water after snorting. This reduces the chance of the harmful chemicals in cocaine causing their destructive effects.

Long-term cocaine use can sometimes alter neural transmission in the brain. This can result in a hunched, shuffling gait, a rigid facial expression, and a small, cramped handwriting. Another effect is called “jerking & punding,” which is the seemingly uncontrollable “twitching” of body parts and compulsive repetition of actions. These symptoms are likely related to a disruption in dopamine regulation, which plays a crucial role in motor skills and impulse control. The best advice is to refrain from using cocaine for a while to allow the body and mind to recover. Over time, the nervous restlessness in the body will diminish. Keeping the hands occupied with something or drawing can alleviate some restlessness. To relieve muscle cramps, applying heat or massaging the muscles can help.

Skin necrosis can occur with cocaine injection. Cocaine has a local anaesthetic effect. It also reduces skin blood flow by slightly constricting the vessels under the influence of cocaine. Damaging the skin while injecting without feeling it is easily done.

If the injection goes wrong—missing the vein and going under the skin—there is a risk of skin necrosis. Disturbed blood flow prevents the tissue from getting enough oxygen, causing it to die. The skin starts to rot and eventually turns black. Seek medical help before it gets to this point. Necrosis is irreversible. Dead tissue is dead.

Avoid injecting cocaine under the skin (subcutaneously) or into the muscle (intramuscularly). If you inject cocaine, you can add a few grains of ascorbic acid to the solution. This provides a tingling effect, allowing you to feel where the needle is despite the local anaesthetic effect of cocaine.

Cocaine is one of the most dangerous substances for a baby. Each use of cocaine acutely reduces blood flow to the baby. There is also a risk of placental abruption. Reduced blood flow increases the chances of premature birth, growth retardation, and brain damage. Since cocaine is present in breast milk, using cocaine while breastfeeding is also risky. The baby can become restless and suffer from sleep problems or seizures.

Short tempers and heightened sensitivity. An exhausted body and overstimulated mind are less tolerant. With prolonged use, the effects of coke diminish, leading to frustration when the expected high doesn’t occur. Sometimes this is due to the quality of the coke, but often it’s because the brain is so overstimulated that it no longer responds as it once did. Additionally, cocaine activates the brain’s fear centre, contributing to agitated behaviour.

Heavy coke use can cause the sensation of bugs crawling under the skin. This results from the stimulant effect of cocaine, which raises body temperature and increases blood flow to the skin, leading to more sweating. This combination stimulates the nerve endings, creating the sensation of bugs under the skin. People may scratch their skin to relieve the sensation, sometimes causing open wounds. It’s advisable to keep nails short and clean to protect the skin and prevent infections.

Cocaine is generally used for its stimulating and mood-lifting effects. However, regular use can lead to a “chemical depression,” caused by a deficiency of dopamine and serotonin in the brain. The resulting feelings of depression often lead to continued use of coke in an attempt to feel better. While this may provide short-term relief, it ultimately exacerbates the problem, further depleting the brain’s resources and worsening the depression.

A chemical depression will subside once cocaine use stops, but the brain may take a week to a month (or longer) to recover. It’s crucial to take chemical depression seriously as it increases the risk of suicidal thoughts and attempts. Rest, healthy eating, and distractions can aid recovery, and if the depression persists, consulting a doctor is wise.

Are you thinking about suicide? Contact 113 Suicide Prevention 24/7 for free and confidential support at 0800-0113 or chat online at 113.nl.

Paranoid thoughts or suspiciousness are common among heavy coke users. Excessive use keeps the body in a constant state of alertness, stimulating the sympathetic nervous system responsible for the “fight-flight response.” This overstimulates the brain’s fear response, causing heightened startle reactions, even when there’s no real danger. This can lead to misinterpretations, such as believing someone is talking about you when they look your way.

In cases of coke paranoia, it’s best to find a quiet place to reduce stimuli and create a sense of safety. Good nutrition and sleep can also be beneficial.

A cocaine-induced psychosis presents similar symptoms to other types of psychoses: hallucinations and/or delusions, often accompanied by intense fear. It is an extreme form of paranoia. Individuals predisposed to psychoses are particularly sensitive to the increased dopamine levels caused by cocaine use. Cocaine psychosis is usually short-lived, lasting from several hours to a few days.

Stopping cocaine use generally alleviates psychotic symptoms. If symptoms persist or the individual poses a danger to themselves or others, seeking professional help is advised. As with paranoia, a safe, low-stimulation environment is crucial.