Cocaine is a powerful, highly addictive stimulant, and long-term cocaine use takes a heavy toll on the body. In 2025, an estimated 4.9 million people in the United States aged 12 or older used cocaine in the past year.[1] While the immediate high lasts only minutes, long-term cocaine use can cause serious and sometimes permanent damage to the heart, brain, lungs and other organs.

The drug also plays a role in a large share of overdose deaths. Nearly 20,000 people in the U.S. died from overdoses involving cocaine in 2025, according to provisional CDC data, and many of those deaths also involved fentanyl.[2]

This article explains how chronic cocaine use affects your body, the warning signs of a cocaine use disorder and how to get help.

How Long-Term Cocaine Use Affects the Body

Cocaine increases levels of dopamine, a brain chemical linked to pleasure and reward. It also speeds up the heart, narrows blood vessels and raises blood pressure and body temperature. With repeated use, the brain adapts. Many people develop tolerance, meaning they need more cocaine to get the same effect. At the same time, they can become more sensitive to cocaine’s toxic effects, such as anxiety and seizures, which raises the risk of overdose.[3]

How cocaine is used also shapes the damage it causes. Snorting harms the nose, smoking crack cocaine harms the lungs and injecting raises the risk of infections.[3]

7 Health Risks of Long-Term Cocaine Use

1. Heart damage

The cardiovascular system takes the hardest hit. Long-term cocaine use is linked to:[3]

  • Heart attacks, even in young people without other risk factors
  • Irregular heart rhythms
  • Inflammation of the heart muscle
  • A weakened heart that pumps less effectively
  • Tears in the aorta, the body’s main artery

Chest pain that feels like a heart attack is one of the most common reasons people who use cocaine go to the emergency room. Any chest pain after using cocaine should be treated as a medical emergency.

2. Brain damage, stroke and seizures

Because cocaine narrows blood vessels and raises blood pressure, it increases the risk of stroke and bleeding in the brain. Chronic cocaine use also raises the risk of seizures and, over many years, may raise the risk of movement disorders such as Parkinson’s disease.[3]

Long-term cocaine use can affect thinking skills too, including attention, memory, decision-making, impulse control and coordination.[3]

3. Nose, mouth and lung damage

Snorting cocaine can lead to loss of smell, frequent nosebleeds, a constantly runny nose, hoarseness and trouble swallowing.[3] Over time, it can damage the tissue that separates the nostrils.

Smoking crack cocaine damages the lungs and can worsen asthma.[3] People who smoke cocaine may develop chronic coughing, breathing problems and lung injury.

4. Mental health problems

Long-term cocaine use often causes irritability, restlessness, panic attacks and paranoia. Heavy or binge use can lead to psychosis, in which a person loses touch with reality and may experience hallucinations.[3] The crash after cocaine wears off often brings depression, exhaustion and intense cravings.

Many people who use cocaine also have co-occurring mental health conditions such as depression, anxiety or PTSD. Dual diagnosis treatment addresses both at the same time.

5. Digestive problems and weight loss

The drug reduces blood flow to the digestive tract, which can lead to tears and ulcers in the stomach and intestines. It also suppresses appetite, so many people who use cocaine regularly lose a significant amount of weight and become malnourished.[3]

6. Infections and other organ damage

Injecting cocaine raises the risk of HIV, hepatitis C, skin infections and dangerous allergic reactions.[3] Cocaine use, especially in high doses, can also cause rhabdomyolysis, a breakdown of muscle tissue that can damage the kidneys.[4] Because cocaine affects judgment and impulse control, it can also lead to risky sexual behavior that spreads infections.

7. Overdose

A cocaine overdose can cause a heart attack, stroke, seizure or dangerously high body temperature. Several factors make overdose more likely with long-term use:

  • Fentanyl contamination. Drug suppliers often mix cocaine with fentanyl, a powerful opioid, sometimes without the user knowing. This is a major driver of cocaine-related overdose deaths.[3]
  • Mixing with alcohol. When a person uses cocaine and alcohol together, the body produces cocaethylene, a substance that may be more toxic to the heart than either drug alone.[3]
  • Mixing with opioids. Cocaine wears off faster than opioids, so people may take more opioids than they realize, raising the risk of fatal breathing problems.[3]

If someone shows signs of an overdose, such as chest pain, seizures, trouble breathing, extreme agitation, very high body temperature or unresponsiveness, call 911 right away. If opioids may be involved, give naloxone (Narcan) if it is available.

Signs of Cocaine Addiction

Long-term cocaine use can lead to a cocaine use disorder, which is a treatable medical condition. Signs may include:

  • Using more cocaine, or using more often, than intended
  • Strong cravings and trouble cutting back
  • Needing more to feel the same effect
  • Spending a lot of money or time getting and using cocaine
  • Neglecting work, school or family responsibilities
  • Continuing to use despite health, relationship or legal problems
  • Feeling depressed, tired or irritable when not using

Can the Damage From Long-Term Cocaine Use Be Reversed?

Some effects of cocaine improve after a person stops using. Mood, sleep, appetite and some thinking skills often get better with time and treatment. Other damage, such as harm from a heart attack or stroke, may be permanent. The sooner a person stops using cocaine, the better their chances of avoiding lasting harm.

Treatment for Cocaine Addiction

There are currently no FDA-approved medications for cocaine use disorder, but behavioral therapies are effective.[3] Treatment often includes:

Finding treatment for a loved one

If someone you love is using cocaine, approach them with compassion rather than judgment. Share specific concerns, avoid arguing when they are high and offer to help them find treatment. Our team can also help you support a loved one.

Finding treatment for yourself

Admitting you need help takes courage. A professional assessment can help you understand your options and find the right level of care. Reach out to our admissions team to get started.

Frequently Asked Questions

What does long-term cocaine use do to your heart?

It can cause heart attacks, irregular heart rhythms, inflammation of the heart muscle, a weakened heart and tears in the aorta.[3]

Can cocaine cause permanent brain damage?

Yes. Cocaine increases the risk of stroke and bleeding in the brain, which can cause lasting damage. Chronic use can also cause problems with memory, attention and decision-making.[3]

How long does cocaine stay in your system?

Cocaine’s effects wear off within about an hour, but urine tests can usually detect cocaine and its byproducts for about 2 to 4 days after use, and longer with heavy, repeated use.

Is cocaine more dangerous when mixed with alcohol?

Yes. Using cocaine and alcohol together creates cocaethylene, which may be more toxic to the heart than either substance alone.[3]

Is there medication for cocaine addiction?

Not yet. There are no FDA-approved medications for cocaine use disorder, but behavioral treatments such as CBT and contingency management are effective.[3]

Get Help for Cocaine Addiction in South Florida

Recovery from cocaine addiction is possible. At First Step Behavioral Health in Pompano Beach, Florida, we offer cocaine addiction treatment that includes medical detox, residential and outpatient care, evidence-based therapy and long-term aftercare.

Call (855) 425-4846 or contact us online to speak with our admissions team or verify your insurance.

References:

  1. Substance Abuse and Mental Health Services Administration (SAMHSA): Release of the 2025 National Survey on Drug Use and Health
  2. Centers for Disease Control and Prevention (CDC): Provisional Drug Overdose Death Counts
  3. National Institute on Drug Abuse (NIDA): Cocaine
  4. StatPearls (NCBI Bookshelf): Cocaine Toxicity

Jump to a Section

Call (855) 425-4846