Cocaine Side Effects and Complications

Cocaine is a highly addictive drug because of its powerful stimulant effects which create an immediate euphoric sensation. Cocaine is processed to form a rock crystal called crack. This form of cocaine is called crack because of the crackling sound it makes when burned. When heated, crack releases vapors that are inhaled, producing an intense though brief high. The National Institute on Drug Abuse reports that 1.7 percent of 18 to 25 year olds use cocaine 13.


Stimulant side effects of crack cocaine are increased energy, mental alertness, rapid and frequent talking, flight of ideas and sensitivity to light and sound. Billie Ann Wilson, Ph.D., Margaret Shannon, Ph.D., and Kelly Shields Pharm.D., authors of “Pearson Nurse’s Drug Guide 2010”, explain that these symptoms occur because cocaine stimulates the sympathetic nervous system 2. Other symptoms include dilated pupils, insomnia, anxiety and restlessness.


The quick absorption of crack cocaine causes an intense feeling of euphoria. NIDA explains how this high is related to cocaine’s interference with the brain neurotransmitter dopamine. Dopamine is involved with motivation, pleasure and movement. Pleasurable stimuli cause certain brain cells to release dopamine which aids in processing and response to the stimuli. After a period of time dopamine is recycled back into the cell. Cocaine prevents dopamine from being reabsorbed by the cell which amplifies the feeling of euphoria.


The euphoric effect of crack cocaine is brief. Repeat use of crack cocaine stops the body’s natural production of dopamine. This leads to a loss of pleasurable sensations despite the drug. Depression, loss of motivation, anxiety and paranoia are the result.

Muscle Tremors

Dopamine is needed to control muscle movement. The loss of dopamine in crack cocaine users causes muscle tremors and twitches. These symptoms worsen with continued crack cocaine use.

Heart Damage

A serious and potentially life-threatening side effect of crack cocaine is heart damage. Crack cocaine use causes hypertension which damages blood vessels, heart valves and the heart muscle. Heart failure, irregular heart rhythms and heart attack are end results of crack cocaine use.

Necrotic Bowel

A side effect of crack cocaine is less blood perfusion to the gastrointestinal tract. Less blood flow to the stomach and bowels causes symptoms of abdominal pain, decreased appetite, nausea, vomiting and constipation. It also increases the risk for a condition called necrotic bowel. Necrotic bowel is death of tissues in the gut which can occur in long-term users or those individuals who ingest crack cocaine.


Crack cocaine is so addictive because it affects a section of the midbrain that is a key area involved in reward. NIDA reports that a year or more after a person quits cocaine he will still remember the pleasurable feelings crack cocaine produced and experience intense cravings for the drug.


High doses of crack cocaine cause toxicity. Irregular heart rhythms, heart attack, seizures, stroke and death can result. Mixing crack cocaine with alcohol or other stimulants increases your risk for toxicity and death.