The long-term effects of cocaine use on cognitive functioning: A systematic critical review

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Whenever we need to mobilize our muscles or mind to work harder or faster, dopamine drives some of the involved brain cells to step up to the challenge. Prolonged use of cocaine may interfere with this natural process, resulting in a buildup of dopamine that can make the drug seem even more desirable. However, 2020 research on monkeys suggests that another neurotransmitter called glutamate may also play a role in the reward system and addiction. Short-term cocaine use can increase the risk of stroke, seizures, headaches, and coma. If a person has been using cocaine excessively or for a long time, their brain may change in several other ways.

Dopamine Recovery: Timeline for Returning to Normal Levels

• A medication aimed at preventing or reversing such changes might be an effective approach for treating cocaine addiction.
• 2, we cannot specifically speak to a reversal by abstinence of those effects as depicted in Fig 5.
• Cocaine changes how the brain works by increasing the amount of a chemical called dopamine in parts of the brain that control reward and motivation.
• Family therapy helps the recovery from cocaine addiction recovery by addressing the dynamics within the family unit and providing support to both the individual and their loved ones.
• This flood of dopamine creates a sense of intense pleasure, often described as a euphoric high.
• One promising area of investigation involves the use of neurofeedback techniques to help individuals with cocaine addiction regain control over their brain’s reward systems.

In the author’s University of Texas laboratory, investigators have been studying cocaine’s effect on one particular genetic component, the effects of cocaine on the brain: mental effects of cocaine a protein called ΔFosB. Using cocaine can cause changes to the brain, such as in the reward system, resulting in a buildup of dopamine and making it difficult for someone to stop using the substance. When the user starts to smoke crack cocaine in “binges,” the drug will start to cause severe irritability, panic attacks, and paranoia. It is also common for the person to experience psychosis that causes them to lose touch with reality altogether. Since crack cocaine is one of the most addictive drugs, it is often the hardest for a person to stop taking altogether.

The Mental Health Risk of Cocaine Abuse

Having a referral network of practitioners or programs that specialize in the treatment of cocaine use disorders is important. Equally important is understanding the components of the treatment program so one can adequately explain the program and prepare the patient. Practitioners and patients should expect the use of nonaddictive, psychopharmacologic treatments for comorbid and secondary psychiatric disorders.

Nicotine’s Long-Term Effects on the Brain: Dopamine Release and Cognitive…

These symptoms result from the brain’s attempt to readjust to functioning without the presence of cocaine. Common withdrawal symptoms include fatigue, depression, intense cravings, and anhedonia. There’s no definitive answer to this question simply because long-term effects are largely based on the individual. Someone who heavily abused cocaine may not be able to fully repair the damage that they’ve inflicted upon their brain and body. Another person may be able to achieve nearly 100% recovery by making the right changes and targeted efforts.

A younger person who abuses cocaine may find that it affects the development of their brain, particularly the prefrontal cortex over a long-term. Genetics may also dictate the degree to which you experience impairment after long-term cocaine usage. Some people may have favorable genetics and may not experience much of any health problems from their usage. When the cocaine is smoked, it travels a direct path from the lungs to the heart and then brain, leading to a seemingly immediate high. People like immediate gratification and/or elevation in dopamine because it gives them a rapid pleasure response. Hence the reason that smoking various forms of cocaine is more likely to lead to abuse, addiction, and ultimately more unwanted long-term effects.

Cocaine Withdrawal

Withdrawal can be difficult, so it may be best to do it with the help of a medical professional. Your brain may become less responsive to other natural rewards, such as food and relationships. Amanda Stevens is a highly respected figure in the field of medical content writing, with a specific focus on eating disorders and addiction treatment. Amanda earned a Bachelor of Science degree in Social Work from Purdue University, graduating Magna Cum Laude, which serves as a strong educational foundation for her contributions.

To help someone overcome cocaine addiction you need to educate yourself on what is cocaine addiction, approach the substance abuser with compassion, encourage the person to seek professional help, and draw boundaries. Cocaine kills you by causing vasoconstriction which increases blood pressure and high dopamine levels leading to neurological complications including seizures. According to the 2023 study by Richards J R., “Cocaine Toxicity”,  published in StatPearls, cocaine toxicity results in stroke, acute coronary syndrome, and death. Cocaine abuse causes ischemia, ulcers, gastrointestinal disorders, weight loss, and malnutrition. According to a 1994 study by Gourgoutis G., et al, “Gastrointestinal Manifestations Of Cocaine Addiction”, published in the Clinical Pharmacology & Therapeutics Journal, acute ischemia is the most common gastrointestinal problem experienced by cocaine users.

• While voluntary use almost always occurs the first time cocaine is tried, cocaine dependence involving compulsive use frequently follows.
• Genetic factors can influence how the brain responds to cocaine and other substances, making some people more vulnerable to addiction.
• Extinguishing these positive memories of pleasure and ecstasy occurs over years through continued abstinence and intensive treatment.
• In addition, a person will likely experience some type of withdrawal from the drug after using it, even the first time.
• Professional addiction treatment is critical for individuals struggling with cocaine addiction.

As mentioned, cocaine also causes structural changes throughout the brain, including the gray and white matter. Cocaine affects neurotransmission, some of which takes place virtually everywhere in the brain.9 Dopamine is produced in the nerve cell bodies within the ventral tegmental area, and it is then projected to the nucleus accumbens and prefrontal cortex. Less is known about the full extent of white matter changes caused by drug use. At a certain threshold, there’s no guarantee that brain damage can be reversed with abstinence.

Atherosclerosis after cocaine exposure may underlie cognitive dysfunction, suggesting involvement of multiple brain areas. Acute drug studies are important to the future development of addiction models. Short‐term withdrawal following repeated exposure to cocaine led also to structural rearrangements, which are known to be critical for addiction. We found, for instance, altered spine dynamics as shown by reduced expression of PSD‐95, cofilin, and F‐actin (Caffino, Giannotti, et al., 2015). Confocal imaging confirmed expression data showing reduced density and altered morphology together with the formation of non‐functional, inactive spines (i.e., filopodia) (Caffino, Giannotti, et al., 2015).

The Future of Cocaine Addiction Treatment: Insights from Mechanism of Action

Dr. Wakim co-founded and served as the CEO of Transformations leading to a successful merger with Shore Capital in May 2021. He is purpose driven towards improving the standard of and removing stigma related to behavioral healthcare. Dr. Wakim enjoys golf, traveling and time spent with his two dogs, Lulu and Rayna.

Gene therapy and optogenetics, while still in early stages of research, offer intriguing possibilities for directly manipulating the neural circuits involved in cocaine addiction. These cutting-edge techniques could potentially allow for highly targeted interventions to normalize brain function in individuals with cocaine addiction. While dopamine is the primary player in cocaine’s mechanism of action, the drug’s effects extend beyond this single neurotransmitter system. Cocaine also influences serotonin and norepinephrine, two other monoamine neurotransmitters with wide-ranging effects on mood, cognition, and arousal. The initial pleasurable effects of the drug lead to repeated use, causing the brain to adapt and rely on cocaine to maintain normal function. This cycle reinforces addictive behaviors and makes it increasingly difficult to quit.