Why is Cocaine so Bad for Your Brain?

All psychoactive drugs affect your brain, by definition. Habitual use will cause change neurotransmitter levels, making you physically dependent so you need more to feel the effects. Long term use of many drugs causes cognitive impairments, including poor memory, poor focus, and lack of coordination. If you quit, many of the withdrawal symptoms affect your mood and cognition, sometimes for months or years until your brain heals. Cravings may last for years or decades. Cocaine does all that and more. In addition to massively increasing your risk of heart attack, cocaine does some nasty things to your brain.

Cocaine kills brain cells. It is often said that alcohol kills brain cells. That appears to be false, although it can damage your brain in other ways. Cocaine, however, really does kill brain cells. That should worry you. Until recently, scientists thought you were born with all the brain cells you would ever have. We now know you do make new brain cells, but it happens very slowly and mostly in the hippocampus, a part of your brain involved in creating long-term memories. Whereas most cells in your body replace themselves relatively quickly, dead brain cells don’t usually get replaced.

The way this happens is especially alarming; your brain cells eat themselves. Normally, brain cells collect cellular waste and recycle it in a process called autophagy. Cocaine seems to make this process go crazy and eat everything, including vital organelles like the mitochondria. The cell can no longer function so it dies.

Cocaine increases your risk of stroke. Your risk of stroke is about seven times higher in the 24 hours after using cocaine. Cocaine causes your blood vessels to constrict, dramatically increasing your blood pressure and reducing oxygen to the brain. It also causes your heart to beat quickly and sometimes erratically. Erratic heartbeat increases your risk of forming clots that can lead to a stroke.

The psychological effects of cocaine can become permanent. The psychological effects of most drugs will gradually disappear. Even the lingering sedative effects of benzos eventually get better. With cocaine, the longer you use it, the more likely the psychological effects will stick. These may include insomnia, anxiety, paranoia, and even psychosis. For people predisposed to conditions like schizophrenia, cocaine may trigger the symptoms. People quitting after using for a long time may experience prolonged anhedonia–or inability to feel pleasure–and severe depression.

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