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The Dangers And Effects Of Smoking Cocaine

Isaac Alexis, M.D., AAMA, AMP-BC

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

February 5, 2019

Smoking cocaine can have damaging effects on a person’s health and rapidly lead to addiction. Those who become dependent on cocaine may need formal treatment within an inpatient rehab program to stop smoking cocaine and overcome their addiction.

Cocaine is a highly-addictive stimulant that can be smoked, injected, snorted, or rubbed into the gums of the mouth. Smoking is one of the most common methods of cocaine use due to its ability to produce a rapid high within minutes.

Smoking cocaine involves inhaling a freebase form of cocaine that has been processed into a rock crystal, known as ‘crack’ or crack cocaine.

How Do People Smoke Cocaine?

Heating crack cocaine with a pipe can create vapors that may be inhaled to experience a rapid euphoric high. Smoking cocaine can produce a high nearly as fast as when it is injected, and quicker than when the drug is taken orally or snorted.

Although the initial high from smoking cocaine can occur quickly, it is also short-lived, causing a ‘crash’ within about 15 minutes after use. The quick and powerful impact of cocaine on the brain can motivate frequent and compulsive use of the drug, commonly leading to dependence and addiction.

Effects Of Smoking Cocaine

The most common effect associated with smoking cocaine is a rapid high, which can increase feelings of pleasure, mental alertness, and a sense of wellbeing.

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Cocaine has an effect on several chemicals in the brain that plays a role in regulating mood, pleasure, cognitive function, as well as sleeping patterns and appetite.

Short-term effects of smoking cocaine on the brain include:

  • euphoria
  • mental alertness
  • decreased appetite
  • anxiety
  • agitation
  • paranoia
  • depression

While some of the more pleasurable effects from the euphoria may be short-lived, the more unpleasurable symptoms of depression, agitation, and paranoia may continue during the ‘crash’ phase. These side effects may become more intense with chronic use.

Effects of smoking cocaine on the body:

  • dilated pupils
  • increased blood pressure
  • rapid heartbeat
  • increased body temperature
  • vertigo
  • muscle twitches
  • tremors

Some side effects of cocaine can vary depending on how it is used. Those who smoke crack cocaine may experience additional side effects of hoarseness, difficulty swallowing, and nosebleeds.

Dangers Of Smoking Cocaine

Cocaine is one of the most commonly abused drugs in the United States and is involved in nearly 40 percent of drug-related emergency room visits. It is also one of the most addictive, especially when smoked in its freebase form.

Cocaine has a higher potency when it is smoked than when snorted, and reaches the brain faster. When cocaine is smoked, it is inhaled into the lungs where it may then go directly to the heart and brain.

Cocaine Dependence And Addiction

The rapid absorption of cocaine through smoking can cause a person to quickly develop a tolerance. This occurs when the body adapts to a substance, resulting in decreased drug effects. This tolerance can often result in cocaine binges — where the person will smoke larger amounts or multiple doses within a short timeframe to achieve the desired effect.

Both the short-term effects and symptoms of crashing contribute to crack cocaine’s high risk for addiction. Even those who use crack cocaine just once are at risk due to the intense drug cravings that can set in after the initial high has worn off. Repeated use of crack cocaine can further enhance the desire to smoke more and make it harder for someone to control or stop their drug use.


Another factor that makes it difficult for people who have become dependent to stop is withdrawal. Cocaine withdrawal can cause several uncomfortable symptoms ranging from anxiety to severe hallucinations and paranoia.

These symptoms can often lead a person to use more of the drug if only to stave off the withdrawal effects. This further entraps them in a dangerous pattern of drug abuse, increasing the risk for short and long-term medical consequences.

Medical Consequences

The most serious medical consequence that can occur from smoking cocaine is sudden death. This can happen with first use, or through chronic use of cocaine over an extended period.

Sudden death from crack cocaine most often occurs due to heart failure or as a result of seizures. Mixing cocaine with other substances, such as alcohol or opioids, can also increase the risk for cocaine-related death.

There are also several short and long-term medical consequences that crack cocaine can cause. The severity of these consequences may vary based on dosage amount, how long you have been smoking crack cocaine, and other personal factors.

Medical consequences from smoking cocaine include:

  • reduced sense of smell
  • perforated septum (holes in the nasal membrane dividing the nostrils)
  • sinus infections
  • a frequent runny nose
  • a headache
  • chest pain
  • nausea
  • stomach pain
  • ulcers
  • bleeding in the brain (intracerebral hemorrhage)
  • poor nutrition
  • sexual dysfunction
  • stroke
  • coma

Smoking Cocaine And Its Relationship With Violence

Like other stimulants, cocaine can have significant effect on behavior due to its interactions with certain chemicals in the brain. For this reason, people who smoke cocaine, particularly in large or frequent doses, may often act aggressive, erratic, or violent.

Some of this violence may be turned on loved ones, resulting in domestic violence against close friends and family. Cocaine can cause extreme paranoia and delusional thinking, causing bizarre behavior that can be unpredictable and irrational. They may question their own identity, or that of others, or believe they are being followed or watched.

Violent behavior caused by cocaine may also lead to drug-related criminal offenses such as stealing or driving under the influence. Cocaine use is linked to risky behavior, and may increase the likelihood of committing a violent or non-violent crime. Committing a crime under the influence of cocaine can lead to legal consequences and additional problems with criminal justice authorities.


Smoking cocaine has a high risk of overdose, which in some cases can be fatal. People are more likely to binge on crack cocaine due to its short-lived drug effects, and the rapid absorption of large amounts of the drug can quickly overwhelm the brain.

It is also common for people to mix cocaine with drugs like heroin, or alcohol. Combining the use of these drugs can create a deadly combination.

Cocaine overdose poses a significant danger to cardiac (heart) function, resulting in symptoms of irregular heartbeat or heart attack. Additional concerns with overdose include stroke and seizures.

Symptoms of cocaine overdose:

  • difficulty breathing
  • extreme agitation
  • anxiety
  • hallucinations
  • high body temperature
  • high blood pressure

Treatment For Cocaine Addiction

People who smoke cocaine may be at high risk for drug addiction and other serious harm to their health. Addiction is a complex problem that can be difficult to face alone. Formal treatment within an inpatient rehab facility may be needed to help a person stop using cocaine.

Inpatient rehab facilities can provide a safe and structured environment for people with a cocaine addiction to undergo medical detox and receive comprehensive care. Cocaine dependence is more than a physical disease, often affecting a person’s emotional and mental health. Additional treatment such as behavioral therapy, support groups, and medication-assisted treatment can be beneficial in this respect and help patients achieve lasting recovery.

Contact one of our treatment specialists today to learn more about treatment options for you or a loved one struggling with cocaine abuse.

National Institute on Drug Abuse - Snorting vs Smoking Cocaine

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