Cocaine Health Risks: Severe and Lasting Mental Effects

Even if a person who abuses cocaine is aware of physical harm that can result, he (or she) may not be aware that lasting and severe mental effects are also possible. These effects are more common as a person’s tolerance to cocaine builds and he must take more of the drug to get the same high.

man experience after effects of cocaine

If a person binges—meaning he uses a large quantity of cocaine continuously over a short period of time—he is at enormous risk for damaging mental effects. Bingeing is associated with irritability, restlessness and paranoia. A person mid-binge can develop a state of complete psychosis where he cannot connect with reality.

Some effects may fade away when a person gets fully clean of the drug but some may either stubbornly refuse to go away or may have such harmful repercussions that no recovery is possible. In a high-profile case, a banker in London who had been using cocaine regularly for years jumped out of a fourth-floor window to his death as a result of his paranoia and disorientation. Unfortunately, there are many examples of cocaine-related deaths that result from the drug’s mental effects.

Cocaine psychosis was described more than 100 years ago by Sigmund Freud. When his patient took cocaine over a period of weeks, he suffered visual and auditory (heard) hallucinations and paranoia.

Specific Mental Effects of Cocaine Include the Following:


Paranoia is a common symptom that accompanies heavy cocaine abuse. One study noted that 68% to 84% of cocaine abusers suffered from paranoia. The problem with this mental effect is that a person may take aggressive actions toward others as a result of this paranoia. If the user harms or even kills another person, the damaging effects of this act can last a lifetime.


Cocaine psychosis can occur in the powdered cocaine user and the crack cocaine smoker. It may be more common among crack users but when a person gets his hands on a large quantity of powdered cocaine and binges non-stop for days, psychosis becomes a common symptom.

Depressed man feels sad


Depression is a common mental effect that may kick in when a person comes down from an intense high. Suicidal thoughts are therefore common when a person enters rehab and goes through withdrawal, requiring close supervision for the early days of withdrawal.


Heavy cocaine abusers may hear or see things that do not exist. These hallucinations can cause him to be paranoid or delusional and may incapacitate him from dealing with real dangers. A review of 85 cocaine users showed that four out of ten were unable to focus on the real world due to their hallucinations. They tended to ignore environmental signals as traffic lights and focus on imaginary threats. A common delusion is that the drug user is being followed or watched, tying in with the person’s paranoia.


A review of patients who suffered from mental problems after cocaine abuse revealed that more than half manifested violent behavior.

Suicidal or Homicidal Thoughts

A study published in the Journal of Clinical Psychiatry notes the coincidence of suicide or homicide with cocaine abuse. In some reviews of suicide, cocaine was present in 18% to 22% of the cases. In homicide cases, cocaine was found to be present in nearly one out of three victims.

An outing with friends who are using cocaine can lead one to join in without a thought for what could result. For some people, it may only take a few times of indulging in cocaine before a habitual pattern to be set. Anyone who wants to start using cocaine would be very wise to look into the mental and physical effects that are part of the deal because his drug-using friends or drug dealers will never tell him.


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