Short-term side effects 

Cocaine has several possible side effects. It numbs the area it touches, so you may feel tingling or numbness in your mouth and throat. Mentally, you may feel restless, on edge, stressed, anxious, or have panic-like reactions. Some people can also become suspicious, confused, overreacted, or irritable. 

The risk of psychotic or paranoid symptoms increases if you take large doses, sleep very little, or use cocaine for several days in a row. 

It is hard to predict which side effects you will get, even with small amounts. The risk of unwanted effects goes up with higher doses, more frequent use, or if you combine cocaine with other drugs or medicines. 

In rare cases, serious complications can occur, such as heart attack, heart rhythm problems, stroke, or sudden loss of consciousness. 

Long-term use 

If you use cocaine often over time, it can affect both your body and your mental health. Many people develop sleep problems, feel down, anxious and low on energy. It is common to have poorer concentration and memory. A small number of people can develop paranoia or psychosis that continues even after the high is over. 

Your body can also be harmed. Long-term use can lead to weight loss, tremors, reduced sex drive and a weakened immune system. The heart and blood vessels are put under strain, which increases the risk of heart problems. If you snort a lot and often, you can develop chronic damage in your nose and, in rare cases, a hole in the nasal septum. 

Dependence 

It is quite easy to become dependent on cocaine, especially if you use it often. Dependence can be both psychological and physical, and for most people it develops gradually. Many experience strong cravings and a sense of losing control. 

When you use cocaine over time, your tolerance usually increases. This means you need larger doses to get the same effect. For a few people, the opposite happens – they become more sensitive and tolerate the drug less well, with symptoms such as anxiety, agitation, or seizures. 

Over time, the reason you take cocaine can change. You may no longer use it just to get high, but to avoid feeling low, anxious, or uncomfortable. This makes it even harder to stop. 

Withdrawal 

When you stop using cocaine, withdrawal can start shortly after the last dose and last from a few days to several weeks. The reactions are often mainly psychological: low mood, anxiety, irritability, sleep problems, inner restlessness, and strong cravings. Many people feel unmotivated, have trouble concentrating, and withdrawing from others. 

Physical symptoms such as headaches, nausea, and muscle aches are also common. After periods of heavy use, there can be a “crash” with extreme tiredness and flu-like symptoms. This happens because your body and brain have been overstimulated over time. 

For some people, cravings can last a long time. It is often triggered by places, people, or situations that remind you of previous use. Some try to cope with the discomfort by using other drugs, but this can make things worse. 

If you experience hallucinations, paranoia, or thoughts of harming yourself, you should seek help.