Doing Cocaine For The First Time: Side Effects and Risks

Identifying Cocaine Paraphernalia

Doing Cocaine for the First Time: Side Effects and Risks

Cocaine is a central nervous system stimulant that can be snorted, smoked, or injected. It’s known by names like coke, blow, crack, and powder. Cocaine has a long history in medicine and was originally used for pain relief before anesthesia was invented. Today, however, cocaine is a Schedule II stimulant, meaning it is illegal to use recreationally in the United States. Despite the short-lived high it produces, many people become curious enough about cocaine to use it, often without understanding its risks. Let’s look at the effects of doing cocaine for the first time and how quickly you can become addicted to it. 

Recognizing the signs of stimulant addiction can be overwhelming, but our cocaine rehab center in Cathedral City, CA is here to help with cocaine addiction treatment and compassionate support.

What Does Cocaine Do to You the First Time?

Cocaine works by activating the mesolimbic dopamine system, which is the brain’s reward pathway. This area of the brain is usually reinforced naturally by stimuli like food and sex but can also be stimulated by drugs of abuse. 

In addition to reward, this region of the brain also regulates emotions and motivation. Normally, dopamine is released by a neuron into the gap between two neurons (called the synapse). 

In the synapse, dopamine binds to specialized proteins called dopamine receptors on the neighboring neuron. In this way, dopamine is used as a chemical messenger that’s carried from one neuron to another. Afterward, another protein called a transporter takes the dopamine from the synapse and recycles it for further use. 

Cocaine interrupts this process by binding to the dopamine transporter, blocking the removal and reuptake of dopamine from the synapse. This causes dopamine to accumulate in the synapse and send 

an amplified signal to neurons. What happens when you take coke for the first time is marked by a rush of euphoria.

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Cocaine First Time Side Effects

Cocaine stimulates the CNS, creating not only a sensation of euphoria but also other side effects marked by rapid neural activity. From the cardiovascular system to the respiratory system, various functions of the body are heightened the first time doing coke. 

Side effects that occur when taking coke for the first time include:

  • Bloody nose
  • Euphoria
  • Increased alertness and energy
  • Chest pain
  • Dilated pupils
  • Insomnia or difficulty sleeping
  • Dizziness
  • Abdominal pain
  • Back or spine stiffness
  • Diarrhea
  • Nausea and/or vomiting
  • Agitation
  • Irritability
  • Restlessness
  • Paranoia or anxiety
  • Muscle spasms


In rare cases, cocaine may lead to sudden death after one use. This is common in people who take too high of a dose or take cocaine that’s laced with fentanyl or other potent substances. Death is usually the result of cardiac arrest or seizures. 

Can You Get Addicted to Cocaine?

Yes, you can get addicted to cocaine. Because of its impact on dopamine and the reward system in the brain, cocaine abuse can eventually lead to addiction. 

This usually begins with tolerance, which is when the person requires a higher dose of the drug to experience the same effects. After a while of use, the brain and body may become dependent. 

Cocaine dependence is marked by withdrawal symptoms like agitation, restless behavior, depressed mood, fatigue, and increased appetite. Withdrawals may occur when the person hasn’t used cocaine for a few hours to a few days, depending on the extent of their use. 

The cravings and depression associated with cocaine withdrawals and comedown can last anywhere from a few weeks to a few months. In addition to physical dependence and addiction, other long-term effects of cocaine include:

  • Breathing problems
  • Perforation of cartilage in the nose
  • Lost sense of smell
  • Frequent nose bleeds
  • Tooth decay
  • Memory loss
  • Lowered attention span
  • Decreased decision-making skills
  • Mental illness, such as depression and anxiety
  • Scar tissue formation in the lungs and airways
  • Internal bleeding in the lungs
  • New or worsening symptoms of asthma or emphysema
  • Increased risk of nervous system disorders like Parkinson’s
  • Increased risk of contracting viruses or diseases like HIV/AIDS and hepatitis C (common in intravenous cocaine users)


Cocaine overdose can also occur in long-time users who continuously increase their doses to get high. An overdose on coke is a life-threatening emergency, producing symptoms like:

  • Shallow or stopped breathing
  • Loss of consciousness
  • Inability to speak, focus, or open their eyes
  • Blue or gray-tinted skin
  • Darkened lips and fingernails
  • Snoring or gurgling sounds from the throat


If you notice that someone is overdosing on cocaine, call 9-1-1 immediately to prevent brain damage, from lack of oxygen, or death. 

Help for Cocaine Addiction
Unfortunately, while you may tell yourself that doing cocaine for the first time will be the only time, you never know. It only takes a handful of uses to become addicted to coke, so while you may think that using it a few times is harmless, it’s not. 

There’s more at stake than your physical health when you use cocaine. Many people who give in to drug or alcohol abuse lose their family, friends, jobs, finances, and more. If you or a loved one has developed an addiction to crack or any other drug, get help before it’s too late. 

Our Massachusetts drug rehab offers cocaine addiction treatment that incorporates a variety of therapy programs – like biofeedback – to help patients come to terms with their addictions and learn how to properly manage their cravings to avoid relapse. Our programs may be held in both individual and group settings to not only offer individualized education and guidance to patients, but also to help them develop strong relationships with and learn from others in the recovery community. 

Taking the first step toward recovery is possible — reach out to our cocaine rehab center in Gilman, IL to learn about cocaine rehabilitation programs options that can make a difference.

For more information about our Massachusetts addiction treatment, contact Banyan Treatment Centers today at 888-280-4763. Our Boston rehab center is here to help.

Related Reading: Cocaine’s Effects on Teeth Cocaine Skin Problems What Cocaine Does to Your Eyes

Sources

  1. National Institute on Drug Abuse (NIDA). (None). Cocaine | National Institute on Drug Abuse (NIDA).
  2. Journal of Ethnopharmacology. (1981). Coca and cocaine as medicines: an historical review.
  3. Drug Enforcement Administration (DEA). (None). Cocaine (Street Names: Coke, Snow, Crack, Rock).
  4. NCBI Bookshelf / StatPearls. (2025). Diphenhydramine - StatPearls - NCBI Bookshelf - NIH.
  5. National Center for Biotechnology Information (NCBI), National Library of Medicine. (2022). An Historical Review of Steps and Missteps in the Discovery of Effective Obesity Treatments.
  6. Frontiers in Behavioral Neuroscience. (2007). Behavioral Functions of the Mesolimbic Dopaminergic System.
  7. National Institute on Drug Abuse (NIDA). (None). Addiction and Health.
  8. National Center for Biotechnology Information (NCBI). (None). Chapter 2—How Stimulants Affect the Brain and Behavior.
  9. NCBI Bookshelf. (None). Schizophrenia - StatPearls - NCBI Bookshelf.
  10. American Heart Association. (2021). Marijuana Use in Patients with Cardiovascular Disease - PMC - NIH.
  11. National Center for Biotechnology Information (NCBI), National Institutes of Health. (None). Amphetamine - StatPearls - NCBI Bookshelf - NIH.
  12. PMC - NIH. (2022). Cocaine Use Disorder (CUD): Current Clinical Perspectives.
  13. Mayo Clinic, American Journal of Kidney Diseases. (2010). Gabapentin toxicity in patients with chronic kidney disease.
  14. MedlinePlus (National Library of Medicine). (None). Cocaine withdrawal: MedlinePlus Medical Encyclopedia.
  15. National Institute on Alcohol Abuse and Alcoholism (NIAAA). (None). The Cycle of Alcohol Addiction.
  16. Scientific Reports. (2023). Urinary profiles of methoxyphenamine and its metabolite after passive and active inhalation. DOI: 10.1038/s41598-023-37747-5
  17. BMJ Case Reports. (2016). Snorting the clivus away: an extreme case of cocaine-induced midline destructive lesions.
  18. PLoS One. (2018). Pre-sleep treatment with galantamine stimulates lucid dreaming: A double-blind, placebo-controlled, crossover study.
  19. PMC (PubMed Central). (2007). Hormesis Defined.
  20. National Institute on Drug Abuse (NIDA). (None). Drugs A to Z | National Institute on Drug Abuse (NIDA).
  21. U.S. Food and Drug Administration. (2009). Lexapro (escitalopram oxalate) Tablets/Oral Solution Highlights of Prescribing Information.
  22. NCBI Bookshelf. (2023). Alprazolam - StatPearls - NCBI Bookshelf.
  23. National Institute on Drug Abuse (NIDA). (2023). Cocaine.
  24. FDA. (2011). 022544Orig1s000Lbl.pdf.
  25. National Center for Biotechnology Information (NCBI/PMC). (2024). Neurological and systemic effects of cocaine toxicity.
Kaitlin

Kaitlin

Kaitlin Jones is a Digital Marketing Specialist and Team Lead at Banyan Treatment Centers. With a strong background in SEO, content strategy, and digital advertising, Kaitlin oversees the development and execution of impactful marketing campaigns that connect individuals and families with addiction and mental health treatment services. This content has been medically reviewed by Dr. Darrin Mangiacarne, Chief Medical Officer at Banyan Treatment Centers.