Cocaine use stimulates the brain and central nervous system, and can result in a variety of adverse outcomes. The effect that cocaine has on an individual depends on a number of factors. These include:

•          how much cocaine is taken
•          the method of use
•          the form and purity of the cocaine
•          the height and weight of the user
•         the user’s current physical and mental health status
•          the user’s previous experience with cocaine (i.e. new user vs frequent user)
•          whether other substances (alcohol, tobacco, medications, or other illicit drugs) are used at the same time as cocaine.

There are a variety of physical health risks associated with cocaine use. Many of these risks are very serious and can result in severe short- and long-term consequences for the user.

Long-term use of cocaine can result in nasal damage, breathing problems, chronic coughing and lung damage. Severe consequences of cocaine use can include weight loss and malnourishment, impaired cognition, cardiovascular problems and heart attack, neurological damage, seizures, stroke, comas and death. The use of cocaine in combination with alcohol or opioids can be particularly dangerous.

Regular use of cocaine may also lead to dependence (addiction). Dependent users develop a tolerance to cocaine, and need to take larger doses of the drug to achieve the same effect and feel ‘normal’. The urge to use cocaine can become more important than other activities in their lives, resulting in poor physical and mental health, social and financial problems, and family and social breakdown. See FAQ What are the diagnostic criteria for cocaine-related mental health disorders?

In 2022-23 there were 985 hospital separations due to the use of cocaine.

In 2021, there were 82 overdose deaths in Australia which involved cocaine, of which the majority (83%) occurred among men. Most of these deaths (94%) were unintentional.

The vast majority  of drug-induced deaths are due to overdose, however a small number of cocaine-related deaths unrelated to overdose may be excluded from the above figure.

The reference guide used by clinicians to diagnose mental health disorders is known as the Diagnostic and Statistical Manual of Mental Disorders (DSM). The most recent version of the manual, the Diagnostic and Statistical Manual of Mental Disorders – 5th Edition (DSM-5), was released in May 2013.

DSM-5 Diagnostic Criteria

According to the DSM-5, there is one main cocaine-related mental health disorder: a stimulant use disorder. This is defined as:

A pattern of amphetamine-type substance, cocaine, or other stimulant use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12-month period:

1. The stimulant is often taken in larger amounts or over a longer period than was intended
2. There is a persistent desire or unsuccessful efforts to cut down or control stimulant use
3. A great deal of time is spent in activities necessary to obtain the stimulant, use the stimulant, or recover from its effects
4. Craving, or a strong desire or urge to use the stimulant
5. Recurrent stimulant use resulting in a failure to fulfil major role obligations at work, school, or home
6. Continued stimulant use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the stimulant
7. Important social, occupational, or recreational activities are given up or reduced because of stimulant use
8. Recurrent stimulant use in situations in which it is physically hazardous
9. Stimulant use is continued despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the stimulant
10. Tolerance, as defined by either of the following:
    a    A need for markedly increased amounts of the stimulant to achieve intoxication or desired effect
    b    A markedly diminished effect with continued use of the same amount of the stimulant.
    
    Note: This criterion is not considered to be met for those taking stimulant medications solely under appropriate medical supervision, such as medications for attention-deficit/hyperactivity disorder or narcolepsy.
     
11. Withdrawal, as manifested by either of the following:
    a    The characteristic withdrawal syndrome for the stimulant (refer to Criteria A and B of the criteria set for stimulant withdrawal, p. 569).
    b    The stimulant (or a closely related substance) is taken to relieve or avoid withdrawal symptoms.
    
    Note: This criterion is not considered to be met for those taking stimulant medications solely under appropriate medical supervision, such as medications for attention-deficit/hyperactivity disorder or narcolepsy.

A mild stimulant use disorder is defined as the presence of 2-3 of the above symptoms.

A moderate stimulant use disorder is defined as the presence of 4-5 of the above symptoms.

A severe stimulant use disorder is defined as the presence of 6 or more of the above symptoms.