Short-Term Effects:

May last up to 4 hours. Exhilaration, dilated pupils, flushed face. If injected, tremors, delirium and convulsions, Irritability, depression, and psychosis can result from large doses. Reduces fatigue and appetite. Increased heartbeat and breathing rate, rise in body temperature, sweating, paleness.

Long-Term Effects:

Damage to inside of nose and blood vessels from sniffing. Severe depression, paranoia, feeling that insects are crawling under the skin. Among habitual users, euphoria is gradually displaced by restlessness, extreme excitability, insomnia and suspiciousness. Eventually these may be accompanied by hallucinations and delusions.

Withdrawal:

Withdrawl symptoms may develop in previously heavy users: fatigue, long but disturbed sleep, strong hunger, irritability and depression. While there is no clearly defined withdrawl syndrome, the user may feel a sharp contrast between the drug-induced 'up' and the `down' as the drug rapidly leaves the brain and body.

Interactions with Other Drugs:

Cocaine and opioids such as morphine or heroin have been used in combinations called 'speedballs' to achieve an addictive effect and to avoid post-cocaine depression. Cocaine and amphetamines have been used in combinations called 'crank'.

Lethality/OD Treatment:
Although deaths from overdoses are now rare, there were many cases this century. At the present time, impurities in 'street cocaine' increase the risk of fatal allergic reaction. The overall effect of cocaine is so short-lived that antidotal treatment is of little value.

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