Cocaine usage can lead to a wide range of complications within the central nervous system (CNS), such as restlessness, seizures, unconsciousness, headaches, bleeding inside the brain, and specific neurological signs. When cocaine triggers excessive physical activity, it can lead to dangerous overheating. This is due to the drug causing the blood vessels near the skin to narrow, preventing the body from cooling down effectively, especially during continuous activity. The risk of death can reach up to 33% in cases where such overheating occurs alongside cocaine intoxication.
This state of heightened activity and agitation is driven by an increase in certain excitatory chemicals in the CNS, including glutamate and aspartate, along with the release of stimulatory neurotransmitters like norepinephrine, serotonin, and dopamine. The extent of overheating in individuals affected by cocaine is closely linked to their level of physical agitation and the surrounding environmental temperature.
Regarding seizures, they are seen in about 3 to 4% of emergency department visits attributed to cocaine, occurring after either acute or prolonged use, sometimes after consuming large amounts in individuals without any pre-existing seizure conditions.
Cocaine can also lead to both temporary and permanent neurological damage, including situations of reduced blood flow to the brain (like transient ischemic attacks or strokes) and brain bleeds. Reports have detailed cases of bleeding within different brain regions following cocaine use, alongside rarer neurological issues, such as paralysis due to reduced blood flow to the anterior spinal cord.
Additionally, cocaine can induce psychotic symptoms, including paranoia, delusions, or hallucinations, which may mimic schizophrenia.
