Effects on the body
What cocaine actually does — system by system.
Cocaine is a strong stimulant. It hits fast and wears off fast. The damage often can't be seen, until it can. Some of it happens straight away. Some builds up quietly over months. And there's usually something else in the powder you never asked for.
Before you read on
You're almost never just taking cocaine.
Around 80% of cocaine seized in the UK has levamisole in it. It's a worming treatment for animals. It was taken off the market for humans because of what it does to your immune system. Most people who use cocaine have never heard of it.
It stops your body fighting infection.
Levamisole stops your bone marrow making the white blood cells that fight infection. A cut. A chest infection. A bad tooth. Things that would normally be nothing can put you in hospital, because your body can't fight back.
It causes skin to die.
You get dark purple patches, usually on the ears, cheeks and nose. The skin under them can die. Some people need surgery. Doctors call it levamisole-induced vasculitis. It can show up weeks or months into using.
It builds up.
The damage adds up every time you use. Someone fine for months can end up in A&E with an immune system that's packed in. There's no warning sign, and no test most people would think to ask for.
It's a global problem.
Levamisole is in 60 to 90% of cocaine in the UK, US, Spain, Holland and Switzerland. In February 2026, Europe's medicines watchdog moved to pull it from all human medicines. Not because of the immune damage above. Because of something else: it can damage the brain. It can cause confusion, weakness and slurred speech, sometimes after one dose. And it's still in most street cocaine.
Levamisole is the one we know most about. It's far from the only thing in there. Some of the others can kill you on one line, not over months. See what's actually in it →
What the cocaine itself does
Tap any part of the body below to see what happens, when it shows up, and what can heal. You can use the arrow keys too.
Heart & circulation
Cocaine squeezes your blood vessels and makes your heart work harder, while cutting its oxygen. Your heart rate and blood pressure shoot up within minutes. It can happen the first time, to someone who's totally healthy. The heart goes out of rhythm. Chest pain. In rare cases the heart stops. Long-term use thickens the heart muscle and damages the arteries that feed it. You won't feel it happening, until you do.
Brain & reward system
Cocaine stops your brain clearing away dopamine, the chemical that makes things feel good. So it builds up to several times the normal level. That's the rush: buzzing, focused, sure of yourself. Then it crashes, and you drop lower than where you started. Keep using and your brain turns its own dopamine down. Normal good things stop feeling good. In the end the drug is the only thing that feels like anything.
Stroke & brain injury
The same narrowing of blood vessels that strains your heart can burst them in your brain. Cocaine causes both kinds of stroke: the bleeding kind and the blocked kind. It does it to people in their 20s and 30s with nothing else wrong with them. The danger is highest while you're using and in the hours right after. Using again and again also damages the tiny blood vessels in the brain. Over time that hits your memory, your focus and your judgement.
Nose, sinuses & throat
Snorting cuts off the blood supply to the inside of your nose. The tissue dies. Heavy users get blocked up constantly, pick up infection after infection, and lose their sense of smell. Over time the wall between your nostrils collapses — doctors call it a perforated septum. Once it's gone, it's gone. The damage can spread back into the roof of your mouth. Surgery can sometimes rebuild it. It doesn't always work.
Lungs (smoked / crack)
Smoking cocaine inflames your lungs, gives you a cough and leaves you short of breath. It also causes “crack lung”. Fever, chest pain, wheezing and bleeding inside the lungs. It can look like pneumonia. Smoking it long term shrinks how much air your lungs hold, for good. You pick up chest infections more easily too.
Gut & bowel
People don't talk about this one, but it's real. Cocaine squeezes the blood vessels that feed your gut. Starved of blood, parts of the bowel can start to die. It shows up as bad stomach pain and blood in your diarrhoea. Sometimes it needs emergency surgery. It happens to young, healthy people too. Long-term use also messes up your appetite and your digestion.
Kidneys & liver
Cocaine is hard on your kidneys. It dries you out, it can break down your muscles, and it pushes your blood pressure up. All of that hits the kidneys. Your liver has to clear it too, and add drink and it has to work much harder. One thing cocaine gets cut with, phenacetin, is linked to long-term kidney damage on its own.
Mental health
Anxiety, paranoia, panic and a short fuse are common, on it and coming down. Keep using and you can start seeing or hearing things that aren't there. Some people feel insects crawling under their skin. If you already live with depression, anxiety, ADHD or trauma, cocaine usually makes it worse. Suicidal thoughts on a comedown are common. Take them seriously.
Sleep, appetite & teeth
Cocaine kills your appetite and wrecks your sleep. You eat badly and you sleep less. That makes the next comedown worse, and the anxiety and paranoia sharper. Clenching your jaw and grinding your teeth is common. Doctors call it bruxism. It cracks teeth, makes your jaw ache, and wears your teeth down fast. Most people don't realise how obvious it looks to everyone else.
Pregnancy & fertility
Using cocaine while pregnant raises the risk of losing the baby. The placenta can tear away from the womb. The baby can come early, or small. It can also affect how the baby grows. Cocaine goes straight through to the baby. If you're pregnant and using, you need specialist help fast, and without judgement. Fear of being judged is the main reason people say nothing. In men, long-term use is linked to a lower sperm count and trouble getting hard.
Tolerance & dependence
You need more and more to get the same high. Your heart never builds up any tolerance at all. So every time you chase that first feeling, you risk more with your heart. Nothing warns you. The mental hold usually takes grip long before anyone notices the physical side. It's the most common reason people come looking for help.
The good news
Stop, or cut right down, and most of the damage heals a long way back. That covers the heart, the brain, mood, sleep and skin. Not all of it, and not always fully. Septum perforations don't heal. Some cardiac scarring is permanent. But for the majority of users in the majority of systems, the body recovers more than people fear. That's a message worth leading with.