Understanding Stimulants: Cocaine vs. Methamphetamine

The following information appears in “Drugs: Shatter the Myths,” a free publication from the  National Institute on Drug Abuse and the NIDA for Teens website.

What Are Stimulants?

Stimulants are drugs such as cocaine, “crack,” and amphetamines that can cause the heart to beat faster, and blood pressure and metabolism to increase. Stimulants often cause a person to be more talkative and anxious and to experience feelings of exhilaration. They are often used to increase alertness and relieve fatigue.

What Are the Differences Between Cocaine and Methamphetamine?

Although cocaine is quickly removed and almost completely metabolized, methamphetamine has a much longer duration of action. The longer presence of methamphetamine in the brain ultimately leads to prolonged stimulant effects.

Both stimulants cause an accumulation of the neurotransmitter dopamine in the brain. This excessive dopamine concentration appears to produce the stimulation and feelings of euphoria experienced by the user.

What Are the Short-Term Effects of Cocaine Use?

The short-term effects of cocaine include constricted blood vessels; dilated pupils; and increased temperature, heart rate, and blood pressure. In rare instances, sudden death can occur on the first use of cocaine or unexpectedly thereafter, usually because of disrupted heart rhythms.

What Are the Long-Term Effects of Cocaine Use?

Large amounts of cocaine intensify the high, but may also lead to bizarre, erratic, and violent behavior. Heavy users may experience tremors, vertigo, muscle twitches, or paranoia. Some cocaine users report feelings of restlessness, irritability, and anxiety. This may result in panic attacks or even full-blown paranoid psychosis, in which the individual loses touch with reality and hears sounds that aren’t there (auditory hallucinations).

Different ways of using cocaine can produce different adverse effects. For example, regularly snorting cocaine can lead to swallowing problems, hoarseness, loss of the sense of smell, nosebleeds, and a chronically runny nose. Cocaine that is eaten can cause reduced blood flow, leading to bowel problems.

How Long Can Stimulants, Such as Cocaine and Methamphetamine, Be Detected In the User’s Body?

There is no hard and fast rule for how long a drug will be detectable in one’s system. Generally, traces of these stimulants can be detected by standard urine testing methods several days after use. The exact length of time varies from person to person and from test to test. It can also depend on the amount of drug used.

What Happens If a Person Drinks Alcohol and Uses Cocaine at the Same Time?

Taken in combination, alcohol and cocaine are converted by the body to a substance called cocaethylene. Cocaethylene lasts longer in the brain and is more toxic than either drug alone. The mixture of cocaine and alcohol is the most common two-drug combination that results in drug-related death.

Are Stimulants Addictive?

Cocaine, methamphetamine, and amphetamines are highly addictive. After trying stimulants, an individual may have difficulty predicting or controlling the extent to which he or she will continue to use the drug. The stimulant and addictive effects are thought to be primarily a result of the drugs’ ability to inhibit the reabsorption of dopamine by nerve cells.

Can a User Develop a Tolerance to Cocaine?

Many cocaine addicts report that they seek but fail to achieve as much pleasure as they did from their first experience, suggesting tolerance to some effects of cocaine. Some users increase their doses to intensify and prolong the euphoric effects. Users can also become more sensitive to cocaine’s anesthetic and convulsant effects over time. This increased sensitivity may explain why some deaths occur after apparently low doses of cocaine.

Medical and Aesthetic Consequences of Stimulant Use

Cocaine use has been linked to many types of heart disease. Cocaine has been found to trigger chaotic heart rhythms, called ventricular fibrillation; accelerate heartbeat and breathing; and increase blood pressure and body temperature. Physical symptoms may include chest pain, nausea, blurred vision, fever, muscle spasms, convulsions and coma.

Different routes of cocaine administration can produce different adverse effects. Regularly snorting cocaine, for example, can lead to loss of sense of smell, nosebleeds, problems with swallowing, hoarseness, and an overall irritation of the nasal septum, which can lead to a chronically inflamed, runny nose. Ingested cocaine can cause severe bowel gangrene, due to reduced blood flow. And, persons who inject cocaine have puncture marks and “tracks,” most commonly in their forearms. Intravenous cocaine users may also experience an allergic reaction, either to the drug, or to some additive in street cocaine, which can result, in severe cases, in death. Because cocaine has a tendency to decrease food intake, many chronic cocaine users lose their appetites and can experience significant weight loss and malnourishment.

Meth reduces the amount of protective saliva around the teeth. People who use met also tend to drink a lot of sugary soda and clench their jaws – all of which can cause what’s known as “meth mouth.” Meth users sometimes hallucinate that insects are creeping on top of or underneath their skin (called formication). The person will pick or scratch their skin, trying to get rid of the imaginary “crank bugs”….soon their face and arms are covered with open sores that can get infected.

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