The sense of stimulation received from cocaine probably results from the release of dopamine, a neurotransmitter. Dopamine is associated with pleasure and a sense of alertness. Chronic cocaine use eventually leads to blockage of the re-uptake sites of the original dopamine projector cells. This results in dopamine depletion, basically rendering the individual incapable of feeling pleasure without the drug. Chronic users experience cocaine-triggered seizures or psychotic behavior.
Cocaine is among the most reinforcing of drugs.
An individual using the drug experiences a strong compulsion to take more of the drug each time it is used. The speed and probability of addiction differs for each individual, but for those with a personal or family history of drug addiction or alcoholism, addiction is significantly increased. Cocaine causes psychological and physiological changes. The psychological symptoms are depression, intense anxiety, confusion, hallucinations, irritability, poor concentration, compulsive lying, withdrawal from normal activities, paranoia, and mental illness indistinguishable from schizophrenia. The physiological symptoms are increased blood pressure, tachycardia, myocardial infarction, myocardial rupture, increased body temperature, insomnia, fatigue, cold sweats, pale skin color, tremors, weight loss, decreased libido, vomiting, dilated pupils, and seizures.