Cocaine is a powerful central nervous system stimulant drug (CNS stimulant) that may be used medically as a local anesthetic, but it is far better known for its significant abuse.
Cocaine abuse peaked in the 1980s and 1990s.
It then began to decline in the United States as other drugs of abuse, such as prescription opiates and methamphetamine became popular.
As strict controls are placed on methamphetamine and prescription drug abuse is being more tightly monitored and controlled, cocaine use has increased slightly in the United States.
Although cocaine is in the class of CNS stimulant drugs, frequently using it in large amounts can lead to feelings of depression. There are several different ways a person may experience depression resulting from their use of cocaine.
Cocaine use results in the blockage of the reuptake of certain neurotransmitters in the brain. Neurotransmitters are the chemical signals that the neurons in the brain use to communicate with each other. The release of neurotransmitters in the brain accounts for a large percentage of an individual’s behavior.
Once the neurotransmitter has been released and attached to a receptor site in the brain, it performs its mission and is released into the space between neurons. A good deal of the neurotransmitter is reabsorbed back into the neuron in a process called reuptake.
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Cocaine affects numerous neurotransmitters, particularly dopamine, norepinephrine, and serotonin. When these neurotransmitters are activated, there is the perception of reinforcement or reward. Depletion of these neurotransmitters is believed to be associated with many effects, particularly depression.
These neurotransmitters are released in massive amounts when people use cocaine, and cocaine blocks their reuptake, leaving them in the space between neurons where they can reattach to the receptor sites. The high from cocaine is extremely short-lived, and abusers of the drug will often go through episodes where they binge on cocaine to maintain the feeling of euphoria.
This activity leads to a cycle of massive neurotransmitter release followed by significant decreases in their availability once a person stops using cocaine.
This cycle accounts for the crash, leads to permanent changes in the neural pathways of the brain, and results in withdrawal symptoms in those who have developed a dependence on cocaine. Over time, this can result in permanent changes in the brain that result in difficulty experiencing pleasure from events that would normally produce it. Chronic feelings of apathy or depression are more likely.
Dealers of cocaine are interested in making a profit from the drug. The cocaine that is sold on the street is rarely pure. It has often been diluted or cut significantly to produce more of the drug, thus increasing profits.
There is a long list of substances that are used to cut cocaine. Basically, any substance that is white and can be ground into a powder could be used as an additive to cocaine. These include:
Many individuals who abuse cocaine use it in conjunction with other drugs that can exacerbate depressive symptoms. Most often, cocaine is abused with the following substances:
Mixing drugs with contrasting effects, like cocaine and alcohol, is a dangerous situation that can lead to serious issues with depression. Mixing cocaine with other stimulants will exacerbate the comedown from the stimulants and can produce serious issues with depression, apathy, and a lack of motivation.
The clinical diagnosis of depression (major depressive disorder, or MDD) requires that an individual is not under the influence of any substance or that their depression is not a result of using any types of drugs or other medications.
A person who has experienced depressive symptoms as a result of cocaine use would not be diagnosed with MDD, but instead would be diagnosed with a substance- or medication-induced depressive disorder.
Symptoms of depression produced by cocaine would be expected to resolve once the effects of the drug have run their course.
If the person continues to experience depressive symptoms following withdrawal from cocaine, they would be reevaluated and could be re-diagnosed.
The effects of depression can include:
Continued use of cocaine will temporarily relieve depressive symptoms; however, this is the worst way to address depression. It may lead to the development of physical dependence on the drug and a formal substance use disorder.
By definition, anyone diagnosed with any type of substance use disorder is experiencing significant distress and impairment as a result of their substance use. People who use cocaine regularly should consider receiving treatment for their substance abuse. In comprehensive treatment, individuals can address all issues related to their cocaine abuse, including depression.
(July 2018). Cocaine. National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/drugfacts/cocaine
(November 2017), The Dangerous Hidden Ingredients in Cocaine. Verywell Mind. from https://www.verywellmind.com/what-is-in-cocaine-21989