Cocaine can cause vomiting, a recognized side effect of using the powerful stimulant, which affects the central nervous system. Vomiting is often a direct result of the body’s reaction to the substance or a sign of increasing toxicity. The mechanisms involved range from direct irritation of the digestive tract to systemic overstimulation of the brain’s control centers. When this occurs, it indicates that the body is struggling to cope with the drug’s effects and should be interpreted as a warning sign of potential overdose.
Physiological Causes of Nausea and Vomiting
The stimulant properties of cocaine disrupt both the brain and the digestive system, leading to nausea and vomiting. One primary cause involves the brain’s Chemoreceptor Trigger Zone (CTZ), located in the brainstem, which monitors the bloodstream for toxins. Cocaine’s systemic presence can overstimulate the CTZ, signaling the adjacent vomiting center to initiate emesis, a protective reflex.
Another major physiological cause is the significant strain cocaine places on the cardiovascular and gastrointestinal systems. Cocaine is a potent vasoconstrictor, meaning it causes blood vessels throughout the body to narrow rapidly. This action dramatically reduces blood flow to organs, including the stomach and intestines.
When the digestive tract is deprived of adequate blood supply, a condition known as ischemia occurs, causing tissue distress and irritation. Reduced blood flow can quickly lead to more serious conditions like ischemic colitis or bowel necrosis. The overall sympathetic nervous system overdrive, or “fight or flight” response, also contributes to gastric upset.
Influence of Administration Method
The specific way cocaine is consumed introduces local mechanisms that contribute to gastrointestinal distress, separate from systemic effects. When cocaine is snorted, a portion mixes with nasal mucus and drains down the back of the throat, a phenomenon sometimes called the “cocaine drip.” This residue is then swallowed, bringing the substance directly into contact with the stomach lining.
The chemical composition of illicit cocaine, which often contains cutting agents, is highly irritating. When this residue is swallowed, it causes immediate local irritation to the esophagus and stomach. This direct contact with the sensitive mucosal lining can cause acute inflammation, leading to nausea, stomach pain, and vomiting.
Oral ingestion, such as swallowing a bag of the substance, causes the most intense local irritation because the entire dose is exposed to the digestive tract. The acidic nature of the substance, combined with its ability to cause local vasoconstriction, can lead to stomach ulcers or even perforation of the intestinal wall. Even though intravenous administration bypasses the digestive tract, the systemic effects on the CTZ and widespread vasoconstriction are potent enough to still induce nausea and vomiting.
Recognizing Signs of Severe Toxicity
Vomiting frequently serves as an early sign of dangerously high cocaine toxicity, indicating a medical emergency. Toxicity involves severe overstimulation of the body. One dangerous co-occurring issue is cardiovascular distress, presenting as severe chest pain, tachycardia (rapid and irregular heart rate), and high blood pressure.
Central nervous system complications are also common, including tremors, extreme confusion, and generalized seizure activity. The drug’s powerful stimulation can overwhelm the body’s ability to regulate its own temperature, resulting in severe hyperthermia. High body temperature can quickly lead to muscle breakdown, kidney failure, and widespread organ damage.
Persistent vomiting creates a significant risk of severe dehydration, which exacerbates cardiovascular and CNS issues. If the vomiting is accompanied by extreme abdominal tenderness, it can signify life-threatening gastrointestinal complications such as ischemic bowel injury or tissue death. Any combination of vomiting with these severe neurological or cardiovascular symptoms suggests a toxic reaction.
When to Seek Emergency Medical Help
Immediate medical intervention is necessary when vomiting is persistent, uncontrollable, or occurs alongside other severe symptoms. Call emergency services immediately if the person experiences chest pain, difficulty breathing, or irregular heart sensations, as these point toward a potential cardiac event.
Emergency help is also required for signs of serious central nervous system involvement, such as a seizure, loss of consciousness, or extreme confusion and agitation. The presence of blood in the vomit, or severe abdominal pain, indicates a potential internal injury requiring urgent surgical evaluation. While waiting for medical professionals, keep the person cool to manage rising body temperature and be forthcoming about the substance used.