Cocaine is a potent central nervous system stimulant that rapidly increases heart rate and blood pressure. While the drug is widely known for its impact on the cardiovascular and neurological systems, it also affects the gastrointestinal (GI) tract. Understanding this connection requires examining how the drug’s stimulatory properties translate into digestive system distress.
The Direct Answer Cocaine and Nausea
Nausea and vomiting are commonly reported acute side effects following cocaine use. These symptoms are a direct response to the drug’s overall toxicity and its powerful stimulating effect on the body’s central regulatory centers. The body attempts to expel the foreign substance as a protective mechanism when overwhelmed by the stimulant’s presence in the bloodstream.
This acute GI discomfort typically manifests shortly after the substance is consumed, sometimes within an hour. Nausea and vomiting can also be signs of a more serious, potentially life-threatening event, such as an overdose. The presence of nausea serves as a clear indication that the body is experiencing a toxic reaction.
Physiological Mechanisms Behind Gastrointestinal Distress
One primary cause of nausea is the drug’s interaction with the brain’s internal monitoring system for toxins. Cocaine stimulates the release of neurotransmitters, particularly dopamine and serotonin, which then circulate in the blood. These chemicals can activate the chemoreceptor trigger zone (CTZ), an area of the brainstem that lies outside the protective blood-brain barrier.
The CTZ is responsible for detecting emetic substances in the bloodstream and signaling the nearby vomiting center to initiate the physical reflex. The surge of stimulating chemicals directly triggers this protective mechanism, leading to the sensation of nausea and subsequent vomiting. This is a rapid-onset effect related to the drug’s systemic presence.
Another mechanism involves the drug’s peripheral effects on blood flow. Cocaine causes systemic vasoconstriction, which is the narrowing of blood vessels. This narrowing significantly reduces blood flow to the digestive organs, a circulatory area known as the splanchnic circulation.
The gut requires a steady supply of oxygenated blood to function properly, and a sudden reduction causes acute distress and pain. This lack of adequate blood flow, or hypoperfusion, can cause the abdominal pain and discomfort often experienced by users, separate from central nervous system-driven nausea. Cocaine achieves this by blocking the reuptake of norepinephrine in the peripheral nervous system, which over-stimulates alpha-adrenergic receptors on blood vessel walls.
Other Severe Digestive System Complications
When vasoconstriction in the splanchnic circulation is prolonged or severe, the lack of oxygen delivery can lead to serious tissue damage. This condition is known as bowel ischemia, where reduced oxygen supply results in injury to the intestinal tissue. The intestinal walls can become congested and hemorrhagic as the tissue begins to die.
Specific conditions resulting from this vascular damage include Ischemic Colitis, which affects the large intestine, and Mesenteric Ischemia, which impacts the blood vessels supplying the small and large bowel. These diagnoses represent life-threatening medical emergencies distinct from simple GI discomfort. Abdominal pain associated with bloody stools is a characteristic symptom.
The ultimate consequence of severe ischemia is tissue death, or necrosis, which can affect the intestinal lining or the entire thickness of the bowel wall. Necrotic tissue is structurally compromised and may lead to bowel perforation, where a hole forms in the intestinal wall. Perforation allows intestinal contents to leak into the abdominal cavity, causing peritonitis and requiring immediate surgical intervention.
Compounding Factors and Purity
The purity of the substance and the presence of cutting agents can significantly worsen cocaine’s GI effects. Illicit cocaine is frequently adulterated with various compounds that are inherently toxic or irritating to the digestive tract. These cutting agents, or bulking agents, are added to increase the product’s volume and profit margin.
Levamisole, a veterinary anti-worming medication, is a common adulterant found in street cocaine and can cause adverse health effects. While known for causing immune system suppression and vasculitis, its presence can compound the drug’s overall toxicity, contributing to GI distress. Other substances, such as laxatives or residual chemicals from the manufacturing process, can directly irritate the stomach lining when consumed.
The route of administration also influences the severity of GI symptoms. While snorting or injecting the drug still causes systemic effects, oral ingestion exposes the entire digestive tract to the substance and its irritants directly. A dangerous situation occurs in cases of body packing, where the drug is swallowed in poorly wrapped packages. If these packages rupture, they release a toxic dose directly into the GI tract, causing severe irritation and overwhelming systemic toxicity.