Cocaine & Adderall: Short and Long-Term Effects

Short and long term effects of cocaine and adderall abuse in adults

Cocaine and Adderall

Cocaine and Adderall are similar in that they are both stimulant drugs that speed up the central nervous system, but they also have a number of differences. 

Adderall is well-known prescription stimulant used to manage attention-deficit/hyperactivity disorder (ADHD). It might surprise some people to know that cocaine is also sometimes used for medical purposes. This is just one of the similarities between the two drugs.
Prescription Drug Categories

Both Adderall and cocaine are central nervous system (CNS) stimulants, which act on the brain to increase synaptic activity – that is, they both increase energy, focus, and a sense of wellbeing. They also can both cause euphoria. As a result, another similarity is that both are abused and long-term use can result in addiction. However, there are differences in how they affect the body, how long their effects last, and what long-term effects may result from use. Below is a discussion of some of the similarities and differences between these substances.


What Is Adderall?

According to the National Library of Medicine’s Medline Plus, Adderall is made a combination formula containing amphetamine and dextroamphetamine. As mentioned above, these two substances are both central nervous system stimulants that increase activity in the brain; the drug is usually prescribed to help people who have ADHD, improving their focus and concentration.

Another use of Adderall is for narcolepsy, a condition in which people are excessively sleepy and may fall asleep suddenly in inappropriate circumstances. By increasing brain activity, the drug can help prevent these “sleep attacks” from occurring.

How Does Adderall Work?

Adderall affects several different neurotransmitters in the brain. Neurotransmitters are chemicals in the brain responsible for communication between neurons. Adderall increases the levels of dopamine and norepinephrine in the brain; dopamine plays an important role in memory, reward, and pleasure, while norepinephrine leads to an increase in energy and attentiveness. Research also indicates that Adderall enhances the action of serotonin, which impacts a person’s mood, sleep, appetite, sexual desire, and social behavior. The surge in concentrations of these neurotransmitters are responsible for the effects people experience.

How Long Does Adderall Last?

Adderall has two forms – short-acting and long-acting formulations. However, when compared with cocaine, both forms produce effects that last significantly longer. The short-acting version of Adderall works for about 4-6 hours, while the long-acting version can last 8-12 hours. The extended-release formula, Adderall XR, results in a milder, less intense high than the immediate-acting.

Also, as a result of its longer action, both formulations of Adderall take longer than cocaine to be eliminated from the body. It can take up to three days, depending on the formulation, for Adderall to clear from a person’s system. This means that withdrawal symptoms will also potentially last longer.

Long-Term Adderall Abuse Effects

Using or abusing Adderall for the long-term can result in some serious health risks. These include:

  • Cardiovascular issues, including stroke, irregular heart beat, and heart attack.
  • Seizures.
  • Insomnia and fatigue.
  • Anxiety and paranoia.
  • Malnutrition and serious weight loss.
  • Aggressive or violent behavior.
  • Coma.
  • Intranasal effects, such as sinusitis, nose bleeds, and perforation of nasal septum.
  • Intravenous effects, such as track marks, hepatitis, and HIV.
  • Inhalation effects, such as coughing and bronchitis.
  • Depression and suicidal ideation.
  • Anhedonia, or inability to feel pleasure.

This last risk could possibly be the result of the fact that chronic Adderall use can damage or destroy dopamine-containing neurons and nerve endings, making it more difficult to feel pleasure. Conversely, some research also indicates that individuals who have higher rates of anhedonia are more sensitive to the subjective, rewarding effects of stimulants. This greater response to the pleasurable effects makes it more likely that these people will develop dependence and addiction.


What Is Cocaine?

Unlike Adderall, cocaine is not an amphetamine; it is a natural extract from the coca plant, found in South America. For centuries coca leaves were chewed to decrease hunger, increase energy, and relieve fatigue. In the 1880s, Albert Niemann began using the drug as a local anesthetic for throat, nose, and eye surgeries; cocaine also constricted blood vessels and limited bleeding during surgery. At first, its stimulant properties were considered safe; however, cocaine was soon shown to be extremely addictive.

Cocaine is still used medically as a local anesthetic. Otherwise, it is an illegal, Schedule II substance due to its high potential for abuse.

How Does Cocaine Work?

Cocaine also acts on dopamine, norepinephrine, and serotonin, like Adderall. Cocaine acts primarily on the dopaminergic system, meaning that it creates a much higher sense of pleasure or euphoria than Adderall. It blocks the reuptake of dopamine in the synaptic gap, thus increasing the levels of dopamine available to interact with receptors. Recent research also suggests that serotonin plays more of a role in cocaine’s effects and addictive potential than previously thought. It can increase serotonin levels around neuronal synapses by blocking the serotonin transporter, and can contribute to lasting changes in the brain. Cocaine’s effects on serotonin are suspected to contribute to the cyclical nature of addiction. Like Adderall, cocaine also blocks the reuptake of norepinephrine, leading to a buildup of the neurotransmitter and subsequent stimulatory effects, such as increased energy, focus, attention, and sociability.

The key is that cocaine’s main mechanism is the pleasure response. The intense euphoria caused by cocaine abuse is a major part of the draw of the drug and its addictive potential.
how long does snorting cocaine last

How Long Does Cocaine Last?

The high that results from cocaine use depends on how the drug is administered. According to the National Institute on Drug Abuse (NIDA), if cocaine is snorted, the high has a slower onset and may last 15 to 30 minutes; if it is injected or smoked, the onset of pleasurable effects is far more rapid but the high may only last 5 to 10 minutes.

Long-Term Effects of Cocaine Abuse

Long-term effects of cocaine are similar as those for Adderall, although some effects may be more likely due to cocaine often being used in binges. For example, repeat dosing in a short period of time can increase the risk of experiencing paranoia, panic attacks, irritability, and psychosis, which is characterized by hallucinations and delusions. Just like Adderall, the method of administration of cocaine impacts the long-term consequences of use. People who smoke crack may experience lung damage and exacerbation of asthma, while someone who snorts cocaine may experience nosebleeds, loss of sense of smell, problems swallowing, and perforated nasal septum. Individuals who inject cocaine are likely to have puncture marks on their extremities and have an increased risk of contracting infectious diseases, such as HIV and hepatitis. NIDA cautions that prolonged cocaine use can cause digestive issues, including abdominal pain and decay of of bowel tissue. Further, there have been reports of intracerebral hemorrhaging, or bleeding in the brain, as well as stroke, seizures, heart attacks, and possible development of Parkinson’s disease. Cognitive functioning may be impaired; people may struggle with memory, attention, impulse control, motor control, and decision-making.


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