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Whilst there are no known direct interactions between cocaine and antibiotics, it’s important to note that cocaine use lowers the body’s immune response, and therefore its ability to combat infections.

When considering the reasons one may be prescribed antibiotic medication, it is, therefore, feasible to conclude that concurrent use of cocaine may limit or delay your recovery from the illness they are prescribed for.

There are a number of ways that cocaine can impact the effects of antibiotics on your recovery, for example, bacteria can enter the body more easily when there is damage to the respiratory system, which is often seen in frequent cocaine users.

Some of the more simple and desired effects of cocaine use, such as lack of sleep or reduced food intake, can also affect the body’s ability to heal from infections, as both sleep and satiation are required for optimum immune response.

In this article, we will take a deeper look at what cocaine is, how it affects the body and how it can affect antibiotics.

What is cocaine?

Cocaine is a highly addictive narcotic that is available in a variety of formats, but usually as a white powder known as cocaine hydrochloride.

Recreational use of cocaine is illegal in the UK, and most of the world, with a few exceptions in South America.

The other main forms of cocaine include freebase, which is treated to remove the hydrochloric salt, resulting in a more intense, and dangerous drug, and crack cocaine.

Crack cocaine often contains significant quantities of impure ingredients, such as baking soda, which are cut with the hydrochloride powder to bulk it out. It is also widely agreed to be the most highly addictive type of cocaine.

What are the risks associated with cocaine use?

Cocaine abuse is prolific on a worldwide scale, and the United Nations World Drug Report suggests that there are more than 20 million frequent cocaine users across the globe.

There are substantial risks involved in regular cocaine use, with cocaine being the most common drug (40.3%) that had resulted in in-hospital treatment in a 2011 US-based report.[1]

Risks include a wide range of physical and mental health issues, which can vary based on the frequency, amount and way in which cocaine is used.

Common physical side effects of cocaine use include heart conditions such as heart attack and stroke, with risks, increased for those with existing heart or blood pressure concerns.

Other physical effects are based largely on the form of cocaine used, for example, snorting cocaine can damage the cartilage in the nostrils, and the inhalation of smoke from crack cocaine can damage the respiratory system.

Injecting cocaine, much like other intravenous drugs, comes with risks of damage to the veins and infections such as gangrene, as well as the additional risks of HIV, when needles are shared.

Common mental health side-effects of cocaine use include depression, anxiety and paranoia.

These conditions can also be exacerbated if they were pre-existing, and it can cause previous mental health issues to re-emerge.

How do people become addicted to cocaine?

Cocaine is highly addictive as it has the ability to disrupt the dopamine neurotransmitters, which help the brain to recognise pleasure.

Dopamine is released when the body experiences any form of pleasure, such as sexual arousal, causing us to feel happiness or euphoria.

Usually, the dopamine is then reabsorbed, ready for release when the next pleasurable experience occurs.

Using cocaine blocks the reabsorption of dopamine, which means that greater euphoria is experienced than when we receive natural stimulants.

Once the substance has left the body, the brain impulsively wants to repeat the experience in order to balance out the extreme lows caused by the loss of dopamine.

Find out how long cocaine stays in your system.

How does long term cocaine use affect the brain?

With continued use of cocaine, the brain becomes dependent on the higher levels of dopamine created, which, in turn, can lead the brain to produce less dopamine.

As dependency grows, more cocaine will be needed to experience the same sensation of euphoria that was originally created.

The pattern of repeated cocaine use and subsequent reduction in dopamine can result in the brain’s reward function becoming completely reliant on cocaine to experience any form of pleasure.

This will leave long term users depressed and anxious when they are unable to use cocaine.

Is cocaine used medically?

It’s fairly rare to see cocaine prescribed, as a range of safer drugs are generally available, however, there are certain conditions whereby it is used in the US, for example, nasal surgery.

In the UK low doses of cocaine may still be used as a dental anaesthetic, with the UK actually exporting the largest quantity of legally produced cocaine in the world.[3]

How does cocaine use affect Antibiotics?

As cocaine and antibiotic medications work in completely different ways, there is no direct interaction between them, however, this does not mean that they should be used concurrently.

Along with the detrimental effects that cocaine can have on the body’s ability to fight infection, such as insomnia and low-calorie intake, dopamine is thought to contribute to the regulation of the body’s immunity.

As dopamine processing is interfered with when cocaine is used, this could also affect the body’s capacity to heal quickly and effectively.

It’s reasonable to assume that anyone that has been prescribed antibiotics is suffering from some form of infection.

It is therefore not recommended that cocaine is used whilst antibiotics are being used to treat that infection, as the lowered immune response will reduce their capacity to receive maximum benefits from them.

Cocaine use could also interfere with antibiotic use at a more basic level, by affecting your mental capacity to take them as prescribed by your doctor.

The significant physiological effects could easily lead to missed doses or failure to complete the course, which can delay recovery.

Use of low dose antibiotics to treat cocaine addiction

On the contrary, antibiotic use has shown some promise in the rehabilitation of cocaine addiction, with the specific category of beta-lactam antibiotics having the ability to normalise glutamate transmission in recent studies.

There is therefore ongoing research into the potential to use beta-lactam antibiotics in low doses to aid in treating cocaine addiction.

So far it has been shown to reduce the instance of relapse in those recovering from cocaine abuse, even after the antibiotic is no longer being administered to the patient.[2]

Side Effects of Mixing Cocaine and Antibiotics

If we set aside the risks that cocaine will reduce the effectiveness of antibiotics and can leave us more vulnerable to infection, there are no actual physical side effects that are experienced as a result of using cocaine and antibiotics, which would not be experienced if each drug was used individually.

With that being said, it is still of great importance that doctors are informed of cocaine use, especially if this is regular use, when antibiotics and any other drugs are prescribed.

Failing to inform medical professionals of recreational drug use can not only place you at risk from interactions between drugs, but can lead to misdiagnosis.

Cocaine and antibiotic use in those with kidney disease

For those with kidney disease, both antibiotic drugs and cocaine pose a higher risk than do those without this condition. This is because their kidneys are less able to process drugs than healthy kidneys.

Whilst antibiotics can still be prescribed, this would be with caution, and they would generally be prescribed lower quantities than other patients.

Cocaine use can cause kidney damage, which is especially important to consider if kidney disease is present.

It is, therefore, reasonable to assume that using both antibiotics and cocaine pose a higher threat of additional kidney damage in patients with kidney disease.

As antibiotics are required medically and prescribed with caution, it is very strongly recommended that people with kidney disease who are on antibiotics (or most other drugs, whether prescribed or recreational) do not also use cocaine.

How can I find help for cocaine abuse and addiction?

There are a range of physical and psychological treatments available for those struggling with cocaine abuse. Depending on the severity of the addiction, both residential or outpatient treatment may be recommended.

Psychological treatments usually focus on the adaptation of behaviours, with contingency management being a successful treatment for many struggling with cocaine use disorder (CUD).

As a rewards-based treatment, this is often a helpful mechanism in convincing patients to abstain from cocaine use.

Cognitive-behavioural therapy (CBT) is also used to treat CUD, and often helps with the prevention of relapse after sobriety has been reached.

It is often used alongside other treatments, as well as one to one care and support from a specialised psychotherapist who is experienced with drug rehabilitation.

Treatment will also vary based on the form of cocaine used, the length of the addiction, and whether any pre-existing conditions are present.

There are also aftercare services available in many communities, which operate to help those in recovery to maintain their sobriety.

Bodies such as Cocaine Anonymous and Narcotics Anonymous offer helpful ongoing support for those in recovery from cocaine abuse or addiction.







Boris is our editor-in-chief at Rehab 4 Addiction. Boris is an addiction expert with more than 20 years in the field.  His expertise covers a broad of topics relating to addiction, rehab and recovery. Boris is an addiction therapist and assists in the alcohol detox and rehab process. Boris has been featured on a variety of websites, including the BBC, Verywell Mind and Healthline.