Rehab 4 Addiction

How Does Cocaine Affect Decision Making?

The regular use or one-off ingestion of cocaine can seriously affect decision making.

Using drugs skews brain chemicals and interrupts signals, tampering with our behaviour and characteristics.

The cycle of constant choice is binding for many; addicts believe they don’t have a ‘choice’ in their behaviour, when they are frequently making decisions for themselves.

Cocaine is a highly addictive stimulant, manipulating the psychology of the user and causing an imbalance in the brain.

This can affect decision making in a negative way; with higher impulses to take risks, disconcert for morality and the inability to learn from mistakes.

Rewiring Neuro-function

Rewiring how the brain works and the signals it sends can override certain decisions after just one use [1].

This is why maladaptive decision-making is a significant feature of cocaine dependant.

Numerous studies report [2]:

  • Deficits in anti-social decisions
  • Self-rewarding impulsivity decisions
  • Monetary gain over relationship decisions

Decisions for addicts seem to be egotistical; self-serving choices in order to satisfy their cravings or apparent needs.

This is evident when users are more likely to accept immediate smaller rewards for decisions rather than larger awards that may be delayed.

For example, if a cocaine addict was to gamble, they would take small immediate rewards and then play again with what they have, rather than holding out for a larger reward later on in the game.

Defective decision-making is manifested in a user’s ability to continue along a path of self-destructive and impulsive behaviour.

This shows that cocaine correlates with faulty decision making, with little planning.

This compromises the ability to self-reflect and could contribute to the development of a worse addiction.

PRO TIP: Learn how long cocaine stays in your system.


According to the Journal of Neuroscience [3], cocaine fills users with chaotic energy, modifying brain circuits.

The difficulty in recognising the effects of ‘bad’ decisions is inherently linked with an addicts ability to predict loss.

Addicts demonstrate destructive decision making. Regarding dopamine, neurons are able to absorb and expel excess dopamine when things go better than you expect them to.

The same works when events and activities fail to meet expectations, remaining the same when prediction equates outcome.

This would explain how your brain learns what to expect from a similar experience in the future.

Scientists believe that our capacity to learn relates to the ability to calculate risks.

For chronic users, they don’t experience a drop in dopamine when something goes worse than expected.

Their self-management of negative predication is heavily weakened, they struggle to feel significant differentiation between expected and unexpected losses.

The lack of ability to comprehend negative feedback explains why it becomes so difficult for addicts to see the positives of sobriety.

This means that they’re more likely to increase the amount and consistency of use – leading to dependency and bad habits.

Addiction and Risk-Taking

Drug-takers take constant high risks concerning:

  • The law
  • Morality
  • Family and private relationships

Users make riskier choices after 3 days of abstinence from cocaine[4].

Addicts have the inability to balance immediate consequences with future outcomes. This is a marker for individuals with substance use disorders.

Risk-taking for users is liked with impulsive behaviour. These actions may be:

  • Poorly conceived
  • Prematurely expressed
  • Risky
  • Inappropriate
  • Resulting in undesirable outcomes

Taking high risks is associated with users incapacity to foresee end results.

Risks can provide sudden satisfaction for goals not readily met by standard strategies or actions.

Dependency on cocaine will lead users to conform to any means possible to meet their goals, particularly addicts who have nothing left to lose.

With users unable to calculate predictions and expectations, their desires outweigh the likelihood of negative behavioural impact.

Cocaine addicts are more likely to value money and the likelihood of being high than the negative social impacts their decisions will result in.

A Study on Impulsivity

Barry Setlow is part of the department of psychology at Texas A&M University.

He examines the ‘relationship of cocaine and its effects on choices’, using and analysing rats’ behaviour[5].

This ‘reinforcer devaluation’ experiment assessed behaviour according to outcome representations[6].

In his experiments, the rats became addicts by choice, pressing a small lever to get high. They gave the rats a choice to make:

  • Small, immediate reward of food
  • Large, delayed reward of food

Setlow’s findings:

  • Behavioural changes regarding choice lasted more than a month after cocaine dose
  • There was a constant inability to use outcomes as a guide for behaviour
  • The rats responded to a change in stimulus rather than evaluating their actions

This means that the change in decisions, focusing on immediate reward after ingestion, can last for months.

Users do not consider the consequences of actions as a moral guide, but rather what will get them what they want the fastest[7].

Selfishness and egotistical behaviour make it easier to fall into addiction. Striving to satisfy personal needs can:

  • Hurt others
  • Ruin relationships
  • End in loneliness
  • Hinder future success

Moral Judgement – Emotional Imbalance

Drugs and alcohol commonly compromise our behaviour, clouding what is normally deemed ‘good’ and ‘bad’.

You are more likely to be rude to a stranger when intoxicated or under the influence of cocaine than if you were sober.

Why? Those with a history in drug abuse find difficulty in recognising emotions in other people. Brain scans show a decline in:

  • Neural activity in frontal lobes and limbic regions
  • The amygdala

Both areas of the brain are associated with emotion.

The reduced brain function, evident in cocaine users, highlights their inability to make complex decisions.

Emotion is crucial because:

  • They build inter-personal relationships
  • Understanding them helps resolve conflict
  • They aid communication and magnify people’s thoughts

Emotions are critical in our understanding of morality. Seeing emotional reactions in others enables us to understand the effect of our behaviour and actions.

We tend to behave more empathetically towards others if we understand that we have induced suffering[8].

Emotions direct a lot of moral choices, and it’s how many make moral judgements.

However, add the inability to understand emotions, with the inability to recognise the failure of expectations, addicts will make wrong choices repeatedly.

Vulnerability to Relapse

Using cocaine and becoming dependant impairs the ability to refrain from relapse[9].

With the failure to optimise decisions and outcomes, users don’t comprehend the ‘real-life’ causal implications that their risks and bad decisions establish.

With large and short-term gains insight, users fail to opt for positive decisions for narcissistic motives.

The denial of negative outcomes will leave users vulnerable to:

  • Overdose
  • Constant relapse
  • A lack of awareness

With skewed priorities, cocaine will enable users to perceive with a narrow mind.

Signs of impending relapse:

  • Cravings increase: it’s key not to interchange cravings with an increase intolerance. If you are desiring cocaine more often, you are at risk of relapse.
  • Romanticising use: When users refer to life before sobriety as ‘better’ or believe that their decisions ‘weren’t that bad’
  • Isolation: without immersing yourself in a standard daily routine, you can become bored or lonely. This will increase the attraction of cocaine use.
  • Changes in behaviour: stopping meetings or therapy and slipping into old habits is an early warning sign.

Does Cocaine Lead to Bad Decisions?

Cocaine use, or any drug use, prevents the brain from functioning normally.

This is the main attraction for most users, but it’s a common misconception of reality.

Cocaine creates a neuro-imbalance:

  • Inability to understand emotions
  • The incapability of managing expectations
  • Likelihood to gamble – high-risk-taking
  • Increase in self-destructive and impulsive behaviour
  • Vulnerable to relapse

If you believe you are struggling with a cocaine habit or dependency, we can help.

By calling 0800 140 4690, we can offer you the treatment and rehabilitation you need to prevent negative decision making.

Call now for a free consultation, the sooner you call, the sooner we can help.


  1. Stout, J.C., Busemeyer, J.R., Lin, A. et al.Cognitive modelling analysis of decision-making processes in cocaine abusers. Psychonomic Bulletin & Review 11, 742–747 (2004).
  2. Hulka, L., Eisenegger, C., Preller, K., Vonmoos, M., Jenni, D., Bendrick, K., . . . Quednow, B. (2014). Altered social and non-social decision-making in recreational and dependent cocaine users. Psychological Medicine,44(5), 1015-1028. doi:10.1017/S0033291713001839
  6. Geoffrey Schoenbaum, Barry Setlow, Cocaine Makes Actions Insensitive to Outcomes but not Extinction: Implications for Altered Orbitofrontal–Amygdalar Function, Cerebral Cortex, Volume 15, Issue 8, August 2005, Pages 1162–1169,



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.