Rehab 4 Addiction

What is Cocaine?

Cocaine is a highly addictive and powerful psychoactive drug. It’s a stimulant that’s normally sold as a white power, which can be snorted or injected once diluted.

It originated from coca leaves and has been used for centuries since it originated in South America.1

The high can last from 15-30 minutes on average and will be felt quicker if smoked or injected. Yet with a rapid high comes a rapid crash, leading to repeated binge use.

The effects are commonly described as euphoric, increasing energy, and enhancing alertness and senses. However, the pleasurable effects are short-lived.

Restlessness, anxiety, and shaking are the most common side effects, paired with a feeling of depression once the rise in dopamine wears off.

Cocaine is metabolised mostly by the liver, whereby only 1% of it is urinated out. Cocaine can be sensed for days in urine after consumption.2

The Role of the Liver

The liver can be located in the top right section of your abdomen:3

  • On top of the stomach
  • On top of the right kidney
  • Beneath the diaphragm

It is cone-shaped, red/brown in colour, and should weigh around 3 pounds. The livers’ role is to regulate chemical levels in the blood.

There are more than 500 known functions of the liver, including the following:

  • Production of bile
  • Production of proteins for blood plasma
  • Production of cholesterol
  • Conversion of glucose into glycogen
  • Clearing of drugs and alcohol
  • Regulating blood clotting

The two sources of blood supply to the liver include both:

  1. Oxygenated blood from the hepatic artery
  2. Nutrient-rich blood from the hepatic portal vein

The liver processes blood that leaves the stomach and intestines. It excretes bile, helping carry waste away from the liver, much like the arteries carry blood away from the heart.

This blood is processed, metabolising the drugs into forms that become easier for the rest of the body to use and that are non-toxic.

When the liver breaks down these harmful substances, the created by-products are excreted into the bile or blood.

By-products of bile exit the body via faeces, and the blood by-products are filtered through the kidneys, leaving the body in the form of urine.

Does Cocaine Damage the Liver?

Many people who use, specifically cocaine, are aware of the dangerous side effects on vital organs.

This sometimes isn’t enough to prevent use, but hopefully, with more awareness, their using will be reduced or avoided altogether. 4

When it comes to the liver and cocaine, the damage starts when this vital organ is flooded with harmful toxins.

These organs are directly affected as they weren’t built to metabolize drugs or flush out harmful chemicals.

Long-term use leads to spikes in liver enzymes, impairing the livers’ ability to function and this has harmful effects on other processes occurring within the body.

Common effects of cocaine on liver functioning:

  • Inflammation of the liver, known as viral hepatitis
  • Low blood pressure, coined arterial hypotension
  • Renal failure – the kidney fails as the liver and kidneys work in sync
  • Rhabdomyolysis – the death of muscle fibres releases content into the blood
  • Liver failure

Further, cocaine is cut with additives such as drain cleaner in order for it to weigh more to aid financial gain.

Cocaine can also be cut with:

  • Fentanyl
  • Caffeine
  • Baking powder and laundry detergent
  • Amphetamines
  • Laxatives

These chemicals that are added to street cocaine amplify the toxicity levels of cocaine.

Moreover, cocaine cutting agents or additives are additional substances added to the drug during production to weigh more.5

Drug dealers often use chemicals including fentanyl, caffeine, amphetamine, laundry detergent, laxatives, and boric acid to make the drug weigh more to make more money from less product.

These additional chemicals amplify cocaine liver toxicity.

Acute Liver Failure

Fulminant hepatic failure, referred to as acute liver failure, can cause severe implications that can cause you to be hospitalised.

Many times this issue can be reversed through treatment, but on occasion, a liver transplant is the only answer.

Liver failure can happen in as little as 48 hours after ingesting too much cocaine.

Liver failure occurs when the liver fails to perform its usual functions such as the manufacturing of bile or removing harmful toxins.6


  • Jaundice (yellowing of skin and eyes)
  • Pain and swelling of the abdomen
  • Nausea and vomiting
  • Confusion and disorientation
  • Restlessness and lack of sleep
  • Tremors and shakes

The complications of acute liver failure:

  • Cerebral edema – this is excessive fluid in the brain, causing pressure build-up. This pressure can cause severe mental confusion and seizures.
  • Bleeding – The clotting factor of the liver fails, and this can cause bleeding in the gastrointestinal tract
  • Kidney failure – since the kidney and liver work concurrently.

Cirrhosis is the final stage of liver failure. Healthy tissue in the liver is replaced by scar tissue, preventing the liver from functioning.

The liver then becomes permanently damaged.

Drug-induced liver injury (DILI) can take months to improve, even once you’ve stopped using.7

Drug-induced liver injury can be classified as:8

  1. Predictable – dose-related and a result of direct toxicity from the drug
  2. Unpredictable – unexpected due to the pharmacological reaction of the drug

Whether your liver damage and injury is predicted or unpredicted, it is still a result of excessive drug use.

Your liver cannot metabolise harmful substances, let alone more than one mixed together.

The liver was not designed to excrete cocaine, but other substances your body doesn’t require.

The amount of strain put on the liver, and consequently the kidneys, can lead you to a kidney transplant.

Street drugs are, more often than not, cut with equally harmful substances.

Preventing these from entering your body can quite literally save your life. If you think you require help or treatment, don’t wait to call us.


  6. Lee W. M. (2013). Drug-induced acute liver failure. Clinics in liver disease, 17(4), 575–viii.
  7. Pugh, A., Barve, A., Falkner, K., Patel, M. and McClain, C., 2009. Drug-Induced Hepatotoxicity or Drug-Induced Liver Injury. Clinics in Liver Disease, 13(2), pp.277-294.
  8. Katarey, D., & Verma, S. (2016). Drug-induced liver injury. Clinical medicine (London, England), 16(Suppl 6), s104–s109.

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.