Cocaine users may take many doses to maintain the high, which can cause anxiety, paranoia and a tolerance for the drug, meaning that larger doses have to be taken to achieve a similar high. Although not addictive in the same way as heroin or opiates, users can become psychologically dependent on the transient high which cocaine provides and find that they suffer anxiety, depression or severe tiredness if they stop using the drug.
Longer-term use of both cocaine and crack can cause severe anxiety, clinical depression, psychotic episodes, aggression, weight loss and malnutrition. Both drugs have also been shown to cause potentially fatal heart problems including heart attack, angina, irregular heartbeat, and inflammation and enlargement of the heart.