The biological mechanisms of cocaine are quite complex.

It effects the dopamine, which can overstimulate the brains fright center, causing the paranoia. For example when the users think that everyone they see are the police. Catecholamines (epinephrine and norepinephrine) serotonin and acetylcholine increase confidence and energy and can cause a euphoric rush that seems extremely pleasurable. At best, using cocaine led to mood swings and depression. (Inaba & Cohen, 2007 p.105) For pregnant women using cocaine can cause miscarriages, stroke, placental separation, and sudden infant death syndrome due to raised blood pressure and blood vessel malformations are increased. (Inaba & Cohen, 2007 p.107) There are many unwanted psychological effects from using crack. They include paranoia, intense craving, a social behavior, attention problems, irritability, drug dreams, hyperexcitability, visual and auditory hallucinations, depression, cocaine psychosis, and certain problems such as high-risk sexual activity. (Inaba & Cohen, 2007 p. 112) A social risk of using crack is the devastation it causes a family. In the United States there are high rates of neglect, abandonment, and abuse of children by single and no parent families. Also, there are high rates of imprisonment and violet deaths from crimes related to crack use. (Inaba & Cohen, 2007 p. 113) Some of the other risks associated with the use of the upper class of substances are withdrawal, craving and relapse. The symptoms range from anhedonia, anergia, emotional depression, loss of motivation, anxiety, vivid and unpleasant dreams, insomnia, increased appetite, psychomotor agitation and an intense craving for the drug. The craving is generally what causes the recovering addict to relapse again and again. The biggest risk for a user is overdosing although most are not fatal. (Inaba & Cohen, 2007 p. 108) (302) Inaba, D. S. & Cohen, W. E. (2007) Uppers, Downers, All Arounders, (6th ed.). Medford, OR: CNS Publications.