![]() 7 Tolerance to cocaine reward and sensitization to cocaine toxicity can increase the risk of overdose in a regular user. 10, 18 At the same time, users can also develop sensitization, in which less cocaine is needed to produce anxiety, convulsions, or other toxic effects. With regular use, tolerance may develop so that higher doses, more frequent use of cocaine, or both are needed to produce the same level of pleasure and relief from withdrawal experienced initially. These combined effects make the user more likely to focus on seeking the drug instead of relationships, food, or other natural rewards. At the same time, circuits involved in stress become increasingly sensitive, leading to increased displeasure and negative moods when not taking the drug, which are signs of withdrawal. ![]() With repeated exposure to cocaine, the brain starts to adapt so that the reward pathway becomes less sensitive to natural reinforcers 10, 18 (see " What Are Some Ways that Cocaine Changes the Brain?").
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