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The Stimulating Neuroscience Behind Why Cocaine Might Make You Shit Your Pants

Does cocaine make you poop? And while we’re at it, let’s also examine why opiates make you constipated

Updated 5/31/2022

Don’t ask me how I know, but rumor has it, cocaine makes you have to poop. Some allege it’s caused by the simple fact that cocaine is an amphetamine and that speedy substances of any variety (including caffeine) can cause your digestive system to work a bit faster than usual. Another theory is that cocaine is cut with baby laxatives. Or maybe cocaine just makes you poop because you’re basically putting poison in your body, and pooping is a way to get rid of it?

But *Oprah voice* what is the truth?

Well, that’s difficult to pin down. To start with, cocaine is rarely ever just cocaine: According to a report published by the Drug Enforcement Agency in 2020, although cocaine purity continues to increase each year, as of 2016, the average brick of cocaine is 85.4 percent pure. In other words, your average gram is typically around 14.6 percent not cocaine. 

That 14.6 percent could be a number of things. According to The Recovery Village, an addiction resource site, “additives most commonly used for cutting cocaine include laxatives, caffeine, creatine and laundry detergent.”  Increasingly, it’s fentanyl — according to a 2019 DEA report, fentanyl-laced cocaine reports quintupled between 2015 and 2017 alone. The purpose of these ingredients isn’t to change the effect of the cocaine, but simply to dilute it for increased profit, as they all come in conveniently white, powdered forms. Any of those substances could make you poop for their own reasons, although laxatives would seem the most obvious culprit. For some, caffeine also induces the urge to head to the bathroom by causing contractions in your colon and intestinal muscles, but that’s not the case for everyone. 

At the same time, though, stimulants are thought to send your guts into Fast and Furious mode on their own. That’s because stimulants like amphetamines and nicotine impact your neurotransmitters — specifically, amphetamines affect serotonin, while nicotine affects acetylcholine. Both serotonin and acetylcholine are thought to impact gut motility, triggering your digestive system to kick into action. Considering that cocaine is itself a stimulant that impacts your serotonin neurotransmitters, perhaps cocaine makes you need to poop just because it’s cocaine. 

Opiates, meanwhile, have the opposite effect. While heroin has particularly low purity — 35 percent as of 2017, by the DEA’s estimate — prescription opiates like Vicodin or Oxycontin are not typically at risk of contamination. However, opiates block you up on their own for basically the same reason stimulates make you have to go: Opiates impact your neurotransmitters, but different ones, triggering the release of dopamine, which reduces gut motility. Thus, fentanyl and other opioids are more commonly associated with constipation, not diarrhea.

In conclusion: Maybe a speedball is the ideal solution for optimal gut function? Please don’t attempt to find out, and if you do, delete this article from your browser history first.