Question

which issue is related to long - term cocaine use?
mental alertness
paranoia
extreme happiness
sensitivity to light

Explanation:

Long - term cocaine use can lead to psychological issues. Cocaine affects the brain's neurotransmitter systems. Paranoia is a known psychological symptom associated with long - term cocaine use. Mental alertness is a short - term effect in some cases (but not a long - term issue related to negative consequences). Extreme happiness is more of a short - term "high" rather than a long - term issue. Sensitivity to light is not a typical long - term effect associated with cocaine use.

Answer:

paranoia