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Cocaine, also known as coke, is a strong stimulant most frequently used as a recreational drug.[10] It is commonly snorted, inhaled as smoke, or dissolved and injected into a vein.[9] Mental effects may include loss of contact with reality, an intense feeling of happiness, or agitation.[9] Physical symptoms may include a fast heart rate, sweating, and large pupils.[9] High doses can result in very high blood pressure or body temperature.[11] Effects begin within seconds to minutes of use and last between five and ninety minutes.[9] Cocaine has a small number of accepted medical uses such as numbing and decreasing bleeding during nasal surgery.[12]

Cocaine is addictive due to its effect on the reward pathway in the brain.[10] After a short period of use, there is a high risk that dependence will occur. Its use also increases the risk of stroke, myocardial infarction, lung problems in those who smoke it, blood infections, and sudden cardiac death. Cocaine sold on the street is commonly mixed with local anesthetics, cornstarch, quinine, or sugar, which can result in additional toxicity. Following repeated doses a person may have decreased ability to feel pleasure and be very physically tired.

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