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Cocaine, also known as benzoylmethylecgonine, and colloquially as coke, Cola, snow, blow, white, and many others, is a naturally-occurring stimulant substance of the tropane class. It is found as an alkaloid in the leaves of the coca plant, Erythroxylum coca. The name comes from coca and the alkaloid suffix -ine, forming cocaine.

Cocaine binds to the dopamine, serotonin, and norepinephrine transport proteins and inhibits the re-uptake of dopamine, serotonin, and norepinephrine into presynaptic neurons. This leads to an accumulation of the respective neurotransmitters in the synaptic cleft and may result in increased postsynaptic receptor activation. The mechanism of action through which cocaine exerts its local anesthetic effects is by binding to and blocking the voltage-gated sodium channels in the neuronal cell membrane. By stabilizing neuronal membranes, cocaine inhibits the initiation and conduction of nerve impulses and produces a reversible loss of sensation.

Cocaine is reported to be extremely energetic and stimulating in a fashion that is comparatively weaker than methamphetamine, but stronger than that of amphetamine, modafinil, caffeine, and methylphenidate. The particular style of stimulation which cocaine presents can be described as encouraged at low to moderate dosages but forced at higher dosages. This means that at certain dosages, it becomes difficult or impossible to keep still as jaw clenching, involuntarily bodily shakes and vibrations become present, resulting in extreme shaking of the entire body, unsteadiness of the hands, and a general lack of fine motor control. This effect is replaced with mild fatigue and general exhaustion during the offset of the experience.

Cocaine consistently raises one’s heart rate to abnormally high levels which can be potentially dangerous with prolonged or high dosages.

Occasional use of cocaine rarely causes permanent or severe trouble to the body and mind. In terms of neurotoxicity, as defined by the damage or death of cells in the brain in response to over-excitation or reactive oxidation caused by drugs, cocaine does not appear to exhibit these effects unlike certain other substances such as methamphetamine. Its extended use or abuse does, however, cause short-term down regulation of neurotransmitters.

The most potentially harmful physical effects of cocaine appear to be not neurological but cardiovascular. Severe cardiac adverse events, particularly sudden cardiac death, become a serious risk at high doses due to cocaine’s blocking effect on cardiac sodium channels. Moreover, long-term cocaine use may result in cocaine-related cardiomyopathy.

Regular cocaine insufflation, the most popular method of ingestion, can have extremely adverse effects on one’s nostrils, nose, and nasal cavities. These include a loss of the sense of smell, nosebleeds, difficulty swallowing, hoarseness, or a chronically runny nose.

It is strongly recommended that one use harm reduction practices when using this substance.