Cocaine
Benzoylmethylecgonine
Coke, Blow, White, Snow, Crack
Cocaine is a tropane alkaloid stimulant derived from the leaves of coca plants native to South America.1 It has a long history of medical use as a topical anesthetic owing to its intrinsic vasoconstrictor properties2, though its high abuse potential3 has largely supplanted this role. Cocaine functions as a serotonin–norepinephrine–dopamine reuptake inhibitor1, producing euphoria and heightened alertness.1 It is notably cardiotoxic4 and carries a significant potential for compulsive redosing1 and addiction.1
Contents
Dosage & Duration
Dosage
Threshold~20 mg
Light20-50 mg
Moderate50-100 mg
Strong100-150 mg
Heavy150+ mg
Bioavailability
60-80%
Insufflation produces rapid onset of effects. Actual doses absorbed can vary considerably depending on the purity of the material.
Duration
Onset3-10 minutes
Come Up5-12 minutes
Peak15-40 minutes
Offset10-25 minutes
After Effects1-4 hours
Total60-90 minutes
Half-life
0.7-1.5 hours
Subjective Effects
Effects vary widely by individual, dose, and context.
Physical
The physical effects of cocaine can be broken down into several components which progressively intensify proportional to dosage.
Cognitive
The cognitive effects of cocaine can be broken down into several components which progressively intensify proportional to dosage. The general head space of cocaine is described by many as one of extreme mental stimulation, increased focus, and powerful euphoria. It contains a large number of typical stimulant cognitive effects. Although negative side effects are usually mild at low to moderate dosages, they become increasingly likely to manifest themselves with higher amounts or extended usage. This particularly holds true during the offset of the experience.
Reagent Testing
Loading reagent data
Expected colorimetric results are being prepared.
Pharmacology
Pharmacodynamics
Cocaine acts primarily as a serotonin-norepinephrine-dopamine reuptake inhibitor (SNDRI), blocking the dopamine, serotonin, and norepinephrine transporters to prevent monoamine reuptake into presynaptic neurons.1 In rat models, uptake inhibition potency is greatest for norepinephrine, followed by dopamine and then serotonin.5 Its action at the dopamine transporter, where it stabilizes the transporter in an outward-facing conformation, is considered most responsible for its reinforcing properties.6 Cocaine also reversibly binds to and inactivates voltage-gated sodium channels, producing local anesthetic effects, while its norepinephrine reuptake blockade results in vasoconstriction.1 Additional targets include the 5-HT3 receptor (as an antagonist), sigma-1 receptor (as an agonist), κ-opioid receptor, and muscarinic M1 and M2 acetylcholine receptors (as antagonists), while the 5-HT2A, 5-HT2B, and 5-HT2C receptors have also been implicated in its locomotor-activating effects.1
Pharmacokinetics
Cocaine is absorbed from all sites of application, including mucous membranes and gastrointestinal mucosa, with oral and intranasal bioavailability of approximately 60 to 80%.78 It has a short elimination half-life of 0.7 to 1.5 hours and is extensively metabolized by plasma esterases and liver cholinesterases, with only about 1% excreted unchanged in urine.17 The primary metabolite is benzoylecgonine.7 In the presence of alcohol, the additional active metabolite cocaethylene is formed.1
Dangerous
Highest riskThese combinations are considered extremely harmful and should always be avoided. Reactions to these drugs taken in combination are highly unpredictable and have a potential to cause death.
Unsafe
AvoidThere is considerable risk of physical harm when taking these combinations, they should be avoided where possible.
Caution
Use cautionThese combinations are not usually physically harmful, but may produce undesirable effects, such as physical discomfort or overstimulation. Extreme use may cause physical health issues. Synergistic effects may be unpredictable. Care should be taken when choosing to use this combination.
Tolerance
Full Tolerance
Tolerance to the euphoric effects of cocaine develops rapidly, potentially after even a single dose. The short duration of action encourages repeated dosing within a session, which accelerates tolerance development. Users often report diminishing returns with consecutive uses, requiring higher doses to achieve initial effects.
Cross Tolerance
Other stimulants (amphetamines, though cocaine may partially block amphetamine's dopaminergic effects)
Harm Potential
Addiction & Dependence
Psychological
HighCocaine has a high potential for psychological addiction and compulsive redosing. Its effect on dopamine levels is primarily responsible for its addictive properties.9 Craving can be triggered rapidly by environmental cues, situations, or memories associated with use.9 Tolerance can develop after a single dose, and repeated use frequently leads to addiction and prolonged craving.
Physical
ModeratePhysical dependence develops after even brief periods of regular use. Withdrawal symptoms include disrupted sleep, irritability, depression, fatigue, increased appetite, and reduced ability to experience pleasure.10 While uncomfortable, cocaine withdrawal is not life-threatening.11 Depressive withdrawal symptoms are associated with worse treatment outcomes and increased risk of relapse.10
Toxicity
Cardiovascular
Central Nervous System
Nasal and Respiratory
Chronic intranasal use causes progressive damage to nasal mucosa, septum, and surrounding structures; approximately 30% of regular users and 47% of daily users experience nasal irritation, crusting, and frequent nosebleeds.17 Severe cases progress to cocaine-induced midline destructive lesions with erosion of the palate and sinuses.18
Hepatic
Acute hepatotoxicity can occur with overdose, typically due to toxic metabolites; most cases resolve quickly but fatal outcomes from multiple organ dysfunction are possible.20
Renal
Renal impairment can occur as part of cocaine toxicity syndrome, particularly in overdose situations involving rhabdomyolysis and hyperthermia.21
Musculoskeletal
Rhabdomyolysis can occur with acute cocaine toxicity, particularly at high doses or during prolonged physical activity while intoxicated.22
Immune System
Chronic use is associated with general weakening of immune function. Levamisole-adulterated cocaine causes severe agranulocytosis in a subset of users, with skin necrosis affecting the ears, face, and extremities.23
Psychosis Risk
More than half of people who abuse cocaine report experiencing psychotic symptoms at some point.24 Typical symptoms include paranoid delusions of being followed or watched, accompanied by supporting hallucinations.24 Delusional parasitosis with formication, commonly called 'cocaine bugs,' is a fairly common symptom.25 Cocaine-induced psychosis shows sensitization, meaning psychosis becomes more severe with repeated intermittent use.24
Seizure Risk
Cocaine can cause convulsions and reduces seizure threshold.11 Seizures are more commonly associated with overdose situations and high doses but can occur with acute exposure.21 Overdose may cause seizures alongside abnormally high body temperature and marked blood pressure elevation.11
History & Culture
Traditional Use and Etymology
Coca chewing dates back at least 8,000 years in South America, making it one of the oldest known psychoactive plant practices.26 The leaves were integral to Andean civilizations including the ancient Wari and Inca cultures, where they served both stimulant and…
Legality
International
UN Single Convention on Narcotic Drugs 1961: scheduled
By Country
United StatesPrescription onlySchedule II
Classified as having high abuse potential with accepted medical uses.89 The 1970 Controlled Substances Act89 regulates manufacture, importation, possession, and distribution. Medical cocaine products remain available for topical anesthesia, including Goprelto (approved December 2017)90 and Numbrino (approved January 2020).90 Historical legislation includes the Harrison Narcotics Tax Act of 1914, which established licensing requirements, and the Jones-Miller Act of 1922, which imposed manufacturing restrictions. The Anti-Drug Abuse Act of 198691 created significant sentencing disparities between powder and crack cocaine.
By state
Across the 50 states, D.C., and the permanent territories, most jurisdictions treat cocaine consistently with federal law, though a number of states impose their own controls or classifications that diverge from the federal position.
CaliforniaRestrictedSchedule I/II
AustraliaSchedule 8 (Poisons Standard)Citation needed
Controlled drug requiring prescription for medical use. In Western Australia, the Misuse of Drugs Act 198132 specifies threshold quantities: 4.0 grams determines court of trial jurisdiction, 2.0 grams creates presumption of intent to supply, and 28.0 grams constitutes trafficking.
BoliviaCoca leaf legal; refined cocaine prohibitedCitation needed
Coca cultivation for traditional indigenous consumption is protected under the Bolivian Cato accord, which specifies allowable annual yields for farmers. Coca leaves may be chewed or consumed as tea. Production, distribution, and consumption of refined cocaine remain criminal offenses.
CanadaPrescription onlySchedule I
Controlled Drugs and Substances Act, S.C. 1996, c. 19; Narcotic Control Regulations, C.R.C., c. 1041383940
Cocaine hydrochloride pharmaceutical preparations are available for legitimate medical purposes.41 Topical solutions have been marketed since the 1990s for clinical applications. Recreational possession, production, and distribution remain prohibited.
ColombiaDecriminalizedDosis personal
Ley 599 de 2000, art. 376 (modificado por Ley 1453 de 2011, art. 11); Ley 30 de 1986, art. 2(j); Corte Constitucional, Sentencia C-491/124344454647
Since Sentencia C-491/12, Article 376 of the Penal Code does not criminalize carrying or keeping a personal dose of cocaine solely for one’s own consumption. Law 30 defines that dose as up to one gram of cocaine or a cocaine-based substance, including crack; any quantity held for distribution or sale is outside the definition. Unauthorized trafficking, manufacture, sale, supply, and possession for non-personal purposes remain criminal offences, while consumption may be restricted in specified public places under the Police Code.
FranceIllegalStupéfiant
Arrêté du 22 février 1990 fixant la liste des substances classées comme stupéfiants50
Cocaine is classified as a narcotic drug. The classification includes the listed narcotic substances and preparations, placing cocaine within France’s narcotic-control regime.
IndiaRestrictedCoca derivative
Narcotic Drugs and Psychotropic Substances Act, 1985 (Act No. 61), sections 2 and 853
The Act defines cocaine as a coca derivative, including its salts, and controls preparations containing more than 0.1 percent cocaine. It prohibits production, possession, sale, use, import, export, and related operations except for medical or scientific purposes authorised under the Act, rules, or a licence, permit, or authorisation.
IrelandIllegalControlled drug
Cocaine is a controlled drug under the Misuse of Drugs Act 1977. Possession is prohibited except as authorised by the Act or regulations made under it.
JapanRestrictedNarcotic
Japan lists cocaine and other ecgonine esters as narcotics under the Narcotics and Psychotropics Control Act. The official controlled-substances list categorises cocaine as a narcotic and controls its salts.
New ZealandIllegalClass A
Cocaine is a Class A controlled drug under Schedule 1 of the Misuse of Drugs Act 1975, except where contained in a Class C controlled drug. The Act classifies Class A drugs as posing a very high risk of harm.
PhilippinesIllegalSchedule I
Cocaine is listed in Schedule I of Republic Act No. 9165. The Act criminalises unauthorised possession and specifies penalties for cocaine or cocaine hydrochloride quantities.
RussiaRestrictedList II
Government Resolution No. 681 of 30 June 1998, List of Narcotic Drugs, Psychotropic Substances and their Precursors Subject to Control71
Cocaine and cocaine hydrochloride are in List II, the list for narcotic and psychotropic substances whose circulation is restricted and subject to control measures. The Russian government instrument treats their handling as controlled rather than unrestricted.
South KoreaRestrictedNarcotic drug
Narcotics Control Act, article 274
South Korea defines narcotic drugs to include all alkaloids extracted from coca leaves and prescribed chemically similar compounds. The definition also covers mixtures or concoctions containing those substances, subject to the stated exception for non-recoverable, non-dependence-causing mixtures.
TurkeyRestrictedControlled narcotic
Law No. 2313 on the Control of Narcotic Substances78
Law No. 2313 subjects coca leaf, crude cocaine, cocaine, ecgonine, tropacocaine, their salts, and preparations over the stated threshold to Ministry of Health supervision. Import requires permission and the requested amount must not exceed the country’s medical and scientific need.
ArgentinaIllegalAnnex I
Cocaine is listed as an estupefaciente in Annex I of the current decree issued under article 77 of the Criminal Code. Ley No. 23.737 criminalises unauthorised production, trafficking, and possession of estupefacientes, including possession for personal use.
BelgiumIllegalAnnexe I
Arrêté royal du 6 septembre 2017 réglementant les substances stupéfiantes et psychotropes, annexe I3334
Cocaine is regulated as a narcotic substance under the Royal Decree of 6 September 2017. Handling of scheduled substances is confined to the authorisations and controls established by that decree.
BrazilIllegalF1 proscribed
Cocaine is listed in List F1, the list of narcotic substances proscribed in Brazil. Unauthorised importation, production, sale, transport, supply, or possession of controlled drugs is subject to the criminal provisions of Lei No. 11.343/2006.
ChinaRestrictedNarcotic drug
Anti-Drug Law of the People’s Republic of China, article 242
Article 2 expressly includes cocaine in the statutory definition of narcotic drugs. Narcotic and psychotropic substances may be produced, traded, used, stored, and transported for medical, teaching, or research needs in accordance with law.
FinlandIllegalNarcotic drug
Cocaine is listed as a narcotic drug under Finland’s controlled-substances decree. The Narcotics Act requires authorisation for manufacture, import, export, and handling, with limited exemptions for specified low-concentration preparations.
GermanyPrescription onlyAnlage III
Cocaine is an Annex III narcotic that is marketable and prescribable. It may be prescribed only by medical, dental, or veterinary practitioners when its administration is medically justified.
IndonesiaIllegalGroup I
Indonesia’s Narcotics Law places cocaine in Group I. Group I narcotics are confined to limited scientific-development purposes rather than ordinary medical treatment, and unauthorised handling is a narcotics offence.
ItalyDecriminalizedTabella I
D.P.R. 9 ottobre 1990, n. 309, Tabella I and article 7559
Cocaine is included in Table I of Italy’s consolidated narcotics law. Personal use is addressed through the administrative sanctions procedure in article 75, while unauthorised production, sale, and trafficking remain criminal offences.
NetherlandsIllegalList I
Opiumwet, Lijst I62
Cocaine is listed in List I of the Opium Act. List I substances are subject to the Act’s prohibition regime, with narrowly regulated medical and scientific exceptions.
PeruDecriminalizedPosesión no punible
Código Penal (Decreto Legislativo N.º 635), arts. 296 and 299, as amended by Decreto Legislativo N.º 1592656667
Cocaine is listed as an estupefaciente in Lista IIA of the Ministry of Health’s controlled-substances catalogue. Article 299 makes possession for one’s own immediate consumption non-punishable up to 5 grams of cocaine paste or 2 grams of cocaine hydrochloride; the exception does not apply to possession of two or more drug types. Manufacture or trafficking that promotes, favours, or facilitates illegal drug consumption is punishable by 8 to 15 years’ imprisonment.
PolandIllegalI-N
Ustawa o przeciwdziałaniu narkomanii; current controlled-substances list70
Cocaine is a narcotic drug in group I-N. Its use is restricted to the purposes authorised by Poland’s drug-control law, and unauthorised possession is prohibited.
South AfricaPrescription onlySchedule 2 Part II
Cocaine is covered in Schedule 2 Part II through coca leaf and chemically equivalent salts, compounds, derivatives, and preparations, as well as ecgonine derivatives convertible to cocaine. Use, possession, and dealing are prohibited unless the statutory medical, prescription, professional, or other lawful-possession exceptions apply.
ThailandPrescription onlyCategory II
Thailand classifies cocaine as a Category II narcotic, an ordinary narcotic. Category II possession, import, and export require Ministry of Public Health permission, with medical use subject to the Thai FDA’s controlled-narcotic procedures.
United Arab EmiratesIllegalNarcotic Schedule I
Federal Decree-Law No. 30 of 2021 on Combating Narcotics and Psychotropic Substances, Schedule 179808182
Cocaine is listed in Schedule 1 to Federal Decree-Law No. 30 of 2021. The UAE’s official controlled-medicines list identifies cocaine as a prohibited Schedule I narcotic; the Decree-Law criminalises handling outside supervised and regulated medical or scientific activity.
References
Source Pages
Citations
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