Cocaine (benzoylmethylecgonine) is a naturally occurring alkaloid obtained from the leaves of Erythroxylon cocca, trees that are indigenous to Peru, Columbia and Bolivia.  The natives of the South American Andes have used cocaine for at least 5000 years, and have a word for the distance an Indian can walk while under the<unk>  of one coca leaf.  Alfred Neiman isolated cocaine from the plant in 1860, and since that time it has been a drug of choice for many, including the Coca Cola company (~1888 - 1914).  In 1884 Sigmund Freud advocated its use for the relief of depression and chronic fatigue, describing it as a ‘magical drug’.  He even wrote the ‘Song of Praise’ to cocaine.  Unfortunately, he later discovered tolerance, dependency and withdrawal depression.
Cocaine is usually snorted as a hydrochloride salt, but it may be smoked as the ‘free base’ or ‘crack’ after alkalinizing the salt and extracting the base with nonpolar solvents such as ether. Crack pops when heated (hence the name), is not water-soluble, melts, but does not decompose when heated, and vaporizes at higher temperatures, thus allowing it to be smoked. The free base can be injected IV, and is often combined with heroin to form a ‘speedball’. It is often cut (mixed) with other agents that increase is bulk (mannitol and lactulose), mimic its stimulant properties (caffeine) or its local anesthetic<unk>  (procaine, lidocaine) in order to increase its selling price.
It is currently considered one of the most commonly abused illicit drugs, with approximately one of every three American males and one of every 5 American females trying it at least once. Approximately 5-10% of all emergency department visits are thought to be related to cocaine use.
Cardiovascular effects of cocaine
Opioid withdrawal
Cocaine withdrawal
Opiate withdrawal
Tricyclic antidepressant overdose
Alcohol withdrawal
Marijuana intoxication
Serotonin syndrome