Cocaine is an alkaloid ester that acts as a stimulant on the CNS (central nervous system). It works along similar pathways to the amphetamine group, acting on the catecholaminergic neurotransmitters (responsible for dopamine, serotonin and norepinephrine uptake).

Depending on strength and route of administration, levels of cocaine in blood will vary, but generally peak at around 400–700 μg/L. Its main metabolites are benzoylecgonine, ecgonine and ecgonine methyl ester, all of which are inactive but which can be detected in bodily fluids.

As well as its stimulant properties, cocaine is an effective local anaesthetic, and has been utilised in medical interventions and minor surgery. When used regularly or at high doses, cocaine can produce adverse reactions such as hypertension (high blood pressure) and tachycardia (increased heart rate), as well as neurological and motor skill/coordination problems.

Cocaine hydrochloride is the salt (base) form of the substance. For one of the freebase forms commonly referred to as ‘crack’ see here.