CocaineCocaine is a powerfully addictive drug of abuse. People who have tried cocaine have described the experience as a powerful high that gave them a feeling of supremacy. However, once a person begins using cocaine, it is impossible to predict or control the extent to which they will continue to use the drug. The main ways to use cocaine are snorting or snorting, injecting, and smoking (including freebase cocaine and crack). Health risks exist whether cocaine is inhaled (snorted), injected, or smoked. However, it appears that compulsive cocaine use can develop even more quickly if the substance is smoked rather than snorted. Smoking allows extremely high doses of cocaine to reach the brain very quickly and cause an intense and immediate high. People who inject drugs also run the risk of contracting or transmitting HIV/AIDS infection if they share needles or other injection equipment. Health risks • Physical effects. The physical effects of cocaine use include constriction of peripheral blood vessels, dilated pupils, and increased body temperature, heart rate, and blood pressure. Some cocaine users report feelings of restlessness, irritability, and anxiety, both during and between periods of use. An appreciable tolerance to the high can develop, and many addicts report that they crave but are unable to obtain as much pleasure as when first exposed. • Paranoia and aggression. High doses of cocaine and/or prolonged use can trigger paranoia. Smoking crack can produce particularly aggressive paranoid behavior in users. When addicted people stop using cocaine, they may become depressed. This depression causes users to continue using the drug to relieve their depression. • Long-term effects. Prolonged snorting of cocaine can lead to ulceration of the mucous membrane of the nose and damage the nasal septum enough to cause it to collapse..