Cocaine is an alkaloid drug compound that creates central nervous system stimulation. It is processed from an organic source, which is the cocoa leaf. In the initial processing a substance of crude cocaine is created which is called Bazooko. Further processing creates a powdery substance known as pure cocaine hydrochloride, or it can be further processed into a prefabricated rock form called crack cocaine. When it is processed into a prefabricated, freebased cocaine called crack, the term crack refers to the crackling sound made when the substance is smoked. Powder cocaine is a white, odorless crystalline powder and it is usually ingested by snorting it or tooting it up the nose. It can also be rubbed on any other mucous membrane. It can also be injected.

Cocaine is a central nervous system stimulant drug. It stimulates in part the region of the brain commonly referred to as the pleasure center. Users of cocaine or crack most commonly report feelings of euphoria, a sense of wellbeing, a feeling of happiness or elation. In short, it is a powerful mood elevator. Other experiences connected to the high are a feeling of increased energy and alertness, an improved sense of self and a loosening of inhibitions.

Signs of cocaine use that are commonly observable include the person being very talkative, laughing and smiling a great deal when under the influence of cocaine.

High doses of cocaine may cause rambling speech, headache, paranoid ideation, aggressive behavior, disturbances in attention and concentration, auditory hallucinations and tactile hallucinations often referred to as the "coke bug". Cocaine and alcohol are almost always used in combination with one another because the depressing effect of alcohol can help take someone down from a cocaine high if it is becoming too intense.

Signs of overdose can include confusion, a rise in body temperature, increased sweating, dehydration, and muscle cramping and seizure. Death has been reported from all forms of cocaine and all forms of cocaine ingestion. Death usually results from heart arrhythmia, heart attack or stroke. Cocaine does have deaths resulting from long time use as well as young, healthy people dying from first experiences with cocaine.

Even after one administration of cocaine, people tend to have a secondary impact that includes feeling depressed and lethargic due to the chemical impact of cocaine on the brain. Those with an underlying serious depression can also experience an increase in depression and possible suicidal ideation. With chronic users this can become very severe depression and be life threatening in nature. It is very common for chronic users to experience suicidal ideation particularly when they are without the drug.

Smoking crack cocaine damages the lungs and very quickly leads to shortness of breath and chronic cough.

People can become both psychologically and physically addicted to cocaine, and the addiction potential for crack cocaine is much higher due to the route of administration.