Cocaine's short-term effects appear soon after a single dose and disappear within a few minutes or hours. Taken in small amounts (up to 100 mg), cocaine usually makes the user feel euphoric, energetic, talkative, and mentally alert - especially to the sensations of sight, sound, and touch. It can also temporarily dispel the need for food and sleep. Paradoxically, it can make some people feel contemplative, anxious, or even panic-stricken. Some people find that the drug helps them perform simple physical and intellectual tasks more quickly; others experience just the opposite effect.

Physical symptoms include accelerated heartbeat and breathing, and higher blood pressure and body temperature.

Large amounts (several hundred milligrams or more) intensify users' "high," but may also lead to bizarre, erratic, and violent behavior. These users may experience tremors, vertigo, muscle twitches, paranoia, or, with repeated doses, a toxic reaction closely resembling amphetamine poisoning.

Physical symptoms may include chest pain, nausea, blurred vision, fever, muscle spasms, convulsions, and coma. Death from a cocaine overdose can occur from convulsions, heart failure, or the depression of vital brain centres controlling respiration.

With repeated administration over time, users experience the drug's long-term effects. Euphoria is gradually displaced by restlessness, extreme excitability, insomnia, and paranoia - and eventually hallucinations and delusions.

While many of the physical effects of heavy continuous use are essentially the same as those of short-term use, the heavy user may also suffer from mood swings, paranoia, loss of interest in sex, weight loss, and insomnia.

Chronic cocaine snorting often causes stuffiness, runny nose, eczema around the nostrils, and a perforated nasal septum. Severe respiratory tract irritation has been noted in some heavy users of cocaine free base.
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