Most cocaine users are episodic recreational use Legal Cocaine Ranger Shirt. However, about 25% (or more) meet the criteria for abuse or dependence. Use among adolescents has decreased recently. The possibility of a highly bioactive form such as crack cocaine has exacerbated the problem of cocaine addiction. Most cocaine in the US is about 45 to 60% pure; it can contain a lot of fillers, additives and impurities. Cocaine also blocks sodium channels, it is used as a local anesthetic. Cocaine causes vasodilation and can therefore affect almost any organ. Myocardial infarction, cerebral infarction and hemorrhage, aortic dissection, intestinal ischemia, and renal infarction are possible sequelae. Severe overdose causes acute psychotic syndrome (eg, schizophrenia-like symptoms), hypertension, hyperthermia, rhabdomyolysis, coagulopathy, renal failure, and convulsions. Patients may present with clinically marked toxicity, on a genetic basis, with decreased serum cholinesterase (atypical), an enzyme required for clearance of cocaine.