Cocaine use causes the pupils in the eyes to dilate because of the drug's stimulant effects.  Look for widened pupils (the dark inner circle of the eye), even in well-lit rooms.  Dilated pupils may or may not be accompanied by red, bloodshot eyes. Because many users administer cocaine by snorting it through the nose, one of the telltale signs of cocaine use is nasal stress. Look for signs of:  runny noses  nosebleeds  damage to the inside of nostrils  difficulty swallowing  a decreased sense of smell  traces of white powder around the nostrils Because cocaine is a stimulant, one of the common physical symptoms of cocaine use is a rapid heartbeat. In some cases, this may lead to cardiac arrhythmias (irregular heartbeat), hypertension, and cardiac death.  A normal, healthy heart rate for most adults is between 60 and 100 beats per minute.  Note that heart rate can be affected by other factors not associated with drug use, including physical activity, air temperature, body position, emotional states, and even certain legal medications. For this reason, heart rate alone should not necessarily be considered a definitive sign of drug use. Another common method of administering cocaine is by smoking the drug, typically in the form of a solid "rock," called crack cocaine. Crack is formed by mixing powdered cocaine with water and baking soda. Signs of crack use include burned fingers or lips from lighting and smoking through a specialized device commonly called a crack pipe. Some users inject cocaine intravenously, using a syringe. This is done to experience immediate effects of the drug but comes with its own set of risks, including endocarditis (heart inflammation), cardiovascular disease, abscesses/infections, and an increased risk of overdose. Intravenous drug use also greatly increases the chances of transmitting a blood-borne disease like hepatitis and HIV. Signs of intravenous drug use include puncture marks (called "track marks"), most commonly seen in the arm, and possible skin infections or allergic reactions caused by additives mixed with cocaine. One method of administering cocaine is by orally swallowing the drug. This produces fewer external signs of drug use than smoking, snorting, or injecting the drug, but it has been known to cause severe gangrene in the bowels and gastrointestinal tract due to reduced blood flow and GI sensitivity to the drug. In cases of oral ingestion, the most visible signs will probably be the symptoms typical of stimulant use, including:  agitation  unusual excitement  hyperactivity  suppressed appetite  paranoia  delusions
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