Cocaine does have a medical use. I work as an anesthesiologist and see a lot of Ear Nose and Throat cases. 4% cocaine is used as a local anesthetic that also cuts down on blood loss by constricting blood vessels in the nose. Cocaine could be replaced by lidocaine and epinephrine or phenylephrine, but the surgeons I work with seem to like it. Patients are under general anesthesia when cocaine is applied so they don't experience the "rush" and I can not see any effects in the recovery room after. Cocaine is a relatively toxic local anesthetic and surgeons know to use it in small amounts. It is hard to sterilize (heat destroys the molecule apparently) so there is no injectable version that I know of. It belongs in schedule 2 .