Which physical sign is associated with cocaine use?

Dilated pupils are a well-documented physical sign associated with cocaine use. Cocaine is a powerful stimulant that affects the central nervous system and leads to increased levels of certain neurotransmitters, primarily norepinephrine and dopamine. When these neurotransmitters are heightened, one of the physiological responses is pupil dilation, which is known as mydriasis. Users may exhibit other signs as well, but dilated pupils remain one of the most recognized indicators that someone may be under the influence of cocaine.

Other options, such as decreased heart rate or being warm to the touch, do not typically relate to stimulant drug use like cocaine. In fact, stimulants usually increase heart rate and body temperature. Flattened affect refers to an emotional state where a person's expressions and emotional responses are very muted, which can relate to various conditions or substances but is not specifically linked to stimulant use like cocaine.