Most observers report athletic deterioration with the use of cocaine; there is no evidence of
its being a performance enhancer. Sometimes behavioral changes are observed with
athletes, who may show up for practice too early or too late, miss practice altogether, or
have altercations with their teammates. Feelings of grandiosity may distort the athlete’s
perception of actual performance. At normal room temperature, cocaine reduces the body’s
core temperature. At higher ambient temperatures, especially during exercise, cocaine
causes a rise in body temperature, so the athlete exercising in the heat may be susceptible
to hyperthermia. This may be related to cocaine-induced changes in the body’s
thermoregulatory set point and to a decrease in heat loss secondary to peripheral
vasoconstriction.