Cocaine, a stimulant derived from the Erythroxylon coca plant, has a long history of traditional use in South America, particularly through coca leaf chewing and tea consumption. While initially embraced in the nineteenth century for medicinal purposes, it is now classified as a Schedule II drug due to its high abuse potential and limited medical applications. Drug testing typically detects cocaine through its primary metabolite, benzoylecgonine (BE), found in urine. A true positive cocaine test may be attributed to herbal coca tea consumption. Even teas labeled as “decocainized” may contain enough residual cocaine to cause positive results. However, procaine and similar anesthetics such as lidocaine or benzocaine do not metabolize into benzoylecgonine and cannot trigger positive tests. Although trace amounts of cocaine may be found in paper currency notes, handling such notes should not cause a false positive test result. Similarly, passive inhalation of crack cocaine in real-world environments has been shown to produce only minimal systemic absorption. Only extreme occupational exposures, such as working in narcotics laboratories, have been linked to high urinary benzoylecgonine levels from unintentional contact.