This chapter aims to enhance understanding of cocaine use disorder and its relationship with executive functions. It explores the cognitive heterogeneity exhibited by individuals with cocaine dependence, emphasizing the implications of dissociations among cognitive reserve, intellectual level, and executive functioning. The study identifies that cocaine use may be associated with global cognitive impairments in some cases, while in others, it manifests as more specific executive difficulties. The assessment involved neuropsychological evaluations of five individuals in a specialized treatment clinic who were abstinent for over 20 days. The evaluations included structured interviews and tests assessing various cognitive domains. The study underscores the importance of a comprehensive neuropsychological approach in evaluating and treating cocaine users, highlighting the need for detailed analyses of both executive functions and overall cognitive and behavioral functioning. The findings also suggest that future research should investigate the impact of comorbid conditions on cognitive profiles, consider both pre-morbid and current IQ, and explore executive function profiles across different substance use disorders. This integration of neuropsychological insights can inform preventive and therapeutic interventions and contribute to public policy development aimed at addressing the needs of individuals with cocaine use disorder.