why take cocaine when you can get your doctor to prescribe Adderall to you
The best elites can dream of is pharmaceutical levels, but even the most pure illegal stuff comes from a production line that's isolated from the rule of law and from transparency and liability and also likely from actual professionals, so it's likely still more toxic than it needs to.
The real "advantage" of cocaine is mostly that the molecule has an inherently stronger euphoric effect, I would assume (I've never taken it), also making it a worse therapeutic if you want to actually do a better job vs just feel "high".