What substance is likely ingested by a patient presenting with mydriasis, paranoia, hallucinations, extreme aggression, and superhuman strength?

The correct answer is PCP (phencyclidine), which is known for causing significant alterations in perception and behavior. Patients under the influence of PCP often present with mydriasis (dilated pupils), paranoia, hallucinations, and extreme aggression. This dissociative anesthetic can lead to an altered state of consciousness where users may feel disconnected from their body and surroundings, producing symptoms such as hallucinations and severe agitation.

The physical effects of PCP can include increased strength and decreased sensitivity to pain, which may contribute to the “superhuman strength” described in the question. Users might act aggressively or engage in violent behavior, often because of the intense psychoactive effects or confusion that the drug induces.

In contrast, other substances listed have different primary effects. Cocaine is a stimulant that primarily causes euphoria and increased energy but is less associated with extreme aggression or significant hallucinations. Marijuana may induce altered perceptions or mood changes but typically does not lead to the aggression or hallucinations as described. Heroin, an opioid, is more likely to lead to sedation and respiratory depression rather than the agitation and aggressive behavior outlined in the question. Therefore, PCP is the substance that aligns most closely with the symptoms and behaviors observed in this scenario.