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Cocaine and Beta Blockers

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Beta-blockers are one of the most commonly prescribed medications in the United States. In fact, approximately 30 million Americans use beta-blockers. Beta-blockers are often prescribed to treat diseases related to the heart and circulatory system. They primarily work by slowing down the heart. In addition to heart conditions, they also help treat anxiety and stabilize blood pressure. Popular beta-blockers include atenolol, bisoprolol, and propranolol.

Unfortunately, cocaine is also a popular drug of choice. 5.2 million people aged 12 and older reported using cocaine in the past 12 months. Guardian Recovery will examine cocaine and beta-blockers, the side effects of taking cocaine and beta-blockers, and how to seek treatment.

If you or someone you love has a cocaine use disorder, Guardian Recovery is available to help. We are dedicated to providing the most comprehensive and individualized medically monitored detox program. To learn more about our programs, contact us today.

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Can You Use Beta-Blockers While Using Cocaine?

Cocaine reduces beta-blockers effectiveness because it does the opposite of what a beta-blocker does. For example, suppose a person uses a beta-blocker to slow the heart rate or lower blood pressure. In that case, cocaine increases those effects, limiting the protective factors for why a person needs this medication.

In addition to cocaine decreasing beta-blockers effectiveness, some dangerous side effects can occur when combining both drugs. Adverse reactions include worsening constriction of blood vessels in the heart and high blood pressure. The results of these reactions have an increased risk of heart attack, difficulty breathing, chest pain, confusion, or severe headache.

However, cocaine use can trigger chest pain or a heart attack if there is a precursor to cardiovascular disease. There is debate about whether doctors should prescribe beta-blockers if a person is using cocaine. Given the evidence supporting the benefits of beta-blockers and reducing mortality with heart disease, research supports prescribing beta-blockers if a person is also using cocaine. However, one should always consult a medical professional if starting a new medication and discuss the pros and cons of how each medicine may interact with other substances.

What Are Beta-Blockers (Propranolol)?

Propranolol is a beta-blocker used primarily to treat heart problems, reduce anxiety symptoms, and prevent migraines. It slows down the heart, which reduces the physical signs of anxiety.

Propranolol has been found to treat the withdrawal effects of early cocaine abstinence. However, there was a discrepancy between propranolol and the severity of cocaine use. It was found to be more helpful for individuals with severe cocaine dependency by reducing early withdrawal symptoms.

However, cocaine and propranolol again have an unclear relationship.

Beta-blockers specifically stop the impact of adrenaline. They open up blood vessels, slow the heartbeat, and lower blood pressure. Beta-blockers are widely prescribed to treat heart issues or high blood pressure, the people most at risk of a heart attack.

Not only does cocaine impair the benefits of beta-blockers, but the combination can also lead to a dangerous effect. During cocaine intoxication, beta-blockers have the potential to constrict blood vessels in the heart. This constriction leads to less oxygen in the heart muscles and increased blood pressure.

Beta-blockers can have the opposite effect of what was intended when combined with cocaine.

Cocaine use makes beta-blockers less effective, and beta blockers may add stress to the heart when it interacts with cocaine’s effects.

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Effects of Cocaine on Beta-Blockers

There have been discrepancies among the medical community on whether beta-blockers should be used when cocaine use is also used among patients. It appears people are strongly divided as some report that the risks of heart attack are more severe than the adverse risks of combining beta-blockers and cocaine. Secondly, the concern about how cocaine creates increased stress on the heart with constriction of blood vessels in the heart makes people believe beta-blockers should never be used when chest pain and cocaine use is disclosed.

According to a research study compiling 12 individual studies regarding cocaine and beta-blockers, due to the risks associated with cocaine and beta-blockers, the bottom line is that beta-blockers should not be used to treat cocaine-induced chest pain.

Dangers of Taking Beta-Blockers While Using Cocaine

As mentioned, the primary danger of taking beta-blockers while using cocaine is the contraindication of coronary vasospasm, which is the constriction of coronary arteries. According to the Journal of American Medical Association, it does specify that this contraindication has only been found with the beta-blocker propranolol, and no extensive clinical studies reviewed the systemic beta-blockers with cocaine-induced chest pain.

Cocaine & The Cardiovascular System

Cocaine impacts the cardiovascular system by speeding things up. It increases heart rate and blood pressure, constricts blood vessels and chest pain, and puts overall stress on the heart leading to increased heart damage.

The damage that cocaine does to the heart and blood vessels increases the risk of heart attack and stroke. High blood pressure, coronary heart disease, and similar risk factors increase a person’s heart attack and stroke risk.

Cocaine also blocks sodium and potassium levels, which affects heart function. In this way, it may damage the heart over time, increasing the likelihood of a heart attack.

2018 study suggests that cocaine may also increase the risk of a heart attack in young people who are generally at low risk. The study reported 2,097 people under the age of 50 years who had had a heart attack.

Interactions of Cocaine & Beta-Blockers

The primary interaction of cocaine and beta-blockers includes the constriction of vessels found in the heart, increased stress put on the cardiovascular system, and increased blood pressure can lead to oxygen restriction, chest pain, or severe headache.

Side Effects of Mixing Cocaine & Beta-Blockers

Side effects of mixing cocaine and beta-blockers include Increased risk of heart attack, stroke, high blood pressure, chest pain, trouble breathing, severe headache, and in extreme cases, death.

Constriction of Blood Vessels in the Heart (Vasospasms)

Constriction of blood vessels in the heart, also known as vasospasms, is a common adverse effect that occurs when cocaine and beta-blockers are combined. This is mainly found to happen in the common beta-blocker propranolol.

Increases in Blood Pressure

Although beta-blockers individually treat and lower high blood pressure, beta-blockers can not prevent the adverse effects of cocaine when combined. Additionally, the combination of beta-blockers and cocaine increases blood pressure, which puts a person with coronary heart disease at significant risk for heart attack or stroke.

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At Guardian Recovery, we remain dedicated to providing our clients with a comprehensive program of cocaine detox — one that focuses on much more than physical stabilization. In addition to emphasizing physical recovery, we tackle mental, emotional, and spiritual well-being. While we prioritize a safe and pain-free cocaine withdrawal, we offer individualgroup, and family therapy sessions, case management services, relapse prevention training, and aftercare planning.

Contact us today if you or your loved one is ready to begin an entirely new way of life and commit to long-term recovery. As soon as you call, we start developing a plan of action that begins with an initial pre-assessment. This assessment helps us determine which level of care is the most appropriate for each unique case. We identify potential coverage options if our medically monitored detox program is a good fit. We work closely with most major regional and national insurance providers. Contact us today for a free, no-obligation insurance benefit check.

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Disclaimer: Does not guarantee specific treatment outcomes, as individual results may vary. Our services are not a substitute for professional medical advice or diagnosis; please consult a qualified healthcare provider for such matters.

  1. https://www.nhs.uk/conditions/beta-blockers/
  2. https://nida.nih.gov/publications/research-reports/cocaine/what-scope-cocaine-use-in-united-states
  3. https://jdc.jefferson.edu/cgi/viewcontent.cgi?article=1189&context=tmf
  4. https://pubmed.ncbi.nlm.nih.gov/11297832/#:~:text=Propranolol%20may%20reduce%20symptoms%20of,abstinence%20and%20improve%20treatment%20outcome.
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564096/
  6. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/415957#:~:text=Previous%20studies%20suggest%20that%20%CE%B2,unopposed%E2%80%9D%20%CE%B1%2Dadrenergic%20stimulation.&text=Recommendations%20against%20%CE%B2%2Dblockers%20in,introduced%20into%20recent%20cardiology%20guidelines.
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6387265/
  8. https://www.acc.org/latest-in-cardiology/journal-scans/2018/05/30/13/38/cocaine-and-marijuana-use-among-young-adults

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Reviewed professionally for accuracy by:

Ryan Soave

L.M.H.C.

Ryan Soave brings deep experience as a Licensed Mental Health Counselor, certified trauma therapist, program developer, and research consultant for Huberman Lab at Stanford University Department of Neurobiology. Post-graduation from Wake Forest University, Ryan quickly discovered his acumen for the business world. After almost a decade of successful entrepreneurship and world traveling, he encountered a wave of personal and spiritual challenges; he felt a calling for something more. Ryan returned to school and completed his Master’s Degree in Mental Health Counseling. When he started working with those suffering from addiction and PTSD, he found his passion. He has never looked back.

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Cayla Clark

Cayla Clark grew up in Santa Barbara, CA and graduated from UCLA with a degree in playwriting. Since then she has been writing on addiction recovery and psychology full-time, and has found a home as part of the Guardian Recovery team.

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The information provided on this website is intended solely for educational and informational purposes. Guardian Recovery aims to improve the quality of life for individuals struggling with substance use or mental health disorders by offering fact-based content about behavioral health conditions, treatment options, and related outcomes. However, this information should not be considered a substitute for professional medical advice, diagnosis, or treatment.

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