What Is Medical Cocaine?

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Cocaine (cocaine hydrochloride) is a drug most often found illicitly, but it is, in fact, approved for some medical uses in the United States. It’s been used since its inception for both medical and recreational purposes. (1) Cocaine is not legal for use outside of clinical environments, and using it for any purposes other than those approved by a health provider is considered misuse. Cocaine is not available by prescription and should be “applied only by or under the immediate supervision of your doctor.” (2)

If you are struggling with illicit cocaine misuse for recreational purposes, you may have a substance use disorder. Guardian Recovery is a specialized addiction treatment center committed to helping those dependent on drugs and alcohol to break free from addiction and work to achieve long-lasting sobriety. Contact us today to learn more about how we’ll help get you started on your recovery journey.

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How Is Cocaine Used in Medicine & Treatment?

Due to its high potential for misuse and addiction, cocaine’s medical use has been largely discontinued. It may sometimes be administered by health professionals such as doctors and anesthesiologists before surgeries involving the ear, nose, and throat. However, other local anesthetics are used much more frequently.

How Is It Used as a Local Anesthetic for Surgery?

Cocaine is used occasionally as a local anesthetic in ear, nose, and throat otolaryngology (ENT) surgical procedures, as it effectively numbs the mucous membranes in these areas. (3) It is used in procedures such as septoplasty (surgery to correct a deviated septum), which is done to relieve breathing difficulties, and tonsillectomy and adenoidectomy (tonsil and adenoid removal). It is never prescribed for home use following these surgeries.

How Is Medical Cocaine Administered?

The most common way of administering cocaine in medical procedures is by applying it using a cotton swab, dropper, or spray bottle. The solution is usually combined with a vasoconstrictor (e.g., adrenaline) to help minimize bleeding during surgery.

Is Medical Cocaine Different From Illicit Cocaine?

Even though it is highly regulated in the country, cocaine remains a prevalent drug of misuse. The chemical makeup of medical cocaine and illicit, unadulterated cocaine is the same. Both are derived from the coca plant and have the same active ingredient, cocaine hydrochloride. The difference between the two is mainly in how they are administered and the context in which they are used.

As noted, medical cocaine is only used in a controlled clinical setting, and illicit cocaine is obtained and used illegally, primarily for recreational purposes. It can be ingested in various forms, such as snorting, smoking, or injection, but never in these ways under medical supervision. Finally, cocaine found on the street is most often adulterated with other drugs or chemicals, whereas medical cocaine is free of contaminants. (4)

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Is There a Chance of Physical Dependence?

If used repeatedly, medical cocaine has the same potential for dependence as when used illicitly for recreational purposes. However, it is rarely administered and would not expect to be done so repeatedly on one patient. In other words, it would be unusual for a health professional to use cocaine on a patient for surgery more than once in any given period.

Can Medical Cocaine Cause Health Issues?

Side effects, risks, and complications have been linked to medical cocaine use. It can cause short-term side effects, but long-term consequences are unlikely because it is not commonly used.

Short-Term Side Effects of Medical Cocaine May Include:

  • Headaches.
  • Anxiety.
  • Agitation.
  • Increased heart rate and blood pressure.
  • Nausea and vomiting.
  • Insomnia.
  • Seizures.

Problems With Patient Sensitivity

Patients with specific medical conditions or who are taking certain medications may be more sensitive to medical cocaine’s effects:

  • Just like recreational users, patients with heart disease or high blood pressure may be at an increased risk of cardiovascular complications after exposure to medical cocaine, as its stimulating properties increase heart rate and blood pressure. (5)
  • Patients with a history of seizures may be at an increased risk of having an episode after being administered medical cocaine, as it can lessen the seizure threshold. (6)
  • Patients taking certain antidepressants, such as monoamine oxidase inhibitors (MAOIs), may be at an increased risk of side effects during medical cocaine use, as it can interact with these medications.

Problems With Rapid Absorption

Medical cocaine is rapidly absorbed when applied topically to mucous membranes, such as the nose, throat, or ears. It begins to work within minutes of application. However, rapid absorption also means the drug’s effects can be felt quickly, increasing the potential for misuse and addiction. This is why it is primarily used as a local anesthetic in specific procedures.

Treatment for Cocaine Hydrochloride Poisoning

Cocaine hydrochloride overdose (whether used medically or recreationally) involves supportive care and symptom management. The main priority is stabilizing the individual’s vital signs and addressing any immediate life-threatening complications.

Commonly Used Treatments for Cocaine Overdose Include:

  • Oxygen therapy to support breathing and prevent hypoxia (lack of oxygen to the brain). (7)
  • IV fluids for proper hydration and to maintain blood pressure.
  • Cardiac monitoring to assess for cardiac problems such as heart arrhythmia.
  • Management of any other symptoms as they emerge.
  • Medications to control seizures and reduce agitation.

Medications Used to Treat Cocaine Overdose Include:

  • Benzodiazepines, to control seizures and reduce agitation.
  • Sodium bicarbonate, to counteract the effects of cocaine on the heart and blood vessels.
  • Narcan (naloxone), in cases involving heroin or other opioids in addiction to cocaine.

If you suspect someone is having an overdose of cocaine or another substance, seeking immediate medical attention is vital to prevent permanent bodily damage and death.

Alternatives to Cocaine in Medicine

In most instances, cocaine is not the go-to topical numbing agent used for ENT surgery. Instead, other safer and more effective local anesthetics are more commonly used for surgical procedures, including the following:

Many alternatives to cocaine are commonly used in medicine as local anesthetics, including lidocaine, prilocaine, mepivacaine, and bupivacaine. These are similar to cocaine in their mechanism of action but are considered to be much safer.

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Contact Us for Help With Cocaine Dependence

Medical cocaine, although chemically identical to cocaine found on the streets, is rarely used and only for topical administration under a doctor’s supervision. Although dependence on medically-administered cocaine is unlikely, it’s not impossible. Cocaine dependence most often results from repeated recreational or excessive use and is a common cause of multiple health problems that may be life-threatening, long-lasting, or permanent.

In either case, cocaine misuse and dependence are not conditions to be taken lightly. Those struggling to end their habit are urged to seek professional treatment to help them overcome their dependence and find better ways to cope with their lives without using substances such as cocaine. Contact Guardian Recovery today for a free, no-obligation assessment and health insurance benefits check, and learn more about our streamlined admission process.

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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.

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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.

Written by:

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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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