What Is Medical Cocaine?

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.