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Cocaine belongs to a class of drugs called Local Anesthetics, Esters. It is a prescription medicine used to treat the symptoms of Anesthesia of the Nasal Cavity and Mucous Membrane and may be used alone or with other medications.
It is often snorted, inhaled as smoke, or dissolved and injected into a vein. Effects begin within seconds to minutes of use and last between five and ninety minutes.
Cocaine hydrochloride (Goprelto), an ester local anesthetic, was approved for medical use in the United States in December 2017, and is indicated for the introduction of local anesthesia of the mucous membranes for diagnostic procedures and surgeries on or through the nasal cavities of adults. Cocaine hydrochloride (Numbrino) was approved for medical use in the United States in January 2020.
The most common adverse reactions in people treated with Goprelto are headache and epistaxis. The most common adverse reactions in people treated with Numbrino are hypertension, tachycardia, and sinus tachycardia.
Uses of Cocaine
- It can be used as a local numbing agent to help with painful procedures in the mouth or nose.
- It is now predominantly used for nasal and lacrimal duct surgery.
- If vasoconstriction is desired for a procedure (as it reduces bleeding), the anesthetic is combined with a vasoconstrictor such as phenylephrine or epinephrine.
- Some otolaryngology (ENT) specialists occasionally use cocaine within the practice when performing procedures such as nasal cauterization.
Cocaine is a powerful nervous system stimulant. Its effects can last from 15 minutes to an hour. The duration of cocaine’s effects depends on the amount taken and the route of administration. It can be in the form of fine white powder, bitter to the taste. When inhaled or injected, it causes a numbing effect. Crack cocaine is a smokeable form of cocaine made into small “rocks” by processing cocaine with sodium bicarbonate (baking soda) and water.
Cocaine use leads to increases in alertness, feelings of well-being and euphoria, increased energy and motor activity, and increased feelings of competence and sexuality.
Dosage and Administration
The dosage varies and depends upon the area to be anesthetized, vascularity of the tissues, individual tolerance, and the technique of anesthesia. The lowest dosage needed to provide effective anesthesia should be administered. Dosages should be reduced for children and for elderly and debilitated patients. Cocaine Hydrochloride Solution can be administered by means of cotton applicators, instilled into a cavity, or as a spray.
Effects of Cocaine Use
Mental effects may include an intense feeling of happiness, sexual arousal, loss of contact with reality, or agitation. Physical symptoms may include a fast heart rate, sweating, and large pupils. High doses can result in very high blood pressure or body temperature.
Cocaine is addictive due to its effect on the reward pathway in the brain. After a short period of use, there is a high risk that dependence will occur. Its use also increases the risk of stroke, myocardial infarction, lung problems in those who smoke it, blood infections, and sudden cardiac death. Cocaine sold on the street is commonly mixed with local anesthetics, cornstarch, quinine, or sugar, which can result in additional toxicity. Following repeated doses a person may have decreased ability to feel pleasure and be very physically tired.