Cocaine (Topical)

You may be prescribed cocaine for use as a local anesthetic before undergoing surgery, though only after a full consultation with your doctor to assess your suitability.

Overview

Cocaine is sometimes used as a form of local anesthetic during surgery to remove the potential of feeling pain in certain areas of the body. It is applied in topical form to specific parts of the body, such as the throat, mouth or nose. It is found to numb the specific areas for just one to two minutes after application and is used for such procedures as wound cleaning, stitching or biopsies.

Using cocaine in a medical format is done very rarely and on a case-by-case basis as the "high"it produces can quickly become addictive. Cocaine abuse is frequent in society and involves patients using a higher frequency, or larger amount, of cocaine on a regular basis. Cocaine is known for the number of deaths it can cause, as well as a notable list of side effects which can be found below.

However, when used in a medical setting, cocaine is far less likely to result in any sort of dependency or addiction issues. It is possible for too high a dose to be absorbed too quickly into the body, resulting in many potential side effects. Before being prescribed the use of cocaine for an upcoming surgery, patients are vetted carefully by their doctor to ensure the least possible risk of adverse side effects, as some people are more sensitive to cocaine than others.

Condition(s) treated

  • Local anesthetic

Type of medicine

  • Topical (solution or paste)

Side Effects

As you may imagine, the use of cocaine as an anesthetic may cause a large number of different side effects to occur. Directly below are a number of more severe side effects. If you experience any, contact your doctor immediately and/or seek medical assistance.

Less common or rare

  • Lightheadedness or dizziness
  • Any mood or mental changes, excitement, restlessness or nervousness
  • Stomach or abdominal pain
  • Sudden headaches
  • General feeling of illness or discomfort
  • Increased sweating
  • Nausea
  • Chills
  • Confusion
  • Irregular or fast heartbeat
  • Hallucinations or feeling, hearing or seeing things that are not present

As well as the above, there are other side effects which may occur. These side effects are not necessarily as immediately dangerous, but can still be disconcerting or worrying. If you experience any of the below, you should still contact your doctor. They may be able to alleviate the symptoms or advise against no future use of cocaine as a local anesthetic:

More common

  • Loss of sense of smell or taste (after use in the mouth or nose)

As well as this, there may be some other side effects which you experience as a direct result of having used cocaine as a local anesthetic. If they are worrying you and you need advice, do contact your doctor right away and make them aware of the situation.

Dosage

There is no strict rule for the amount of cocaine that will be applied, as it is based on a patient-by-patient basis. They will examine your complete dietary intake, as well as your medical condition as a whole. This will allow your doctor to understand how susceptible you may be to the effects of the cocaine, and to ensure as best as possible against any unwanted side effects. When used, your doctor will apply to the very least amount needed, and no more, as a means to avoid any unwanted interactions or side effects.

Interactions

Cocaine is known to react to a wide variety of different drugs, and so you should inform your doctor of any drugs you take during your consultation. This includes prescription, non-prescription, supplements and any herbal drugs. It could be that cocaine may cause some minor adverse interaction, or that there is a way to minimise any potential interactions from occurring. Regardless, your doctor is best informed to come to that decision, so you should be honest and forthright about any drugs you are taking at that time, or have recently taken. Below is a list of drugs with which using cocaine is not recommended. Your doctor may choose to alter your prescription of one of the below, or instead prescribe a different anesthetic.

  • Phenelzine
  • Dihydroergotamine

As well as these, below you can find a list of drugs with which cocaine may likely cause an interaction, but using it may still be necessary. Still, make your doctor aware if you are using any of the below as they may instead need to switch your dosage or frequency of the medication.

  • Almotriptan
  • Amitriptyline
  • Amoxapine
  • Buprenorphine
  • Desvenlafaxine
  • Dolasetron
  • Donepezil
  • Fentanyl
  • Fluoxetine
  • Granisetron
  • Hyaluronidase
  • Hydroxytryptophan
  • Iobenguane I 123
  • Levomilnacipran
  • Lorcaserin
  • Meperidine
  • Methylene Blue
  • Mirtazapine
  • Oxycodone
  • Palonosetron
  • Safinamide
  • St John's Wort
  • Tramadol
  • Trazodone
  • Vilazodone
  • Vortioxetine
  • Ziprasidone

As well as this, it's notable to mention that using cocaine as an anesthetic while you are also taking cannabis may lead to an increased risk of a number of side effects. Again your doctor may advise you stop taking cannabis, or adjust the amount you take in accordance with healthier practices.

Beyond drugs, cocaine also tends to interact with a number of different foods, drinks, and tobacco. Be honest with your doctor about your daily dietary intake so they can decide whether it is best to go ahead and use cocaine as an anesthetic. Notably, it has been highlighted that using cocaine alongside a patient consuming ethanol can lead to a higher chance of potential side effects. Your doctor can come to that decision and advise you to alter your diet accordingly before you go under anesthetic using cocaine.

Finally, the rest of your medical condition will weigh heavily on your doctor's decision to prescribe cocaine. The following is a list of medical problems which is known to react negatively when using cocaine as a local anesthetic. If you are experiencing any of them, then tell your doctor as they may likely need to find an alternate form of anesthetic for your surgery.

  • A history of myocardial infarction (heart attack)
  • A history of convulsions (seizures)
  • Irregular or fast heartbeat
  • A history of chest pains
  • Cancer
  • ┬áLiver disease
  • Blood vessel or heart disease
  • An overactive thyroid - This may increase the chance of serious side effects
  • Tourette's syndrome - This may make your condition worse
  • High blood pressure

Warnings

As mentioned, your doctor will need to properly examine you before allowing the use of cocaine as a local anesthetic. You should be upfront and honest with your doctor about any allergies you have. These allergies can be in relation to cocaine as well as any other drugs you may have used in the past. Also, be honest about other allergies such as to foods, preservatives, animals or dyes.

With regards to pediatric patients, your doctor will first need to examine your child and examine any benefits of using cocaine over other anesthetics. Cocaine has been known to have a number of side effects on all patients, and children are no different, and possibly more susceptible.

Geriatric patients as well will need to be carefully examined, as they are typically more susceptible to the effects than younger patients. Common side effects in older patients include fast or irregular heartbeat, lightheadedness, and dizziness. A doctor will only prescribe a geriatric patient cocaine as anesthetic under very rare circumstances.

Cocaine can be potentially harmful to a baby, but there have not been appropriate studies carried out on pregnant women when using cocaine as a local anesthetic. Your doctor will be best placed to advise the use of it. If you become pregnant at all and you are scheduled for the use of cocaine again in an upcoming surgery, notify your doctor immediately.

Studies have revealed notably adverse effects as a result of using cocaine in patients who are breastfeeding. It is highly recommended you do not use cocaine at all, and that a different anesthetic should instead be used.

After having used cocaine for an anesthetic, do be aware that the presence of it will be in your bloodstream and urine for several days after. If anyone were to test you for drugs, then you would indeed test "positive"for having used cocaine. Therefore, if you are undergoing any sort of compulsory drug examination 5 days or more after the operation, advise the person beforehand of your surgery. Make it clear that the use of it was for medical purposes and they can check with your doctor for more information. To help such a situation, you may wish to receive a dated and informative letter from your doctor advising of when the operation took place, how much cocaine was used, and for what exact purpose.

Storage

You will not be required to store the cocaine at any time, as it will only be applied before the surgery. Your doctor is responsible for ensuring it is safely stored.

Summary

Cocaine is very rarely used as a local anesthetic but may be necessary under some very selected circumstances. You must not attempt to self-prescribe or use cocaine at any point, and it is at your doctor's decretion whether you are a suitable candidate to use it for a minor operation. Do be aware that, using cocaine can lead to a wide variety of different adverse side effects, and is known to react with all sorts of things, from allergies to other drugs, as well as alcohol and certain foods.

When undergoing a consultation with your doctor for the potential use of cocaine as an anesthetic, be as honest and open as you can about all manner of your existing medical condition. Also be aware that, when used, it is only applied in the smallest of amounts, and the numbing effects are only expected to last for 1-2 minutes for the minor operation to take place. If you have any other concerns or worries surrounding using cocaine for an upcoming operation, then address them to your doctor who may be able to advise on an alternate form of anesthetic.