The fact that cocaine has anesthetic properties is unsurprising since cocaine and lidocaine are chemical cousins, and lidocaine is used as an anesthetic during dental procedures. Nevertheless, it’s compelling to take a closer look at cocaine as a medical treatment.

As a medical treatment, cocaine is used during procedures involving the upper respiratory tract. In addition to anesthesia and vasoconstriction of the upper respiratory tract, cocaine also shrinks the mucosa or mucous membranes.2

Cocaine used during medical procedures comes in the form of a topical solution. This cocaine hydrochloride solution comes in three different concentrations: one percent, four percent or 10 percent. Because of potential toxicity, usually, only the one percent or four percent solutions are used.3

Cocaine as a Street Drug

On the street, cocaine is sold as a crystalline powder. This powder is diluted or “cut” with sugars to increase its street value. Cocaine is also turned into crack, which takes the form of irregularly shaped chunks that are called “rocks.”

Powdered cocaine can either be snorted or dissolved in water and turned into a solution that is injected into veins. Crack is smoked.

When ingested, cocaine causes euphoria. It can also cause increased alertness, restlessness, irritability, and paranoia. Cocaine increases blood pressure and heart rate and can lead to heart attack and stroke.

Actions and Effects of Cocaine

Cocaine is an alkaloid derivative refined from coca leaves. Coca leaves grow on Erythroxylum Coca, a plant commonly found in South America.4

Cocaine is readily absorbed across mucous membranes including the linings of the nose and mouth, which explains why people who abuse the drug snort it or rub it on their gums.

As a drug of abuse, cocaine works on the brain by blocking the reuptake of dopamine—the “feel good” neurotransmitter. Cocaine also works by blocking the reuptake of the neurotransmitters serotonin and norepinephrine, which also contribute to a short-lasting rush or euphoria experienced after ingestion5 . Other effects of the drug include increased heart rate and increased blood pressure as well as a boost in self-confidence, vigilance, and well-being.

Over time, the chronic use of cocaine reduces the concentration of neurotransmitter metabolites thus permanently interfering brain function. Signs of chronic abuse include an intense craving for more drug and feelings of irritability, violent outbursts, paranoia, and depression. Repeated doses may also lead to involuntary motor activity, heart disease, seizures, psychoses, respiratory failure, sexual dysfunction, and death.6

In addition to powder, cocaine can also be abused in the form of crack. Crack is a yellow-white “rock” processed with ammonia or baking soda. Crack rock is smoked or “freebased” using a crack pipe.

Crack is even more potent, addictive, and dangerous than cocaine powder. People who have used crack only once have become addicted. Furthermore, crack pipes burn so hot that they can damage the lips and mouth resulting in bleeding. When people share a crack pipe, they can also share blood-borne diseases like HIV.