Does Cocaine Have Any Medical Uses?

woman's hand cutting powdered cocaine with razor blade
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Whenever the word cocaine is mentioned, the first thing that comes to mind is its abuse on the streets and the terrible consequences of dependence on the drug. And it's true, cocaine is most commonly abused as an illicit drug. However cocaine also has legitimate medical uses.

Medical Uses of Cocaine

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

There are different ways that medical professionals may use cocaine during procedures or in the treatment of certain conditions.

Anesthetic

Cocaine is an excellent topical anesthetic. In fact, The American Academy of Otolaryngology Head and Neck Surgery considers cocaine to be a valuable anesthetic and vasoconstricting agent when used as part of the treatment of a patient by a physician. In fact, the group states that "no other single drug combines the anesthetic and vasoconstricting properties of cocaine." 

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.

Cocaine is a particularly effective local anesthetic that works by blocking nerve impulses. Specifically, by blocking norepinephrine uptake, cocaine causes vasoconstriction and anesthesia.

Other Medical Uses

Cocaine is also 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.

Cocaine used during medical procedures comes in the form of a topical solution. This cocaine hydrochloride solution comes in three different concentrations: 1%, 4%, or 10%. Because of potential toxicity, usually, only 1% or 4% solutions are used.

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. Crack is a yellow-white "rock" processed with ammonia or baking soda.

Powdered cocaine can either be snorted or dissolved in water and turned into a solution that is injected into veins. Crack rock is smoked or "freebased" using a crack pipe.

Actions and Effects

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.

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 ingestion.

When ingested, cocaine causes euphoria. Other effects of the drug include a boost in self-confidence, vigilance, and well-being. 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.

Cocaine Abuse

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, 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.

In addition to powder, cocaine can also be abused in the form of crack. 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.

A Word From Verywell

Cocaine probably suffers from an image problem. Because most people automatically associate this drug with abuse, its use is feared, reviled, or parodied. In reality, however, like many other drugs that are often abused, including marijuana, opioids, and (possibly) MDMA, cocaine does have legitimate and beneficial uses.

Please note, however, that the clinical uses of cocaine are absolutely confined to a clinical setting when administered by a physician. Cocaine bought off the street is always dangerous.

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  1. Position Statement: Medical Use of Cocaine. American Academy of Otolaryngology Head and Neck Surgery. Revised 5/6/2013

  2. Oka S, Shimamoto C, Kyoda N, Misaki T. Comparison of lidocaine with and without bupivacaine for local dental anesthesia. Anesth Prog. 1997;44(3):83-6.


  3. Middleton RM, Kirkpatrick MB. Clinical use of cocaine. A review of the risks and benefits. Drug Saf. 1993;9(3):212-7. doi:10.2165/00002018-199309030-00006


  4. Richards JR, Laurin EG. Cocaine. Treasure Island, FL: StatPearls Publishing. Updated June 8, 2019.


  5. Sora I, Hall FS, Andrews AM, et al. Molecular mechanisms of cocaine reward: combined dopamine and serotonin transporter knockouts eliminate cocaine place preference. Proc Natl Acad Sci USA. 2001;98(9):5300-5. doi:10.1073/pnas.091039298


  6. American Heart Association. Illegal Drugs and Heart Disease. Updated May 3, 2018.


  7. Morton WA. Cocaine and Psychiatric Symptoms. Prim Care Companion J Clin Psychiatry. 1999;1(4):109-113.


Additional Reading
  • Drug Fact Sheet: Cocaine. www.dea.gov
  • O'Brien CP. Chapter 24. Drug Addiction. In: Brunton LL, Chabner BA, Knollmann BC. eds. Goodman & Gilman's The Pharmacological Basis of Therapeutics, 12e. New York, NY: McGraw-Hill; 2011.
  • Prosser JM, Perrone J. Chapter 181. Cocaine, Methamphetamine, and Other Amphetamines. In: Tintinalli JE, Stapczynski J, Ma O, Cline DM, Cydulka RK, Meckler GD, T. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 7e. New York, NY: McGraw-Hill; 2011.