Is There Still a Medical Use for Cocaine?

Medical Bottle Spilling Many physicians are surprised to hear that cocaine is still used today in medicine –but why is this? Is it because it’s not that relevant to their specialty, and they don’t have the need to use it, or is it because they simply don’t think that it’s still relevant as a drug to be used in “legitimate” medicine and/or that there are better, less risky drugs out there?

Today’s use of cocaine is mostly limited to plastic surgery, and ENT/otolaryngology. According to, it is used for topical anesthesia and its vasoconstricting properties. It is available in several forms: flakes, tablets, crystals and various solutions.

Interestingly, the American Academy of Otolaryngology-Head and Neck Surgery, Inc. has an official statement addressing the use of cocaine. The policy was adopted in 1988 and has been reaffirmed twice since –in 1995 and 1998. Clearly, they are comfortable with its use.

But what about the number of adverse reactions and cardiac concerns?

And, while many say that there is no substitute as good as cocaine, a recent study says otherwise. A study in the February 2007 issue of the Journal of Laryngology & Otology evaluated the difference between cocaine and tetracaine in septoplasty. The study found tetracaine superior to cocaine as an anesthetic and said that cocaine use should be limited.

Not sure where you stand on the topic? To make up your mind, see a list of excellent references discussing the topic at the end of the Medscape article.

Do you use cocaine in your practice? If so, you may want to call your medical malpractice insurance agent to see if he or she has any concerns or suggestions to minimize your risk and exposure.

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