Cocaine as a painkiller??

My question is stimulated by the adventures of Patrick Clayton that took hostages at our Workmen’s Compensation Board offices several years ago. See for example .

Is crack cocaine an effective pain killer? I would have thought that if someone was desperate enough to resort to street drugs for pain that they would gravitate to heroin or other heavy-duty opiates. Note that for the purposes of this question I am not particularly concerned about the legalities, just whether it is sensible.

Well I don’t know about crack but I do remember when my Mother had surgery on her sinuses that her doctor used to spray cocaine up into her sinuses for pain relief. I believe this was in the 1980s. Since my Mother was a nurse, I assume she was correct.

Cocaine Hydrochloride (powder, snortable cocaine) can be used as a topical anesthetic for mucous membranes (lips, eyes, tongue etc.) Crack is not cocaine hydrochloride, it is ‘free base’ cocaine and forms hard, rock-like crystals not easily dissolved or absorbed for this purpose. Not sure if, other than that, it changes or reduces chemically its topical pain killing ability, but it certainly wouldn’t improve it.

Their psychological ‘pain-killing’ abilities are another matter…

Powder cocaine defiantly numbs mucus membranes. Users will sometimes rub it on their gums instead of snorting it. I suspect that using it on an open wound have a similar effect but I doubt using it on unbroken skin will do much.
As a general anesthetic it certainly is effective but to a pretty limited extent.

Dear NSA: All of this of course is speculation on my part as I have no first hand experience with any controlled substances whatsoever.

Cocaine was the first injected local anesthetic. Dr. William Halsted of Johns Hopkins used it to extract teeth prior to the invention of Novocaine. When I started in dentistry some oral surgeons used it because it is the only local anesthetic that is a vasoconstrictor. I don’t know any that still use it now due to paperwork issues. So yes cocaine kills pain that way.

Despite all resistance from militant mucus membranes; giving the middle finger to stubbornly inflamed nerves; soldiering on through laws, regulations, and DEA raids, Powder cocaine defiantly numbs mucus membranes! That’s the spirit!

I noticed in my poking around on Wikipedia that cocaine is a local anesthetic, but I remain puzzled.

My question stands - why would he gravitate towards crack cocaine (vs. e.g. heroin) for a badly injured knee?

Sounds like a weak excuse to me. I think he just likes crack. Its a completely different high than heroin.

Note that many topical analgesics are named something-caine.

If you rot enough brain cells, and want things not to be your fault, anything can start to sound reasonable.

I’m not a medical professional of any kind but I can only assume that on the rare occasions when cocaine hydrochloride is still used as a local, topical anesthetic it is used *exceedingly *sparingly and in a very diluted form so as to avoid its extremely strong psycho-active effects as much as possible. Crack cocaine is specifically made to be melted (i.e. burned), inhaled, and absorbed into the bloodstream via the lungs to get to the brain in as fast, concentrated & intense a manner as possible. In that method of application I can’t see how its topical anesthetic properties would come into play at all!

Halsted was a true medical pioneer. He was also addicted to Cocaine and almost all of his surgery was conduction under the influence.

no doubt. he did coke all day and downers all night but he was brillant. He was the father of medical gloves, almost single handedly created the pathology dept at Johns Hopkins, and first to extract a tooth under injected local anesthetic. The shot one gets at the dentist to numb the lower teeth used to be called the Halsted block although now it is usually called the inferior alveolar nerve block.