Cocaine may be used as a topical anesthetic in the mouth, throat, and nose. It’s a unique topical anesthetic because it can be used off-label to stop nosebleeds and pack wounds to staunch bleeding. Although cocaine vasoconstriction sounds like a terrifying condition – and it can be – it’s also the reason why the drug is so useful in the medical field.
So, what is vasoconstriction? Also known as vasospasm, vasoconstriction is the narrowing or constriction of the blood vessels by small muscles in their walls. When blood vessels constrict, blood flow is reduced or blocked, and blood pressure rises. Vasoconstriction may occur when a person experiences a heart attack. In an attempt to keep the body alive, the muscles in the walls of blood vessels tighten to maintain arterial pressure or blood pressure. Vasoconstriction may also occur when it’s cold to preserve body heat. When vasodilation occurs, blood vessels swell or dilate, which causes more heat to be carried to the skin when it can be lost to the air. Blood vessels may shrink in response (vasoconstriction) to reduce heat loss through the skin until the person’s temperature has been regulated.
Cocaine causes vasoconstriction by increasing the production of vasoconstrictor endothelin. At the same time, it decreases the production of nitric oxide, a powerful vasodilator. Endothelin is referred to as a vasoconstrictor because it causes fibrosis or the thickening or scarring of vascular smooth muscle cells. Endothelin is one contributing factor to vasoconstriction. Nitric oxide is a vasodilator produced by nearly every type of cell in the body. It does the opposite of endothelin by relaxing the blood vessels' inner muscles, causing them to widen. Cocaine-induced vasoconstriction also occurs when the levels of calcium across endothelial cell membranes are increased. These cells form the barrier between vessels and tissue and regulate inflammation, balancing coagulation (blood clotting) and protecting the skin.
When it occurs naturally, vasoconstriction can be a good thing. It’s a natural process the body uses to balance its system. Vasoconstriction is needed to help maintain regular blood flow, prevent your body temperature from getting too low, and raise blood pressure when it’s necessary. Certain medications, like cocaine, believe it or not, can mimic the body’s natural signals to cause vasoconstriction. In an emergency, this can be life-saving. For instance, vasoconstrictor medications can stop blood pressure from dropping too low during an allergic reaction and can stop or staunch blood flow in an injury. However, abusing cocaine is completely different.
The use of cocaine to produce vasoconstriction is done under the medical supervision of healthcare professionals using very small doses. In this setting, it can be helpful. On the other hand, the abuse of cocaine can produce vasoconstriction and various other cardiovascular issues, like harder arteries, thicker heart muscle walls, and higher blood pressure. These issues make it difficult for the heart to function properly, increasing the risk of heart attack, stroke, heart failure, and death. Vasoconstriction is an essential process the body uses to keep itself safe, but cocaine-induced vasoconstriction isn’t safe when the drug is abused. Those with an addiction to coke may need additional help, such as a medical cocaine detox, to quit and reduce their risk of cardiovascular disease.
Now that we know the pros of vasoconstriction let’s discuss some negative vasoconstriction symptoms. Abnormal vasoconstriction, like vasoconstriction caused by cocaine abuse, may cause or worsen high blood pressure. Chronic high blood pressure can increase your risk of heart attack and stroke. High blood pressure can also damage your arteries by reducing their elasticity, which decreases the flow of oxygen and blood to your heart, resulting in heart disease. Decreased blood flow to the heart can also cause chest pain, otherwise known as angina. Drug use, such as cocaine abuse, can cause too much vasoconstriction or induce it in areas where it shouldn’t occur, such as parts of the brain.
Abnormal or cocaine-induced vasoconstriction can also reduce oxygen in cells, preventing these cells from producing the energy they need. Without energy, the cells eventually start to die. Additionally, the body has certain safety mechanisms set in place to stop vasoconstricting from happening for too long. For instance, if the body is cold, blood vessels will constrict until body temperature has regulated. However, cocaine causes the body to ignore those warnings, allowing blood vessels to constrict past the point of danger. Prolonged vasoconstriction can lead to ischemia or reduced blood flow. As a result, problems like heart attack, chest tightness, sudden cardiac death, and kidney damage may occur.
Simply put, abnormal or cocaine-induced vasoconstriction effects include: