Topical Anesthetics: Cocaine

[liveonearth]

I look up cocaine and find this impressive list of slang about it. My goodness. I have never tried it in any form. It was "discovered" in 1860 when someone happened to notice that tasting it numbs the tongue. Pretty soon everybody was using it for toothaches, and in 1894 doctors started using it as a local anesthetic for surgeries, especially to the nose, eyes (lacrimal ducts!), and sinuses. Freud didn't think it was addictive, but it is, because it activates the mesolimbic dopamine pathway, the reward and desire pathway, the addiction pathway. Cocaine is a dopamine reuptake inhibitor. It is also a serotonin and norepinephrine reuptake inhibitor. But these effects should not happen if it is a tiny local dose. The local numbing effect occurs because cocaine blocks nerve permeability to sodium, preventing nerve transmission. The vasoconstrictive effect is due to the inhibition of norepi reuptake. Cocaine is the only anesthetic that is vasoconstrictive, the rest vasodilate necessitating the use of injected epinephrine to minimize bleeding and loss of the anesthetic into the systemic circulation. Can anybody tell me where the world's bounty of cocaine is coming from these days?