Benzocaine

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What is Benzocaine?

Benzocaine is a topical local anesthetic utilized for temporarily alleviating pain and itching linked with minor burns, sunburn, scrapes, insect bites, or minor skin irritations.

Overall Risk:

Occasional use may not be severely harmful, but avoid excessive exposure. The combination can significantly increase the risk of cardiovascular complications, overdose, and other serious health issues, even with small amounts.

Concern:
Methemoglobinemia
Severity:

Major, Moderate

Risk of OD:
Increased

Benzocaineused as cutting agent forCocaine

The use of local anesthetics has been associated with the development of methemoglobinemia, a rare but serious and potentially fatal adverse effect. The concurrent use of a local anesthetic with other local anesthetic drugs may increase the risk of developing methemoglobinemia. Methemoglobinemia (MetHb) is a rare blood disorder that affects how red blood cells deliver oxygen throughout your body. Not everyone has symptoms, but nearly all people with this condition have skin, nails or lips that are a distinctive shade of blue or purple. In some cases, methemoglobinemia can be life threatening.

Why it's used as a cutting substance?

Benzocaine is used as a cutting agent in cocaine due to its numbing effects, which can mimic the numbing sensation associated with cocaine use, potentially deceiving users into thinking the cocaine is of higher quality.

Interaction

When Benzocaine is used with cocaine, it can enhance the numbing effects of cocaine, potentially increasing the risk of overdose due to the combined effects on the cardiovascular system.

Short-term effects

  • Produces numbing sensation and loss of feeling (similar to cocaine).
  • Relief from pain and itching caused by various conditions (burns, sunburn, scrapes, insect bites, etc.)
  • Potential for skin irritation

Long-term effects

  • Side effects like vasodilation, hypotension, irregular heart rate, and muscle contractile issues.

Sources

  1. Fowler, G.C. (2020). Pfenninger and Fowler’s Procedures for Primary Care (4th ed.). Elsevier. [ISBN:9780323476331]
  2. US Food & Drug Administration: FDA notification regarding unapproved local anesthetics and required methemoglobinemia warning (October 22, 2018) [Link]
  3. Benzocaine (Topical Application Route) Description and Brand Names – Mayo Clinic. | [ Link ]
  4. Benzocaine: Uses, Interactions, Mechanism of Action. DrugBank Online. | https://go.drugbank.com/drugs/DB01086
  5. Identification and Quantification of Cocaine and Active Adulterants in Coca-Paste Seized Samples: Useful Scientific Support to Health Care | [ Link ]
  6. Methemoglobinemia: MedlinePlus Medical Encyclopedia | [ Link ]
  7. Benzocaine: Uses, Interactions, Mechanism of Action. DrugBank Online. | [ Link ]

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