Cocaine is a local anesthesia and vasoconstrictor that is clinically used during diagnostic proceedures or during surgery in or through the nasal cavity. It comes in drugs called Goprelto and Numbrino which comes as a nasal spray. In these clinical drugs it takes the form of cocaine hydrochloride. The illicit drug has the same effects. It primarily acts on sensory neurons in the nasal cavity, but also inhibits dopamine, serotonin, and norepinephrine re-uptake channels. This inibition leads to an accumulation in the synapse of these neurotransmitters. For dopamine this leads to activation of dopamine receptors, especially the D2 dopamine receptor which has been implicated in the cause of addiction through the reward pathway. D2 receptors inhibit adenylate cyclase which leads to a lower concentration of cAMP which lowers neuronal excitability. Other dopamine receptors also have an effect on addiction,, especially the D1 dopamine receptor. The exact mechanisms in which D2 receptors cause addiction is unknown. D1 dopamine receptors also have an effect on addiction. They are Gs coupled and activated adenylate cyclase rather than inhibit. D1-D2 dopamine receptor heteromers have also been found to effect addiction, although they have not been researched enough to understand how.

Cocaine Dopamine-reuptake Inhibitor Pathway References