The Not So Fun Novocaine Trigger
By Amy Dresner
(Originally posted on THE FIX on 08/21/15)
I know novocaine isn't cocaine. So why did I freak out and start crying when my dentist shot me up with it during a tooth extraction?
I now have two less teeth than when I was doing meth. I still, in my 40s, have never had a cavity. I lost one molar from a grand mal seizure—some asshole believed the idiotic myth that I would choke on my own tongue, so he put a metal spoon in my mouth and I bit down and cracked a tooth. I lost a second molar from grinding so hard during my divorce that I split it straight through to the root. I got a shitty, cheap root canal which did not hold for long. The throbbing pain mounted, and after a recent x-ray I was told that one day, “The tooth has to go.”
It’s a commonly held belief that novocaine is related to cocaine, but I did some research and that is absolute horseshit.
“I’ll pull it for $125 right now,” the doctor said.
“Umm, ok.” I agreed, shocked at the low price—I am a Jew—and wondering shamefully if all my boasting about my “perfect teeth” and my snickering at toothless hillbillies had finally karmically caught up with me.
I knew from the previous root canal that I had a high tolerance for novocaine. Most recovering drug addicts seem to boast a high tolerance for drugs and a low tolerance for pain, be it emotional or physical. As the doctor shot me up, I felt my heart race. My breathing got tight and fast, and I began to shake. At first I was like, “Awww hell ya! Freelapse”—as it was reminiscent of that first line of cocaine. But there was no euphoria and I quickly went from mild stage fright to being on a bullet train straight to panicville. Tears began pouring down my face and I felt sad and freaked out, but I couldn’t pinpoint why. Once the tooth was out and I had paid, I got in the car and became completely hysterical, hyperventilating—the whole deal. I looked in the mirror, glossy eyes, bloody mouth, and told myself to “calm the fuck down.” And then I got on the phone and called my sponsor.
Don’t get me wrong, I like “UP.” I loved speed, cocaine, Adderall, Ritalin. I used to drink 24 ounce Monsters and Rockstars until I had a seizure from all the caffeine and taurine. I still drink iced lattes with so many shots that the baristas give me a look of pity, as if to say, “What’s missing in your life, honey?” I go to Whole Foods and buy 12 yerba mates at a time. “Somebody needs to start a yerba mate rehab!” I chirp. It never gets a laugh. “Yeah people love that stuff,” the pretentious cashier always says. “It gets you amped as fuck if you drink enough of them. Okay. Bye!” But believe me, this specific novocaine experience was a whole different feeling of “jacked” with a side of pathological anxiety.
It’s a commonly held belief that novocaine is related to cocaine, but I did some research and that is absolute horseshit. Granted, cocaine was used back in the good old days for early dentistry, but these days, it is a type of lidocaine or prilocaine mixed with epinephrine. An allergy to the amide “caines” is very, very rare. And according to my research, nobody can be allergic to epinephrine because our bodies actually produce it in the form of adrenaline. Supposedly the amount of epi in local anesthetics is tiny compared to the adrenaline our own bodies can pump out. Sure, occasionally, a dentist can inject right into a vein instead of a muscle or the gum, and really dose you. But that is hard to do with the recent use of aspirating syringes. So why my crazy reaction? Did a chemically-induced adrenaline rush triggered my using memories? Was it the epi compounded with general dental anxiety? I asked some other recovering addicts if they’d had this experience and I found that I was not alone.
One woman with over a decade sober said, “I cried without emotion...the tears literally would not stop falling on their own while my chest was constricted like I did too much coke. I was freaking out because I couldn't stop it. Terrible experience. Now I refuse epinephrine. The novocaine is much shorter acting without it but I’m fine with that.”
Another girl, nine months sober, had the same reaction. “At first, I was like, ‘Wheeeee! I feel like doing puzzles. I wanna do stuff! This is fun.' But quite quickly I felt really anxious, upset and freaked out.”
However, a third sober woman with eight years told me, “No it didn’t set me off too badly.”
When I went trolling online, there were addicts who had “massive cravings” one day after being numbed with novocaine. They were under the same mistaken impression I held that cocaine is in the same family as novocaine, when the only similarity they share is that they are both numbing agents and “vasoconstrictors” (narrowing the blood vessels and therefore any bleeding).
Yes, some people do show more sensitivity to epinephrine. One thing that does affect epinephrine reactivity seems to be metabolism. So if you have a high metabolic rate, you will metabolize the epinephrine faster. Also, caffeine seems to have an impact. Caffeine raises your blood pressure and then the epinephrine will increase it even more. Caffeine can also interfere with the local anesthetic working properly, so you’ll need more shots, which will mean more epi. (I am a caffeine-addict, like most others in early-ish to late-ish sobriety, and I did greedily chug a ginormous coffee before the procedure. My bad.)
So no, you don’t have a higher tolerance to novocaine because you used to be a drug addict (unless maybe if you were a novocaine addict). Sorry if that ruins your street cred. Plenty of normies need eight or nine shots so they don’t violently grip the armrests and scream like a banshee. But if you drink a lot of caffeine before the procedure, you will have a harder time getting numb. But hey, maybe pain is your thing. To me, what’s most interesting about all of this is that something I used to enjoy, that over amped “I might have a heart attack but I can’t shut the fuck up” feeling, is now thoroughly unpleasant. The memories it triggers are more traumatic than nostalgic or romantic now. I actually enjoy being present in my life. And that’s growth.