Cocaine use leads to increased levels of catecholamines like norepinephrine and dopamine. This can cause chest pain and cardiovascular issues like coronary vasoconstriction and myocardial ischemia. While guidelines recommend treatments like aspirin, nitroglycerin, and calcium channel blockers for cocaine-induced chest pain, the use of beta-blockers is more controversial. Some studies suggest beta-blockers could worsen coronary vasoconstriction and produce unopposed alpha stimulation. However, a recent meta-analysis found no association between beta-blocker use and adverse outcomes. More research is still needed to fully understand the risks and benefits of beta-blockers for cocaine-induced chest pain.