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Drugs and the Whole Person

Illicit Drugs: Cocaine

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Cocaine is a stimulant drug closely related to the xanthine alkaloids caffeine, theophylline, and theobromine. Cocaine is a crystalline alkaloid extracted from the leaves of the coca plant, which grows in the Andes of South America at a range of 1,500 to 6,000 feet above sea level. Coca leaves were chewed by the Incas before the Spanish conquest and continue to be used by their descen¬dants to this day. No health or social problems seem to result from this practice, nor do the Indians who move to lower altitudes seem to experience any difficulty in giving up the practice.

In 1873 Alexander Bennett demonstrated the anesthetic properties of cocaine, but little use was made of this discovery. Ten years later a German army physician named Aschenbrandt gave cocaine to Bavarian soldiers engaged in their autumn maneuvers and reported that it improved their performance and increased their endurance for fatigue.

Having read of Aschenbrandt's trial of cocaine, Sigmund Freud decided to try drug in treating "nervous exhaustion" and heart disease. Freud himself was suffering from depression and tried the drug on himself. He apparently found the relief to be little short of miraculous and was soon encouraging his friends, family, and fiancee to try the drug. He wrote several papers praising the substance in terms more poetic than scientific. Freud's enthusiasm gradually faded during subsequent years as he saw his friend Dr. Ernst von Flieschl-Marxow become dependent on increasing doses of the cocaine he took to relieve the pain of multiple tumors of his peripheral nerves. One of Freud's friends, Carl Roller, introduced the use of cocaine as an anesthetic for eye surgery, thus giving cocaine its place in medical practice. Cocaine also came to be used in dental surgery until it was replaced by synthetic cocaine -- procaine (Novocain®).

In the meantime cocaine had found its real niche in nineteenth-century society as an unrecognized drug. Vin Mariani, a red wine laced with cocaine, was introduced in 1863 and soon gained worldwide popularity. Among those who endorsed product in published advertisements were the Prince of Wales, the Czar and Czarina of Russia, the kings of Italy and Sweden, and the commanding general of the British Army. Queen Victoria was also known to be a regular user of it. Inventor Thomas Edison, whose work schedule allowed him only 4 hours sleep per day, drank Vin Mariani steadily and lent his name and picture to its advertisements. The physicians of the late President Grant praised it for giving the dying Grant the strength to work several hours a day on his memoirs (the large doses of opium he was taking to ease the pain of his cancer undoubtedly also helped in making his memoirs possible). Pope Leo XIII not only drank Vin Mariani and allowed his name and picture to be used in its advertisements, but he also presented Angelo Mariani with a gold medal and praised him as a "benefactor of humanity" for introducing cocaine as a beverage. Vin Mariani, it seems, had earned this status as a great boon to humanity because it made fasting easier on holy days or as penances.

In 1885 an Atlanta pharmacist named John Syth Pemberton began marketing a product modeled after Vin Mariani that he called French Wine Coca®. The following year he introduced a nonalcoholic version—a drink syrup containing caffeine from kola nuts and cocaine from coca leaves. He called this new product Coca-Cola®. In 1909 the Coca-Cola® Company was actually prosecuted by the Food and Drug Ad¬ministration on the charge that the product was adulterated and contained no coca and little kola. The case was settled 9 years later, by which time the cocaine was illegal.

In the 1890s, articles began to appear in the news media about the dangers of cocaine. In particular, use of cocaine by African-Americans was emphasized; it was widely believed at the time that cocaine and Coca-Cola were used primarily by African-Americans, but modern historians doubt that this was ever really true. The South, busily engaged in dis¬mantling Reconstruction and eliminating the civil rights gained by African-Americans after the Civil War, was fearful of anything that stimulated African-Americans and was quick to grasp at any legal basis for further persecuting them. Cocaine seemed to be both.

Reports in the media began to tell of African-Americans stirred to sexual frenzy by cocaine and subsequently raping white women. Cocaine was reported to improve the aim of Black gunmen. Most frightening of all, it was reported that the frenzy induced in African-Americans by cocaine was such that they could not be stopped in one of their homicidal attacks by the .32 caliber bullets then used by most police. Police forces all over America switched to .38 caliber revolvers because of this myth.

Although the importation of cocaine actually began to decrease drastically in 1908, advocates of prohibition insisted that cocaine use was increasing. In 1910 Dr. Hamilton Wright, as U.S. representative to the Shanghai Conference, reported on the problem of cocaine in America, stating that its use by African-Americans was "often the direct incentive to the crime of rape." When the Harrison Narcotics Act (of which Wright was the principle author) was passed, it includes cocaine under its ban. This was the beginning of the misclassification of cocaine as a narcotic, which it in no way resembles.

Cocaine continued to have rather limited use in the bohemian-jazz culture and later among rock musicians. Its high price made it a symbol of affluence in these unconventional groups. It was to become a popular drug again only in the late 1960s. In September 1969 the Nixon administration mounted a major offensive against marijuana smuggling known as Operation Intercept. Timed to coincide with the September marijuana harvest, Operation Intercept involved massive search and seizure operations at the border between the United States and Mexico by strengthening the border patrol and providing technical assistance to the Mexican authorities in searching out marijuana traffickers on their side of the border. Combined with a drought in Mexico and an increasing demand in the U.S., Operation Intercept resulted in a substantial shortage in the U.S. in the months that followed. Very few smugglers were actually caught, but many may have been discouraged from trying. Millions of tourists were inconvenienced, the econ¬omy of the border region was damaged, and U.S.-Mexico relations were brought to a low point.

In the long run the effects of Operation Intercept were not at all what the Nixon administration had expected, Marijuana smuggling was quickly reestablished along new routes—by air and by sea. New smuggling routes began to bring in marijuana from South American through Florida, thus skipping Mexico entirely. Here we find the relevance of all this to cocaine. Marijuana smugglers operating out of South America soon found that cocaine was an available and even more profitable cargo. Cocaine therefore became more available and less expensive on the illicit market in the United States. Soon cocaine was the "in" drug among affluent drug takers

cocaine.jpg
cocaine hydrochloride

Effects of Cocaine

Cocaine is a CNS stimulant, producing essentially the same effects as caffeine. Cocaine enhances alertness and relieves fatigue. It produces a state of excitement, restlessness, and talkativeness. Euphoria, heightened self-confidence, and temporary relief of depression all result from cocaine use. Appetite is also suppressed. As these effects wear off, the user may experience a period of depression, confusion, and dizziness.

Small doses of cocaine slow the heart rate, but larger doses stimulate the heart. Blood pressure is increased due to cocaine's property of constricting blood vessels. Respiration becomes shallow and rapid. If it is applied directly to skin or mucous membranes, cocaine will act as a local anesthetic, numbing these tissues.

Repeated use of large doses of cocaine will lead to weight loss, insomnia, and anxiety. Paranoid delusions of persecution may result from repeated high-dosage use. Use of cocaine by snorting (inhaling the powdered drug into the nose) may eventually result in ulceration of the nasal tissues and, in extreme cases, in perforation of the nasal septum -- the tissue separating the nostrils. Although this effect is often mentioned, it is very rare, and most of the accounts are from the early literature on cocaine use, around the turn of the century in the midst of a scare campaign.

Psychological dependence on cocaine because of its ability to relieve depression, fatigue, or other forms of psychic distress is distinctly possible. The relatively small number of actual cases is probably due to the greater availability and cheaper cost of other drugs capable of producing the same effects, such as amphetamines or even caffeine. No evidence of physical dependence has ever been found.

References

Duncan, D. F. (1987). Cocaine Smoking and Its Implications for Health and Health Education. Health Education, 18(4), 24-27.

Duncan, D. F. (1995). Ten Years of Cocaine: A Follow-up Study of 64 Cocaine Users in Amsterdam. Contemporary Drug Problems, 163-186.



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