Cocaine

views updated

Cocaine

History

Introduction to the West

Treatment and prevention

Resources

Cocaine is a colorless or white narcotic crystalline alkaloid derived from the leaves of the South American coca plant, Erythroxylum coca. Aside from its use as a local anesthetic, which has largely been supplanted by safer drugs, its medical applications failed to live up to the hopes of physicians and chemists of the late nineteenth century. They administered cocaine to themselves and others in the hope that it would be a cure-all wonder drug. After about two decades of wide use in prescription and patented medicine, the harmful effects of cocaine became manifest, and its use as a drug in medical practice was eventually banned.

It subsequently became an illegal drug used for its mood-altering effects, which include euphoria and bursts of short-lived physical energy. The “high” produced by cocaine lasts for a short time. The crash that follows leaves the user in need of another dose to get back to the former high. But each encounter produces diminished a high, so that increasing doses are required to recapture the initial experience. The physical and social consequences of cocaine addiction are devastating both to the individual and society. It leads to impoverishment and the destruction of the individual’s health.

In the late 1970s cocaine was snorted, or sniffed through the nose, in its crystalline form, then known as “snow.” Because of its high cost, the number of users was limited. In order to get a faster and stronger high, cocaine was also taken by injection with a hypodermic needle. In the 1980s a cheaper version of pure cocaine made its appearance on the illegal market in the form of “crack,” which is smoked. In the form of crack, cocaine has reached a larger population, making it one of the chief drug problems of the twenty-first century.

History

Coca plants, which are the source for cocaine, are indigenous to Central and South America. The name of the plant is derived from the Inca word Kuka. Archaeological evidence points to the use of coca plants in South America as early as seven thousand years ago. They were used for many centuries by the Incas as part of their religious ceremonies. To help the dead in the afterworld, mounds of stored coca leaves were left at burial sites in the area of modern Peru. These sites are estimated to be about 4, 500 years old. The Incas may also have been using liquid coca leaf compounds to perform brainsurgery 3, 500 years ago. Inca records dating from the thirteenth through the sixteenth century indicate that coca was revered as a sacred object with magical powers. The magic plant of the Incas was chewed by priests to help induce trances that led them into the spirit world to determine the wishes of their gods. Artifacts dating back thousands of years to the earliest Incan periods show the cheeks of their high priests distended with what in all probability were the leaves of the coca plant.

Even before the Spanish conquest, Indians working in silver mines of the northern Andes chewed thecoca leaf to help overcome pain, fatigue, and the respiratory problems common at high altitudes. Early European explorers in the fifteenth century compared the common sight of Indians they saw chewing the coca leaves to cattle chewing cud. After the Spanish conquest the Church sought to ban the practice of chewing the coca leaf, mainly because of its association with Incan religious ceremonies. When the ban failed, the Spanish allowed the Incan survivors to continue their ancient practice of coca leaf chewing in order to maintain mining production. South American farmers, who are descendants of the Incas, continue the practice to the present day.

Introduction to the West

The main alkaloid in the leaves of the coca plant was extracted in 1859 by Albert Niemann (1834–1861), a German scientist, who gave it the name cocaine. Reports soon followed of therapeutic benefits of cocaine in the treatment of a number of physical and mental disorders. These reports also praised cocaine for being a highly effective stimulant, able to conquer the most severe cases of fatigue.

Sigmund Freud (1856–1939), two decades after Niemann’s work, began experimenting with cocaine, thinking it could be used to treat “nervous fatigue,” an ailment many upper- and middle-class Viennese were diagnosed with. He gave his fiancée cocaine and also administered it to himself. Then he wrote a paper praising the curative powers of cocaine in the treatment of such problems as alcohol and morphine addiction, gastrointestinal disorders, anxiety, depression, and respiratory problems. In this paper, Freud completely dismissed the powerful addictive properties of the drug, insisting that the user would develop an aversion to, rather than a craving for, its continued use.

Freud shortly afterwards became aware of his mistake when he attempted to cure a friend’s morphine addiction with the use of cocaine. At first the treatment seemed to work, but he soon saw that the friend developed an addiction to cocaine instead. Soon afterwards Freud’s friend suffered a complete nervous breakdown.

Unfortunately, there were other physicians and chemists who misjudged the properties of cocaine in the same way Freud had done. For example, a

neurologist and former surgeon general of the United States, William Hammond, also praised the healing powers of cocaine and pronounced it no more addictive than coffee or tea.

Coca-Cola

In the 1880s, John Pemberton (1831–1888), a pharmacist from Atlanta, concocted a drink called Coca-Cola from a prescription syrup that had been used to treat headache, hysteria, and depression. Pemberton’s elixir drink contained coca leaves, kola nuts, and a small amount of cocaine in a sugary syrup. His secret formula was picked up by Asa Chandler, who formed the Coca-Cola company. The drink was praised by the New York Times as the new wonder drug. At about the same time, cocaine was sold in a cigarette produced by the Parke-Davis pharmaceutical company. The cigarettes were marketed as a cure for infections of the throat.

Early drug laws

From all the nineteenth-century hopes for the possible medical uses of cocaine, the only practical application that held up was its use as a local anesthetic. All the other efforts to prove that cocaine was a wonder drug were dismal failures in light of the powerful addictive effects of the drug. By the early twentieth century, it had become clear that cocaine posed a serious hazard to any user.

In 1904, the cocaine was removed from the Coca-Cola syrup. In 1906 the Pure Food and Drug Act was enacted to stop the sale of patent medicines containing substances such as cocaine. Before that date, manufacturers were not required to list the ingredients of their patent medicines. The 1906 act made truthful labeling of patent medicines sold across state borders mandatory, but it did not stop the sale of cocaine products. New York State tried to curtail cocaine sales by passing a law in 1907 that limited the right to distribute cocaine to physicians. That law merely paved the way for the illicit street traffic. Dealers obtained cocaine from physicians and then sold it on the street.

The cocaine drug problem continued to rise until 1914, when the Harrison Act was passed. This legislation used the federal Treasury Department to levy taxes on all phases of cocaine trafficking and imposed further strict measures on the sale and distribution of cocaine. From that time to the 1960s, cocaine use dwindled, in part because of the rising popularity of amphetamines on the illegal market. The medical use of cocaine as a topical anesthetic and as an ingredient in cough medicines continued, while its illegal use was largely confined to the very rich.

After the 1960S

By the 1970s, when illegal drug use became more widespread in the general population, middle- and upper-class groups began to use cocaine in its white crystalline form. A mythology of its effectiveness as an aphrodisiac (a substance supposed to enhance the sex drive), a mental energizer, and a self-esteem booster began to develop. Along with benefits that active and ambitious middle-class people hoped for in their drug of choice, came reports of the relative safety of cocaine use in comparison to other drugs. The harsh lessons learned around the turn of the century were all but forgotten.

Crack

By the late 1970s, cocaine addiction in the United States had reached epidemic proportions. In the mid-1980s people started smoking cocaine after “freebasing” it, that is, dissolving the cocaine alkaloid from its white powder base to create a smokable form of pure cocaine. Ether is used to remove the hydrochloride base, which does not burn. The smoked cocaine goes straight into the bloodstream and gives a quicker and stronger high. Freebasing with ether can be dangerous because if any ether remains in the freebase cocaine, it can quickly ignite into flames when smoked. The comedian Richard Pryor, to mention one of the more famous cases, was severely burned when he freebased cocaine.

Besides freebase cocaine, there is another form of smokable cocaine, called “crack,” which also gives a fast and potent high. Crack is safer and easier to obtain than freebase cocaine because baking soda is used instead of ether to remove the hydrochloride. The baking soda produces pure forms of cocaine in small pellets that can be smoked in a pipe (where it makes the crackling sound that gave this form of cocaine its name). The cost of crack is so low that anybody, even a child, can afford it, and the drug soon began to wreak its devastations on the working classes. The widespread use of crack cocaine has led most visibly to rising crime rates, with gang wars erupting over control of territory and with users resorting to theft, prostitution, and other crimes to support their habits. Other consequences have been impaired workplace performance, new public health problems including such phenomena as crack babies, and a host of other social and economic evils.

Biochemistry

Used as a local anesthetic, cocaine constricts the blood vessels, thereby slowing down blood circulation. It also reduces the sensitivity of nerve endings, especially in the skin, eyes, and areas of the mouth. Because cocaine is a stimulant, it increases the heart and pulse rate and raises blood pressure, causing alertness, insomnia, loss of appetite, and dilated pupils.

Several theories have been proposed to explain the addictive effects of cocaine, which differs from other stimulants in its ability to trap the user in a cycle of continued use. Experiments using animals who are able to self-administer cocaine show that, once the need for cocaine is established, an animal will neglect its hunger and sex drives in order to satisfy the craving for the drug. Rats took cocaine until they died, while monkeys

KEY TERMS

Alkaloid— A nitrogen-based chemical, usually of plant origin, also containing oxygen, hydrogen, and carbon. Many are very bitter and may be active if ingested. Common alkaloids include nicotine, caffeine, and morphine.

Amphetamines— Stimulant drugs discovered in the 1930s that were widely prescribed as diet pills and became a staple in the illegal drug traffic.

Aphrodisiac— A drug that is supposed to stimulate sexual impulses.

Coca leaves— Leaves of the coca plant that were chewed by the Incas and are still used by farmers of certain regions in South America.

Crack— A smokable and inexpensive form of pure cocaine sold in the form of small pellets, or “rocks.”

Dopamine— The neurotransmitter believed to be responsible for the cocaine high.

Euphoria— Feelings of elation and well being produced by drugs such as cocaine.

Freebasing— Processes used to free drugs such as cocaine from their hydrochloride base.

Local anesthetic— A pain killer that acts on a particular site of the body without affecting other sites or causing unconsciousness.

Snow— The white powder of cocaine hydrochloride that is inhaled through the nostrils. This way of taking cocaine is called “snorting” and was popular in the 1970s before the advent of crack cocaine.

indulged until they exhibited such behaviors as paranoia, hyperactivity, convulsions, and heart failure.

Cocaine, like the opioids morphine and heroin, causes addiction by arousing an intense sense of pleasure. Certain parts of the brain induce pleasurable sensations when stimulated. Unlike the opioids, though, cocaine appears to have a greater access to those parts of the brain known as the limbic system, which controls the emotions. Cocaine stimulates the release of the neurotransmitter dopamine, which is responsible for the stimulation of the limbic system. The drug is therefore more potent than other drugs in being more psychologically rewarding. According to a recent theory, most of the mood and behavior changes brought about by cocaine use is due to the release of excess amounts of dopamine in the reward centers of the brain. The ensuing depression and craving for the drug are caused by dopamine depletion after the effects of the drug wear off.

Treatment and prevention

Breaking a cocaine dependency is difficult, and treatment is costly and prolonged, involving treatment centers and support groups. Since addiction is a chronic disorder, the detoxification process is just the first step, and there is no final cure. Remissions can be expected, and the goal of treatment may have to be the control and reduction of use and dependency.

Prevention efforts in the United States have for a long time been focused primarily on stopping cocaine imports from South America, mainly Peru and Colombia, and these efforts have had some success in breaking up the powerful and wealthy cartels that control the cultivation and trade of the coca leaf. However, these producers are still sending coca to the United States and continue to seek other markets worldwide. The U.S.-backed war against coca growing in Latin America has also been criticized as having negative environmental and cultural effects, especially in countries such as Bolivia, where coca continues to be a major crop for non-cocaine purposes. Coca growing has been legal in Bolivia since shortly after a former coca-growers’ union member, Evo Morales, was elected President in 2005.

Studies have shown that a recent decline of cocaine usage in the United States is directly correlated to educational programs targeting young people and aiming to enhance their understanding of the dangers of cocaine use. Such educational programs are more likely to lead to results than interdiction efforts and provide the best hope of curtailing the current epidemic of cocaine abuse and preventing similar epidemics in the future.