Cocaine's botanical origins, historical uses, and modern social impact

Cocaine

Botanical Origins

Cocaine is synthesized from the leaves of the coca plant. These plants grow in Bolivia, Peru, Columbia, Africa, Taiwan, Indonesia, and Formosa. The leaf contains between 0.5% and 1.5% cocaine and the processing methods extract pure cocaine from the leaves.

In the late 15th century, the Incan people thought coca leaves were direct gifts from the gods in order to help them through the brutal physical abuse of working long days and nights in the gold and silver mines at very high altitudes. These people used the leaves during their burial ceremonies and religious rituals; they were controlled as a very special blessing from supreme beings. By mixing the coca leaf with lime or ash, the chewers could "graze" for days - offsetting the effects of physical and mental exhaustion.

Invaders to the Incan and Andean cultures were divided over the "permitted" use of the coca leaves by these people. One faction held that these Indians should not use the leaves at all since it was an idolatrous barrier to Christianity while the second encouraged the leaf chewing because they could wring days of hard labor out of the Incans with very little time required for rest, food, or water.

The coca leaf arrived in Europe along with tea, coffee, and tobacco, through the travels of 16th century explorers, but remained largely unpopular until the 19th century. In 1863, Albert Niemann extracted purified cocaine from the coca leaf's crystalline powder and is credited with medical advances in anesthesiology during eye, nose, and throat surgeries as it constricted blood vessels, limited hemorrhaging, and immediate anesthesia.

Steeped infusions using the coca leaves are used for medicinal purposes such as elevation sickness, syncope, headache, and throat and stomach problems. Poultices contain coca leaves for treatment of rheumatism, bone fractures, and dislocations. These uses continue to this day among the mountain-dwelling Indians.

Social Uses

Cocaine was the chief ingredient in Coca-Cola, advertising itself as "the drink that relieves exhaustion." In 1903 - due to the widespread use and ensuing addiction and in compliance with governmental efforts - the company removed the chemical from their recipe and replaced it with caffeine.

Cocaine has been classified as an illegal, prohibited drug in both patented medicines and recreational use since 1914. Emergent trauma use still occurs today, but with the plethora of alternative drugs available to the critical care medical team, it is very rare.

Cocaine use grew in popularity in the 1960's among the wealthy and those in the public eye (e.g., celebrities, musicians, sports performers, show business performers, et. al.) It rose to the dubious classification of a "status" drug in the 1970's and its danger was largely ignored throughout that decade and part of the 1980's. The accumulation of empirical medical evidence and the introduction of "crack" cocaine caused fear and concern for its use once again.

Cocaine use crosses all social, economic, educational, occupational, gender, racial, age, and religious lines; young people are historically the more frequent users, with men outnumbering women two to one.

Abuse

Cocaine is a highly addictive central nervous system stimulant. Affected pathophysiology includes enlarged pupils, elevated heart rate and blood pressure, sweating, tremor, hyperactivity, seizures, stoke, heart irregularity, and unannounced sudden death.

Psychological effects range from a sense of euphoria, to paranoia, confusion, mimicked paranoid schizophrenia, psychosis, transient or "binge" paranoia, dependence, underlying depression, and high comorbid psychiatric factors.

Crack cocaine is the street name for a form of cocaine, which has been processed from cocaine hydrochloride into a "free-base" for smoking. The smoke delivers very high doses of cocaine to directly reach the brain. This results in an intense and rapid (i.e., immediate) "high." Compulsive use rapidly leads to abuse and addiction with no predictable addiction patterns definable prior to an individual's first use.

Chronic abuse patterns are seen in even the casual user over a short period of time with social and economic factors rapidly appearing with the decline of impulse-control and incline of the addiction.

A combination of marijuana and crack cocaine - known as "fireweed" - is a street drug offering a more "mellow" high but with the increased intensity of paranoia and perceptual changes.

Behavior

False hallucinations are common among cocaine users. Tactile hallucinations - "cocaine bugs" - sensations of itching and particles moving under the skin, visual hallucinations - "snow lights" - the flashing of lights behind closed lids, olfactory hallucinations - smelling repulsive odors of feces, garbage, and urine, and digestive hallucinations - failure to detect strong food and drink - are often reported in users of short duration (i.e., three to six months) and become more pronounced as the abuse lengthens.

An addict will often display a personal fascination with their own thought processes and become quite philosophical about the meaning or core of things. Repetitious, almost compulsive behavior can be seen in the moderate to heavy user of cocaine.

Chronic use and defined addiction often leads to a "reverse tolerance," convulsive behavior, dysphoria, paranoid psychosis, insomnia, apathy, anxiety, and melancholy.

Summary

Cocaine is the product of a naturally occurring botanical mixed with non-botanicals to produce an unnatural state of euphoria in the human brain. With the unpredictability of addiction - one never knows if they will fall victim to its lure - it is unwise to take the first "snort," smoke, or injection.

With the emerging data on the side effects, social stigma, naturally attendant aggressive and violent tendencies, illegality and criminal consequences, family decimation, economic drain, and psychological problems, which stem from its use, cocaine is a dangerous drug.

Flirting with this drug can result in a lifetime of problems - including poverty, loss of job, paranoid-affective inability to function, loss of family and support systems, diminished self-esteem, repeated criminal records, and even loss of life, the wise will never try it at all and those who have will never do so again!

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