Cocaine — When did people start "taking" it?

Dear Reader,

Cocaine use dates back long before Eric Clapton’s famous song from the 1970s. An illegal drug in the United States and many other countries around the world, cocaine has been used in the past for a variety of purposes. Its rich history shows an evolution from food to medicine to illicit drug, with scientists discovering along the way the effects that can accompany cocaine use.

About 4,000 years ago, long before cocaine was the refined, purified stimulant it is today, its source (the coca plant) was used as a food substitute during difficult agricultural periods caused by tribal wars in Central and South America. This is the region in which coca plants are native. Interestingly, nutritional analyses have revealed that the leaves contain carbohydrates, protein, calcium, iron, phosphorus, and vitamins A, B, C, and E. However, the purified cocaine used as a drug today doesn't contain the nutritional benefits of the coca leaves because the active ingredient — cocaine hydrochloride — has been refined and the rest is discarded.

One population in particular, the Peruvian Amara Indians have been documented as using coca (by chewing the leaves) for over a thousand years with few physical effects. Due to the low concentration of active ingredients in the leaves, paired with the limitations of how many leaves a person can chew, even the most persistent chewer can only gnaw on a limited number of leaves. Later, lime, or other substances, were taken in combination with the coca leaf to extract the active ingredients within. Additionally, Inca traditional healers used coca leaves medicinally, as a local anesthetic (when mixed with saliva), or to treat various illnesses, including eye or mouth irritation, mountain sickness, or indigestion. Coca leaves were even used as an aphrodisiac. When the Spanish explorers arrived in the Americas, they were first skeptical of the use of coca, even considering it to be evil. Then, they discovered its economic potential. They observed Native Americans using coca leaves to increase worker efficiency in the high altitudes of the silver mines, and by the mid-1500s the King of Spain had officially approved its use by native workers. The tax collected from the coca sales were then used to construct buildings, such as churches, providing an additional economic benefit. 

In the 1600s, Europeans, such as Bernabe Cobo, a missionary from Spain, began to investigate the other potential properties of coca leaves. Cobo was specifically interested in the coca leaf's potential medicinal properties. After observing indigenous communities of Peru using the plant, he began to use coca leaves to reduce toothache pain in 1653, demonstrating their anesthetic properties, and beginning cocaine's journey to widespread use in Europe. 

The active ingredient from the coca plant wasn't isolated until 1860, when Albert Niemann, a German chemist, successfully separated cocaine hydrochloride from the rest of the leaf. This marked a turning point in the history of cocaine because the cocaine hydrochloride could now be used as an ingredient in food and medicines. From its European debut as a wine additive (in a drink called Vin Mariani) to the American creation of Coca-Cola (originally concocted by pharmacist John Styth Pemberton), the refining process improved. By 1880, cocaine was also considered a beneficial surgical anesthetic, following scientific experiments by Basil Von Anrep, although the effects of its use in this manner began to surface just a few years later. 

Sigmund Freud, called the “founding father of psychoanalysis,” touted cocaine as a miracle drug, hailing its use in treating depression and indigestion. Newspapers reported cocaine use as a way to boost intelligence. Merck, a German pharmaceutical company, began mass-producing cocaine to use as a local anesthetic. By the late 1800s, cocaine had become a key trade commodity, with coca plants being grown in Asia and the active ingredient being produced mostly by pharmaceutical companies. As the increasingly refined cocaine form was being ingested, its harmful effects — including severe addiction and cardiovascular problems — became more apparent. Essentially, as people were ingesting larger quantities of the active ingredient (made possible by improved purification technologies), physical, psychological, and social consequences also increased. 

By the early 1900s, cocaine abuse became a pressing concern, and alternate anesthetics were investigated to reduce cocaine use in medicine. Starting in New York and soon spreading across most parts of the United States, cocaine use was legally restricted through the 1914 Harrison Narcotics Act, and mandatory drug education was implemented in public schools. During World War I, the United Kingdom saw many of its soldiers returning from war with cocaine addictions and followed suit in banning its use. Of course, just because something is made illegal doesn't mean people will stop using it. The Harrison Narcotics Act left loopholes open to allow cocaine buying to continue, and crack cocaine, a smokable form of the drug, emerged in the twentieth century, resulting in more serious health effects due to its higher concentration of cocaine than powder cocaine. As a result, the 1970 Comprehensive Drug Abuse Prevention and Control Act was enacted to create stricter controls on the drug.

Today, cocaine remains a popular recreational drug. Overdose deaths from cocaine have increased since 2013. Many of these deaths have been when cocaine was also involved with opioids. While alternate anesthetics and treatments are used, the Academy of Otolaryngology-Head and Neck Surgery still considers cocaine appropriate for limited medical uses as an anesthetic and blood vessel narrower. Despite its long history, cocaine in its current forms poses the potential for serious health risks. To learn more about the drug and addressing cocaine use for yourself, a friend, or a family member, you can check out the related Q&As. You can also search through the Go Ask Alice! Cocaine, Speed, & Other Stimulants archive for additional information.

 Hope this history lesson proves helpful!