When Americans today think of dangerous and illicit street drugs, cocaine is usually among the first to come to mind. However, it wasn’t that long ago when cocaine was commonly available to the everyday consumer and hailed by some of the most influential people in society, from doctors to authors to popes.
At the turn of the 20th century, cocaine and products containing it were regularly sold at corner pharmacy stores. It was a normal ingredient of tonics, medications, and health products that were popular at the time. However, the dangers of cocaine addiction were lurking not far beneath the surface. While many supported or rationalized its use based on stimulant and anesthetic effects, addiction quickly ravaged those who turned to it.
While much has changed since, public perception of cocaine has travelled a long road: from traditional use by indigenous populations in the highlands of the Andes Mountains to modern America and the crack epidemic that destroyed lives and entire communities. It wasn’t always recognized as the incredibly addictive and damaging drug it is understood to be today, but the history of cocaine tells the tale of a largely dangerous substance in the evolution of its use around the world.
A brief introduction, first. Cocaine is derived from the leaves of the coca plant, erythroxylum coca. The plant grows naturally only in a select part of the world, northwestern South America.1 And even then, not all species of coca plant contain enough of the cocaine alkaloid — the chemical compound that produces the drug’s effects — to be used as crops for harvesting. Other alkaloids include nicotine, caffeine, and morphine. Viable coca plants are grown primarily in Colombia, Peru, and Bolivia. All three are consistently ranked as the world’s biggest producers, in varying order.
Chewed coca leaves produce stimulant effects that include feelings of alertness, increased stamina, decreased appetite, and euphoria. However, the cocaine most today are familiar with is cocaine hydrochloride, the powdered salt of the isolated cocaine alkaloid that is snorted or injected. Cocaine base, also known as crack, is the solid form of cocaine that is smoked. Both of these drugs have to go through multiple stages of chemical processing to render the final product — cocaine hydrochloride more so than cocaine base. Cocaine powder may also be cut with other substances, like fentanyl, that increase the dangers.
What Are the Effects of Cocaine?
As seen through the history of cocaine, many have turned to the drug because of stimulative physiological effects that increase energy and sociability, or provide a euphoric high. Cocaine can also act as a local anesthetic, another theme in its history, and is used for its effect on the central nervous system. A numbing sensation is created by inhibiting nerve excitation and blocking conduction. Cocaine also constricts blood vessels, which along with anesthetic qualities, give it medical use that is justifiable today. This is seen in cocaine being a schedule II drug in America.
Make no mistake, however; cocaine is a drug of abuse. Its effect on neurotransmission — which makes it practical in medical settings — is largely responsible for its addictive potential.1 Cocaine prevents the natural recycling of dopamine by receptors, and instead allows the chemical to build up and flood the brain. Continued use will disrupt neural communications in the brain so that it expects excess dopamine and will increasingly reward drug-seeking behaviors. The fact that cocaine’s effects are short-lived compound the problem, forcing drug abusers to seek more frequent use and higher doses.
In terms of effects on the body, there are many acute and chronic conditions, as well as the possibility for fatal overdose.1 These may include:
- Paranoia, irritability, restlessness, and aggression.
- Hypersensitivity to light, touch, and sounds.
- High blood pressure, collapsed veins, and fast or irregular heartbeat.
- Nosebleeds as well as deviated septums in the long term.
- Diseases and infections transmitted by shared or dirty needles (e.g. HIV and hepatitis).
These risks vary according to the type of use and form of cocaine. Yet they have always been present in some way throughout the history of cocaine.
Indigenous People Chewed Coca Leaves in South America
The coca plant was used often by the populations who were native to Andean regions where it grows. Its use was incorporated in several facets of life, over thousands of years, whether during physical tasks or ceremonies and rituals. Eventually, coca leaf became a fixture of the Inca empire, which absorbed the separate cultures and assimilated traditional users from different ethnicities and groups. So systemic was the use that the peoples were observed to have specific tools and containers for coca leaf and lime, which was chewed in tandem to activate the cocaine alkaloid. It was also considered a religious sacrament, and thus subject to various rules governing its use.
Conquistador forces from Spain, however, were among the first non-natives to document traditional coca leaf use. These invaders enslaved the natives and brutalized them through a long colonization campaign in the 1500s. At first, the Catholic Church entreated these forces to ban coca leaf. That never came to pass after colonizers saw how chewing it contributed to the efficiency of the laborers in their mines and fields. The church itself would then go on to amass cultivation operations and collect tax on the plant. The Spanish were even thought to have become coca leaf users themselves, according to an excerpt from Richard J. Miller’s “Drugged: The science and culture behind psychotropic drugs.”4
A priest who accompanied the Spanish wrote, perhaps presciently, of its constant use and value to the culture: “… coca, which is the leaf of a small tree that resembles the sumac found in our own [historical kingdom of] Castile, is one thing that the Indians are [never] without in their mouths, that they say sustains them and gives them refreshment, so that, even under the sun they feel not the heat, and it is worth its weight in gold in these parts.”
Coca Gains Popularity in the Victorian Era
It took some time before cocaine became more widely known and used in the Western world. This is in part due to coca leaves not traveling well. Rarely did shipments of coca from the Spanish-controlled Andean regions make it to Europe intact, as the potency of the leaves degraded quickly during the time at sea, unlike other commodities such as tea.
It wasn’t until the middle of the 19th century when scientists, doctors, entrepreneurs and others began to take notice of coca leaves and their potential. Italian physician Paolo Mantegazza traveled to Peru and witnessed coca leaf use firsthand — and indulged himself. His glowing accounts described energetic jubilance and included theorizing practical medicinal use.5
Published in 1859, these writings were among the first breaks in Western acceptance of the drug; the biggest would occur fewer than five years later.
In 1863, a chemist from the French island of Corsica starting selling a tonic that was touted for restoring vitality, calming nerves and giving imbibers a pep in their step. Angelo Mariani had read Mantegazza’s writings, as well as other early literature on coca, and brewed coca leaves in Bordeaux wine. The combination was meant to cover the bitterness of the leaves, but the greater effect was the ethanol of the wine acting as a solvent for the cocaine alkaloid. Coca use was by that time growing for all sorts of reasons—as a digestive, as a mood enhancer, as a cure for aches and ails—and Vin Mariani soon earned distinguished advocates and a massive following.
The drink, which contained around 6 milligrams of cocaine per ounce, was so acclaimed that Pope Leo XIII officially recognized it with a Vatican medal.6 He was far from being the only well-known historical figure with an affection for Vin Mariani — let alone the only pope. Other notable fans included Queen Victoria of England, Presidents Ulysses Grant and William McKinley, and Thomas Edison. Many authors of the day also swore by it, including Alexandre Dumas, Emila Zola, and Jules Verne.
The Cocaine Alkaloid Is Isolated
Around the same time as coca gained prominence in Western culture, chemists made rapid scientific progress, fed by better technology and tools. Isolation of alkaloids—like nicotine or morphine—became more efficient and effective.
Chemists before Alfred Niemann had moderate success in extracting cocaine, but the German made the biggest steps forward in 1860. Given a cache of coca leaves from South America to investigate for his doctoral thesis, Niemann extracted cocaine in a crystalline form and first sketched out its molecular formula. The extraction produced a numbing effect when administered to the tongue, Niemann recorded. He would die the next year, but Wilhelm Lossen, a former student of Niemann’s, would carry on his work and map out a fuller picture of the formula. 7
The scientific community would have to wait until close to the turn of the century in 1898 until a full understanding of cocaine’s chemical structure was achieved. Richard Willstatter, using knowledge of the tropane alkaloid family to which cocaine belongs, confirmed the structure when he made synthesized cocaine according to the chemical formula he worked out.
Freud, Coca-Cola, and the Retail Medicalization of Cocaine
Before Willstatter had confirmed the structure, Lossen’s elucidation of the cocaine alkaloid would pave the way for the rise of cocaine hydrochloride — the snorted or injected powder that is most commonly associated with drug use.
A famous proponent of this form of cocaine, and its overall use, was Sigmund Freud, one of the most influential psychologists in history. The Austrian wrote “Uber Coca” in 1884, an ode to the substance that contained praise for cocaine’s ability to induce “… exhilaration and lasting euphoria, which in no way differs from the normal euphoria of the healthy person …You perceive an increase of self-control and possess more vitality and capacity for work.”8 At the time, Freud, a habitual user, would significantly downplay cocaine’s addictive qualities, saying it created “no craving” even after repeated use, but recommended it for several pharmacological applications. His conversations with Karl Koller, a peer and opthamologist, would lead the latter to experiment with cocaine as a topical anesthetic.
American advances in cocaine would soon follow, both commercially and medically. A pioneer in U.S. medicine, William Halsted, read about Koller’s success with cocaine and conducted his own trials with the drug as a nerve block for use in surgery.9 The American version of Vin Mariani would also arrive on the scene in the 1880s: Coca-Cola. The drink was first developed by John Pemberton, who had a morphine addiction, as a wine-based tonic. Later, a series of tweaks to the recipe in response to Georgia’s outlawing of alcohol led to the carbonated fountain drink consumers today are familiar with. The beverage as Americans in the late 19th century knew it, however, provided a bit more energy, as it contained cocaine, not caffeine. Like the Bordeaux wine and coca leaves concoction from Mariani, Coca-Cola took off with the public thanks to highly effective marketing.
Soon enough, cocaine was being packaged into home medical kits and sold as a salt in both local drug shops and downtown department stores. Pharmaceutical companies like Merck and Parke-Davis would enter the business of producing and refining cocaine for use, while other patent medicines became staples among Americans.
Addiction Rears Its Head and Law Enforcement Takes Aim
Access to cocaine was nearly without limits and regulation was scant, allowing thousands of drug-containing products to proliferate and be abused, largely without an understanding of how habit-forming and dangerous cocaine could be. As America, and the world at-large, entered the 1900s, cocaine consumption and addiction rose rapidly. It was estimated there were 200,000 cocaine addicts in America in 1902, and coca leaf imports had tripled from 1900 to 1907.10
The risks of cocaine abuse became apparent to the public, and intimately so to the influential minds that had normalized its use, to a degree. Halsted did have success with cocaine as an anesthetic, and was a founder of the Johns Hopkins School of Medicine. However, he tested cocaine on himself and would develop a severe addiction that ultimately forced him to give up his medical career. Freud, also, would come to terms with his cocaine addiction, as well as his responsibility for recommending cocaine to countless patients and almost killing one with cocaine-related therapies. Irregular heartbeats and other reasons would lead Freud to renounce his support for cocaine. By 1903, Coca-Cola had altered its formula drastically and removed cocaine amid increasing pressure, instead using spent coca leaves that didn’t contain the alkaloid.
By the 1910s, the tide had turned against cocaine and the public and government no longer saw it as a harmless substance, but a dangerous drug. The first attempt to rein in cocaine use and availability had been made in 1906 with the Pure Food and Drugs Act, which required tonics and other products to list cocaine and other potentially harmful ingredients on their labels. States took action to outlaw its use — a trend that paralleled the growing temperance movement. The Harrison Narcotics Act of 1914 was the first federal law enforcement push targeted at cocaine and other drugs like heroin and morphine. It didn’t outright ban the use, but instead limited coca availability to those who got it from a doctor, which functionally restricted the street-level access. Unfortunately, the Harrison Narcotics Act was influenced by racist fear-mongering, a tangent line that would appear again in the 1980s. Ultimately, the Jones-Miller Act of 1922 would effectively stamp out rampant cocaine abuse by instituting federal controls over import and export of harmful substances (namely opiates and coca) and by establishing the Federal Narcotics Control Board, essentially convened to eliminate recreational use.
After a Lull, Cocaine Remerges and Crack Explodes
By all accounts, those efforts succeeded in dampening American enthusiasm for and use of cocaine. While drugs did not disappear entirely, the counterculture that defined the ’60s and early ’70s was more favorable to marijuana, LSD, and other hallucinogens. Cocaine didn’t exactly fit the mellow mood.
Cocaine would reappear, however, amid renewed fame and acclaim. In 1977, Eric Clapton released the song “Cocaine,” extolling its many uses, while 1982 saw the film “Scarface,” which glorified drug trafficking and cocaine abuse, and which is still extremely popular to this day. Wall Street embraced ’80s excess and cocaine, which was also played up in media and pop culture. Even Richard Pryor would joke about setting himself on fire while trying to freebase cocaine. The cumulative effect was a reemergence of the drug that picked up in the disco era, continued into the club scene of the ’80s and beyond. It also seemingly amounted to a collective public forgetting of the very real dangers of cocaine. Deaths due to cocaine abuse quadrupled between 1976 and 1981.11 Despite this grim toll, 1983 saw 10.4 million people try cocaine for the first time, marking the peak of American use.
But perhaps the defining moment in the history of cocaine in the United States was the crack epidemic. Cocaine hydrochloride was, and is, a comparably expensive drug: A gram in the 1980s cost between $100 and $125, equal to nearly $300 in the late aughts.12 Crack cocaine was invented as a less pricey and safer alternative to freebasing that amplified both the psychostimulant effects and addictive potential. Crack, which is powdered cocaine cooked with water and baking soda to form cocaine base, allowed drug dealers to stretch their supply — but the result was an inner-city crisis that has had long-term socioeconomic effects.
Crack cocaine use became an unstoppable wildfire in major urban areas like New York City, Los Angeles, Detroit, Chicago, Houston, Atlanta, and Miami. The low price and glut of crack abuse led to a rash of addiction and crime that destroyed lives and communities, and which was largely undermanaged by the government. By 1985, there were more than 12 million cocaine users in America, with around a quarter of a million using daily.13
The eventual federal response was to begin the War on Drugs and introduce mandatory minimum sentences for crack cocaine-related offenses. The ratio for crack offenses and powder cocaine charges was 100:1, meaning the low-level crack dealer and user was punished more than the drug trafficking kingpins of cocaine hydrochloride. Several studies would show mandatory minimums had a disproportionately negative impact on minorities, particularly blacks, and would lead to high incarceration rates for youths. Cocaine use would taper off—but not before deaths due to its use climbed to a peak in the 1990s.
While cocaine and crack remain among the most dangerous drugs, their use has retreated once again. According to the 2017 National Survey on Drug Use and Health, around 6 million people in America had used cocaine in the past year, and 930,000 had used crack in the same time. Importantly, teenage use of cocaine has largely fallen.14
However, there are warning signs that cocaine use could be back on the uptick. Overdose deaths involving cocaine in 2015 were their highest in nearly a decade, and second-highest since 1999.15 Other government data found that cocaine use has tracked higher along with the wider opiate epidemic. For deaths across all drug categories observed between 2015 to 2016, the largest overall increase occurred in deaths involving cocaine.16
The history of cocaine is a long one, meaning the issues of abuse and addiction that the U.S. and the world experience are not going away. Cocaine will always be a dangerous drug, and many will develop substance abuse disorders around it. If you or a loved one need help addressing such a dependency, don’t hesitate to contact American Addiction Centers today for more information about treatment options.
- National Institute on Drug Abuse. (2016). What is Cocaine?
- (2019). Cocaine.
- National Institute on Drug Abuse. (2018). DrugFacts: What is cocaine?
- Miller, R.J. (2013). A brief history of cocaine.
- Wahrig, B. (2009). “Fabulous things”. Drug narratives about coca and cocaine in the 19th century. Ber Wiss, 32(4), 345-364.
- Proof Drinks. (2017). The Illustrious (& Outrageous) History of Vin Mariani.
- Dronsfield, A., Ellis, P. (n.d.). Cocaine-a short trip in time. Education in Chemistry.
- A Spoonful of Sugar? org.
- Redman, M. (2011). Cocaine: What is the Crack? A Brief History of the Use of Cocaine as an Anesthetic. Anesth Pain Med, 1(2), 95-97.
- A Social History of America’s Most Popular Drugs.
- New York Times. (1982). Death Rate Soars in Cocaine Cases.
- United States General Accounting Office. (1991). Drug Abuse: The Crack Cocaine Epidemic: Health Consequences and Treatment.
- Miroff, N. (2017). American cocaine use is way up. Colombia’s coca boom might by why. The Washington Post.
- Seth, P., Scholl, L., Rudd, R.A., Bacon, S. (2018). Overdose Deaths Involving Opioids, Cocaine, and Psychostimulants — United States, 2015–2016. Weekly, 67(12), 349-358.
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