Part V

Coca Leaves, Cocaine, the Amphetamines, "Speed" and Cocaine Again

Cocaine, a drug extracted from the leaves of the South American coca plant, is a stimulant of the central nervous system that produces euphoria (a sense of well-being). It still has some medicinal uses in anesthesiology, but has for the most part been superseded by synthetic drugs.

The  amphetamines are a large group of synthetic drugs with marked cocaine-like effects but are longer-acting than cocaine. Examples are dextroamphetamine (Dexedrine), methamphetamine (Methedrine, Desoxyn), and amphetamine itself (Benzedrine). The amphetamines are widely used to stave off sleepiness among those who work (or play) long hours, and are popular as "diet drugs" and as antidepressants.

Tolerance to the effects of both cocaine and the amphetamines sometimes sets in; hence there is a tendency among some who use the drugs nonmedically to escalate the dosage. Though usually taken orally, these drugs are injected intravenously by "speed freaks." Excessive doses, especially if taken intravenously, produce hyperactivity, paranoid thinking, other psychotic symptoms, and (occasionally) violent behavior. Both cocaine and the amphetamines are addicting to some people under some circumstances.

Other central nervous system stimulants that differ from the amphetamines chemically but resemble them in numerous pharmacological respects include phenmetrazine (Preludin) diethylpropion (Tenuate, Tepanil), and methylphenidate (Ritalin); they are often prescribed as anti-depressants and as "diet drugs." These drugs and the amphetamines should not be confused with drugs prescribed as antidepressants that do  not stimulate the central nervous system, such as imipramine hydrochloride (Tofranil) and amitriptyline (Elavil), which are rarely used nonmedically and therefore are not covered in this Report.

Chapter  34. Coca leaves

When the Spanish  conquistadores, early in the sixteenth century, first encountered the empire of the Incas, * they found that the Emperor himself –– the Inca-controlled the use of a remarkable drug contained in the leaves of a mountain shrub now known as  Erythroxylon coca. When these leaves were chewed, euphoria and other desirable effects soon followed. "Among the highest rewards the Inca could give," Dr. Hector P. Blejer explained in the  Canadian Medical Association Journal for September 25, 1965, "was the right to chew the coca leaf, which was prized far above the richest presents of silver or gold." Priests and supplicants were allowed to approach the Altar of the Inca only if they had coca leaf in their mouths. "Even at the moment of death it was, and still is, believed by the natives that, if the moribund person was able to perceive the taste of the coca leaves pressed against his mouth, his soul would go to paradise." A plentiful supply of the divine drug was buried with each Inca nobleman.

* The portion of South America that today comprises Peru, Bolivia, Ecuador, and parts of Chile and Colombia.

The conquistadores took over the Inca's coca leaves along with his empire. Although superstitiously afraid to use the drug themselves, they "gave coca freely to the Indians to control them, and hold them more tightly as virtual slaves. Under the effects of the coca leaf the Indians worked harder, longer, and with less food [coca, like amphetamine, is a potent appetite suppressant].... It also helped them, perhaps, to endure, and forget, and even escape their misery."

The Spaniards supported their empire by taxing the Indians heavily; "ironically, some of these taxes had to be paid in coca leaves, a commodity in which the administration had a very profitable turnover."

Meanwhile, high in the Andes Mountains, where the coca shrub has been cultivated since time immemorial, natives beyond the reach of the Spanish occupation continued to chew coca leaves, as no doubt they had chewed them before the days of the Incas, and as they continue to chew them today. Far from suffering disaster, they have managed through the centuries to survive the rigors of an incredibly harsh mountain environment, to the continuing amazement of European visitors. Nor do the Andean leaf-chewers appear to become addicted; on moving down to ordinary altitudes, many of them give up their coca without apparent hardship. *

* Dr. Jerome H. Jaffe wrote ( 1965): "it is reported that two million Peruvians who live in the Andean highlands, or 90 percent of the adult male population, consume ... cocaine . . . in the form of coca leaves. In view of the fact that many of these highlanders, who have chewed coca leaves for years, abandon the practice when transferred to a lower altitude, it does not seem appropriate to call this use of cocaine an addiction ."

Nineteenth-century European and American scientists, naturally enough, took an interest in this potent drug. "All trustworthy travelers agree," an American physician, Dr. J. L. Corning, wrote in 1886, "that the most noticeable effect . . . consists in a marvelous invigoration of the strength, both mental and physical. The native is enabled to undertake the most difficult and prolonged marches with little other sustenance." A large dose, however, Dr. Corning added, "produces a species of intoxication, accompanied by sensations of lively satisfaction as well as hallucinations of various kinds."

The chewing of coca leaves, for some unknown reason, never became popular either in Europe or North America. Various drinks made from the coca leaf, however, were introduced into Europe–– notably "Mariani's wine," a red wine or elixir containing coca, manufactured during the nineteenth century by a Corsican, Signor Angelo Mariani. "Among his clients," Dr. Blejer notes, "were Gounod, Massenet, and Pope Leo XIII, who for years was supported in his ascetic retirement by Mariani's product." just as caffeine helped pious Mohammedans stay awake during prolonged religious rituals, so coca helped Christian ascetics withstand the pangs of hunger during prolonged fasts.

In the United States, a resident of Atlanta, Georgia, named John Styth Pemberton, introduced a product similar to Mariani's wine in 1885. Pemberton had previously been marketing patent medicines such as Triplex Liver Pills and Globe of Flower Cough Syrup. The registered trademark for his new product was  French Wine Coca–– Ideal Nerve and Tonic Stimulant. The next year, he added yet another coca product, a syrup that he called Coca-Cola. * The "Cola" in the name indicated the presence of an extract of kola nut–– an African product that contains about 2 percent caffeine. That year, Pemberton is said to have sold twenty-five gallons of the syrup. At various times it was advertised as a remarkable therapeutic agent" and as a "sovereign remedy" for a long list of ailments, including melancholy and (curiously) insomnia.

* These and other Coca-Cola facts are taken from E, J. Kahn's book,  The Big Drink: the Story of Coca-Cola (New York: Random House, 1960).

Coca-Cola became one of the chief targets of Dr. Harvey Wiley in his drive to have a Pure Food and Drug Law enacted (see Chapter 7). By 1906, when the law was passed, Pemberton's successors as makers of Coca-Cola had switched from ordinary coca leaves to decocainized coca leaves, but caffeine was still included in the formula. In 1909, Dr. Wiley, as head of the Bureau of Food and Drugs, initiated a famous case entitled   United States v. Forty Barrels and Twenty Kegs of Coca-Cola. The company was charged with adulteration (because the Pure Food Act prohibited adding caffeine to a product) and misbranding (because, it was charged, Coca-Cola contained no coca and little cola). After dragging through the courts for nine years, and following Dr. Wiley's retirement from the government, the Coca-Cola Company agreed to make certain changes in its manufacturing process; in exchange for paying all legal costs, the company was allowed to reclaim its barrels and kegs. (As reported in the January 1971 issue of  Consumer Reports, Consumers Union laboratory tests confirmed the presence of caffeine in Coca-Cola and in Pepsi-Cola.)

The Harrison Narcotic Act of 1914 mistakenly classed coca products as narcotics; and since 1914 coca leaves have been subject to the same penalties as opium, morphine, and heroin. The American coca-leaf interests, however, were powerful enough to secure a special clause in the Harrison Act exempting  decocainized coca leaves–– just as the proprietary opiate interests were able to secure a clause in the act exempting patent medicines containing small amounts of opium, morphine, and heroin.

A search of the medical literature has turned up little data to indicate that the chewing of coca leaves or the imbibing of beverages containing small amounts of coca is more damaging to mind or body than the drinking of coffee or tea. * Nor are the physiological and psychological effects notably different; both coca and caffeine are primarily stimulants of the central nervous system.

* A leading American authority on drugs of plant origin used by primitive peoples Professor Richard Evans Schultes, Director of the Botanical Museum of Harvard University–– reports that during his plant explorations in the Amazon Valley he chewed coca leaves daily for eight years, did not become addicted, and suffered no apparent physical harm from the custom.

Footnotes
Chapter 34

1. Hector P. Blejer, "Coca Leaf and Cocaine Addiction–– Some Historical Notes,"  Canadian Medical Association Journal, 93 (September 25, 1965): 701.

2. Ibid.

3. Ibid.

4. W. G. Mortimer,  Peru History of Coca, "The Divine Plant" of the Incas, With an Introductory Account of the Incas and Andean Indians of Today (New York: J. H. Vail and Co., 1901), pp. 28 and 119; cited by Blejer, p. 701.

5. Jerome H. Jaffe in  Goodman and Gilman, 3rd ed. (1965), p. 299.

6. J. L. Corning,  Local Anesthesia in General Medicine and Surgery, Being the Practical Application of the Author's Recent Discoveries (New York: D. Appleton and Co., 1886), p. 21; cited by Blejer, p. 702.

7. Mortimer,  Peru History of Coca, p. 179, cited by Blejer, p. 702.

8. Personal communication.