Cocaine Use and Abuse


Cocaine has had, and continues to have, an influence on popular culture. It has been highlighted in songs, such as Cocaine Blues, sung by Johnny Cash, in That Smell by Lynyrd Skynyrd, Cocaine by J.J. Cale, and Life in the Fast Lane by The Eagles, as well as in other songs by various artists. Yet, what is it about cocaine that keeps it such a popular topic?

The coca plant is native to the high mountain ranges of South America and serves as the building block of the drug. It was first extracted from the plant in 1855 and was called Erythroxyline. In 1862, it was given its current name, cocaine, after being extracted and purified.

Its medical use as an anesthetic was first recognized in 1884. Sigmund Freud reportedly used the drug to treat post-natal depression. Although his experimentation ended due to side effects, he extolled its virtues. It ultimately became thought of as a cure-all.

The noted physician W. S. Halsted found that he could, by injecting cocaine into a sensory nerve, block all conduction through that nerve. This rendered the whole area from which the nerve branches emerged insensitive to pain. Halsted became addicted to the drug. Others promoted its anesthetic value or its potential as a cure for alcoholism and opium abuse.

The beverage Coca-Cola was created by a physician. In its original formulation and through the early 1900s, the drink contained traces of cocaine. This is what puts the “Coca” into the brand’s name. The “Cola” comes from the caffeine-rich kola nut that also became a part of the formulation.

The drug has been used and abused; its use even discreetly making its way into the literature of Sir Arthur Conan Doyle. Sherlock Holmes was thought to have suffered from an addiction to it. This is gleaned from Dr. Watson’s lecturing of Holmes, where the sleuth’s companion says: “But consider! Count the cost! Your brain may, as you say, be roused and excited, but it is a pathological and morbid process, which involves increased tissue change, and may at least leave a permanent weakness. You know, too, what a black reaction comes upon you. Surely the game is hardly worth the candle. Why should you, for a mere passing pleasure, risk the loss of those great powers with which you have been endowed? Remember that I speak not only as one comrade to another, but as a medical man …”

Fast forward a few decades and it seems that the addictive substance had a press agent working for it. A July 1986 issue of Time magazine portrayed a martini glass filled with white powder on the cover with a headline that read “HIGH ON COCAINE – a drug with status – and menace.” New York Magazine, a lifestyle publication, was reported in 1981 to have called it “every bit as enjoyable as Freud claimed.” Today it is considered by the U.S. Food and Drug Administration as a Schedule II drug – not available for prescriptive use but only for institutional application.

In its purest form, it is a white, pearly product and is chemically considered a salt when in powdered form. Street use by “cutting,” or diluting the drug, with other white powders, such as lactose, increases the weight while reducing the original potency of the drug. Crack is a form of the drug that is smoked. The vapors enter the body faster and can cause more damage than the powdered form, especially to the lungs.

Regardless of how it is used, it is a highly addictive substance. Cocaine causes nerve cells to release abnormally large amounts of dopamine. This increases nerve firing or prevents the normal recycling of the brain chemicals that are needed to turn off the signaling between neurons. The brain regions involved in emotion and feelings of pleasure are bathed in dopamine and become overactive, effectively producing euphoria. The user gets reinforced and, in order to get the same result, repeats the same behavior. In essence, usage becomes learned, and addictive behavior results. Long-term involvement with the drug has been shown to change normal brain chemistry, leading to thinking impairment or compulsive use.

It is clear that when used as white powder or rock, it becomes addictive and potential for abuse abounds. Rapper Chris Kelly died at 34 from an overdose; singer Whitney Houston drowned as a result of complications of cocaine; Billy Mays, the pitchman for Orange Clean, Orange Glo, and Oxi-Clean, among others, died of heart disease in which cocaine use was possibly implicated; singer Ike Turner died of cardiovascular issues and lung disease complicated by cocaine overdose; and John Entwistle of The Who died of a heart attack induced by cocaine.

By Bob Reinhard

Sources: History of Cocaine
University of Bristol School of Chemistry: The history of the extraction and study of cocaine
World of Coca-Cola: The History of Coca-Cola The History of Coca-Cola
The Sign of Four: Arthur Conan Doyle
National Academy of Sciences of the United States of America:
Biographical Memoirs Volume XVII – Seventh Memoir: Biographical Memoir of William Stewart Halsted (1852-1922) by W. G. MacCallum
Etymonline: Dope
Time: Cocaine July 6, 1981
FDA: Regulatory Information Controlled Substances Act
Internet Archive Way Back Machine: Psychedelic Chemistry – Cocaine by Michael Valentine Smith citing California State Attorney General in 1973 Understanding Drug Abuse Addiction Drug-Related Deaths – Notable Celebrities
Photo Courtesy of Michael Sauers’ Flickr Page – Creative Commons License

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