Cocaine Abuse

Cocaine is a white crystalline powder that is extracted from the leaves of the coca plant. When ingested in quite small quantities, cocaine produces a state of euphoria [Page 421], mental acuity, and freedom from fatigue that is very attractive to many people. As a result, the production and distribution of cocaine, which has been designated an illegal narcotic internationally, has become a major international undertaking involving an unknown number of producers. The enormous demand for the drug mostly derives from the developed world and the United States in particular.

The coca plant grows wild in Ecuador, Bolivia, and Peru, where local people had been chewing its leaves since before recorded history and enjoying the stimulant effect associated with it. Chewing the leaf also ameliorates the effects of hunger, thirst, and fatigue; it was regarded as a gift from the gods and, consequently, has important cultural connotations in those societies. In this context, the hallucinogenic effect of intense use of the drug was often employed. Europeans visiting South America noticed this phenomenon and its use spread. Cocaine was extracted from the leaves and transformed into a white powder which, being concentrated, has a much more intense effect than the leaves.

Initially, cocaine was regarded as something of a miracle cure for all kinds of ailments and it was distributed widely as part of various well-known soft drinks. Coca Cola, for example, was marketed as a product able to combat menstrual cramps, headaches, and alcoholism, among other health issues. The company changed to cocaine-free coca leaves in 1903. In 1914, the United States introduced legislation to control cocaine (the Harrison Narcotic Act), under which it was designated as a dangerous narcotic. Nevertheless, the use of cocaine grew throughout the 20th century and cultivation of the plant spread across South America to as far afield as Sri Lanka and Java.

Most cocaine is converted into the form of cocaine hydrochloride close to its place of production. It is then smuggled to its market after passing through various intermediaries. Commonly, the cocaine is “cut” or mixed with some other much cheaper agent with a view to increasing profitability. The cutting agent may be something comparatively harmless, such as sugar or talc, but in other cases powerful hallucinogens or even poisons may be used, which necessarily result in subsequent negative health outcomes. The purity of the cocaine bought at the street level varies anywhere from 0 to 95 percent.

Smuggling is often conducted by poor or vulnerable individuals, “mules,” who carry the drug in often large quantities but are given only very limited incriminating evidence as to its origin or destination. The cocaine may be stored in a condom and the mule must swallow it to pass through customs undetected. Should the condom break inside the body, an intense reaction will immediately occur and death is a common result. Swallowing cocaine even in small quantities can lead to toxic reactions of different levels of severity but also include death.

Cocaine users adopt a variety of means to use the drug. Snorting through a paper tube is probably the most common and iconic. The drug has become fashionable in some social sets and is associated especially with those such as performers who wish to recreate the high-adrenaline feeling of live performance or else with fashion models, who use the drug both as stimulant and appetite suppressant. It is also possible to inject the drug or rub it in small quantities into the body tissue, from which it can diffuse through the body. In some forms, the cocaine may be dissolved into water and ingested in that form. When the cocaine is converted into sulphate form, in which impurities are burnt away, then it is smoked in the practice known as “freebasing.” A similar process is used to create crack, or rock cocaine, which is sold in the form of solid pellets. It reportedly produces a very intense high, which is often associated with acts of violence. Generally, the more intense the feeling, the shorter lived is the stimulating effect and the [Page 422]more rapid the onset of addiction. Breaking the compulsion is very difficult and those without money to feed their addiction are often obliged to enter a life of crime, including for example burglary or prostitution, to raise regular amounts of cash. The money required may amount to thousands of dollars per day, although this varies enormously depending on location and various supply and demand conditions. The illicit drugs trade is of such value that it has led to the involvement of organized crime and violence that threatens the international relations of a number of South American countries in particular.

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