HipPocrates

Cocaine Cocaine

Several people have asked recently about the effects of cocaine so I’ve sniffed out some information for you.

Dr. Eugene Schoenfeld speaking at Community Arts Auditorium, May 28, 1969 at a benefit for Open City. Photo: Alan Gotkin.

Cocaine is a stimulant to the central nervous system, reduces hunger and, when applied directly to mucus membranes, such as those lining the nose and mouth, produces anesthesia and constriction of blood vessels. The drug is derived from leaves of Erythroxylon coca and for centuries natives of Peru and Bolivia have chewed coca leaves for their stimulatory effect.

An article on Argentina appearing in the current Braniff Airlines travel magazine recommends to adventurous tourists the local custom of chewing coca leaves after dining! Its author describes pleasurable tingling sensations of the mouth and tongue resulting from cocaine’s anesthetic effects. Perhaps Braniff Airlines officials risk prison for using Madison Avenue techniques to promote pleasure through drugs.

Cocaine was first used in medicine by a young Viennese physician named Sigmund Freud. Freud experimented personally with cocaine for some time and apparently developed many of his theories of psychoanalysis aided by the drug. (Use of a drug to develop a drugless therapy is illustrated also by Synanon games, which evolved from an LSD experience.) Freud thought cocaine was a psychiatric wonder drug and prescribed it for virtually every mental illness. He rapidly became disillusioned with cocaine, though, when he discovered his patients easily got strung out behind the drug.

Cocaine is similar to amphetamines in many ways. Tolerance (the necessity to take more and more to achieve the same effect) develops easily and high doses can cause a toxic paranoid psychosis. According to Goodman and Gilman’s The Pharmacologic Basis of Therapeutics (the standard guide of pharmacology reference):

“Unlike the user of morphine, whose drives are decreased, the cocaine user is stimulated and may act in response to his persecutory delusions, carrying weapons and using them on his alleged persecutors. The stereotype of the ‘depraved dope fiend’, so inappropriately used to describe the opiate user, is not entirely unjustified when applied to the cocaine user who develops toxic symptoms.”

An overdose of cocaine may cause convulsions and death.

Intravenous use of cocaine seems rare today, but sniffing the drug is in vogue once more. Cocaine sniffers frequently develop perforations of the nasal septum (the cartilage between the nostrils) due to constrictions of local blood vessels resulting in tissue damage from lack of oxygen.

Cocaine is usually classified as an addictive drug, though withdrawal doesn’t cause the abstinence symptoms seen in junkies.

Don’t want to sound like a pundit, but dangers from cocaine aren’t to be sniffed at.

Another Dangerous Drug

Investigators of the University of Florida College of Medicine have found that toxic agents in tobacco smoke, especially cigarettes, cause the body to generate a substance which greatly reduces oxygen transport by red blood cells. Reduced oxygen transport may contribute to heart attacks.

Blood from donors who smoke is probably less useful therapeutically than from non-smokers. When the Florida researchers incubated red blood cells from a non-smoker in blood plasma of a tobacco fiend, the cells showed a decrease in their oxygen handling capacity. Robert Eliot, M.D., who led the investigations, said, “These changes are apparent even in a young person who smokes more than 12 cigarettes a day.”

A report in the Journal of the AMA of 3/30/70 indicates smokers not only have eleven times more lung cancer than non-smokers, but that heavy smokers develop a more malignant form of the disease than the lung cancer seen in light smokers.

The same issue refers to Philip Roth’s Portnoy’s Complaint in quoting from the Medical bulletin on Tobacco:

“Handling things can be satisfying, but there are many ways to keep your hands busy without lighting up or playing with a cigarette.”

Dear Dr. Hip Pocrates is a collection of letters and answers published by Grove Press. $.95 at your favorite bookstore.

Dr. Schoenfeld welcomes your questions. Write to him at P.O. Box 9002, Berkeley CA 94709.