Appendix C: History of Cocaine

The cocaine epidemic of the 1980s was not unprecedented. The United States has previously dealt with the public health concern of cocaine addiction and its concomitant results: rising crime and devastating impact upon social welfare. The following is a condensed history of cocaine in the United States, leading up to the creation of crack cocaine.

The Origins of Cocaine in America

Natives of the Andes Mountains have used the plants containing cocaine's active ingredient for medicinal and recreational purposes for at least fifteen centuries. The Incas chewed the leaves from the erythroxylon plant to stimulate their productivity and mood. The practice of chewing coca leaves continues today in South American countries with indigenous coca plants.

Processed cocaine hydrochloride was first synthesized by Albert Niemann of the University of Gottigen in Germany in 1859. Cocaine was immediately heralded by European doctors as a wonder drug that cured fatigue, toothaches, headaches and a variety of other ailments. By the late 1880s, cocaine was being hailed both in Europe and the United States as an effective local anaesthetic and a treatment for morphine addiction. Dr. William Halstead, a noted United States physician who later became Surgeon-in-Chief at Johns Hopkins Hospital, became one of the first physicians to use cocaine as a local anesthetic; he would later struggle with an addiction to cocaine.

By the turn of the century, cocaine had become an ingredient in everyday items in the United States, such as hay fever elixirs and nerve tonics. Even Coca-Cola contained cocaine until 1903, when the ingredient was replaced with caffeine.(1) By some estimates, the American public was consuming as much cocaine in 1906 as it would in 1976, and with only half the population. But in the wake of the excitement generated by this new "wonder drug" came the scourge of addiction. Tales of cocaine abuse began to proliferate as members of the medical establishment and high society became cocaine addicts. In 1910 President William Taft declared that cocaine was a national threat.

Cocaine was first federally regulated in December 1914, with the passage of the Harrison Act. The Harrison Act banned non-medical use of cocaine; prohibited its importation; imposed the same criminal penalties for cocaine users that were levied against users of opium, morphine, and heroin; and required a strict accounting of medical prescriptions for cocaine. As a consequence of the Harrison Act -- and the emergence in the 1930s of cheaper, legal, and readily available drugs like amphetamines -- cocaine became scarce in the United States. By the 1950s it was no longer considered a problem worthy of law enforcement attention.

Cocaine use began to rise again in the 1960s, prompting Congress, in 1970, to classify it as a Schedule II controlled substance, meaning it was potentially susceptible to abuse and could produce dependency but had legitimate medicinal uses.(2) However, it was still not considered by many in the medical profession to be a serious health threat.(3) Even as late as 1980, influential scientific writings reflected the prevailing non-critical assessment of the dangers of cocaine: The 1980 edition of the Comprehensive Textbook of Psychiatry asserted that cocaine posed no serious problem, if use was limited to two or three times a week. Like the cocaine epidemic that occurred at the turn of the century, cocaine once again was embraced by the social elite. The deleterious effects of cocaine that were discovered merely 60 years earlier appeared inexplicably to have been forgotten. However, by the early 1980s, the nation's attitude toward cocaine had changed and various law enforcement and public health efforts intended to control its use were underway.

1. D. Musto, The American Disease, at 3.

2. The Controlled Substances Act of 1970.

3. Dr. Peter G. Bourne, a drug expert who would later become President Carter's Special Assistant to the President on Health Issues, wrote in 1974: "Cocaine ... is probably the most benign of illicit drugs currently in widespread use .... Short acting -- about 15 minutes -- not physically addicting, and acutely pleasurable, cocaine has found increasing favor at all socioeconomic levels in the last year." Peter G. Bourne, "The Great Cocaine Myth," Drugs and Drug Abuse Education Newsletter 5: 5 (1974). See also, F.H. Gawin and H.D. Kleber, "Evolving Conceptualizations of Cocaine Dependence," Yale Journal of Biological Medicine 61: 123-136 (1988).