Abuse of coca and cocaine

Coca leaf is the leaf of the coca bush and may be chewed or used for the manufacture of cocaine, a powerful stimulant drug. Cocaine can be sniffed, smoked or injected. It is one of the most addictive drugs known and is characterized as the most pernicious drug currently being abused world-wide, with heavy use often leading to paranoia, psychosis and violence. Coca paste is an intermediary product in the manufacture of cocaine which usually contains an impure mixture of cocaine sulphate and other alkaloids, which is then mixed with tobacco or marijuana. It has a high potential for psychic dependence and psychopathology. "Crack" is a more potent crystalline form of cocaine, composed of small rocks which are usually smoked to give quick, intense highs which usually leave the user desperate for more of the drug. Especially because of its potency and cheapness, it is responsible for serious harmful physiological and psychological effects in non-producer countries.

Coca-leaf chewing is a traditional practice among South American Indians and although officially recognized to be harmful, it is encouraged by their present-day employers, some of whom even pay partly in coca-leaf. Coca-leaf chewing enhances their poverty, malnutrition and exploitation, keeping peasant populations in bondage through debts incurred, and therefore undernourished because of the need to pay debts in kind (food, animals). With prolonged use coca dulls both mind and body, impairing the intelligence of the user's children, and increasing occupational risk when the user is working with a machete or other dangerous instruments. Excessive consumption of coca renders the individual more susceptible to disease and early death.

The use, distribution and sale of cocaine and its by-products are major social and health problems. The social problems include crime: murder, smuggling, selling illegal drugs and laundering money; prostitution; degeneration of the family; losses in productivity for businesses; increasing medical costs; and corruption of police and other government officials.

The major routes of administration of cocaine are sniffing or snorting, injecting, and smoking (including free-base and crack cocaine). Snorting is the process of inhaling cocaine powder through the nose where it is absorbed into the bloodstream through the nasal tissues. Injecting is the act of using a needle to release the drug directly into the bloodstream. Smoking involves inhaling cocaine vapor or smoke into the lungs where absorption into the bloodstream is as rapid as by injection.

There are over 6 million abusers of cocaine substances. Three-quarters are cocaine abusers, mainly in the USA where in 2001 more than 30 million tried cocaine and 5 million reported regular use. It was estimated that in 1993 criminals in the USA made between $15 billion and $17.5 billion per year out of the sales of cocaine alone. This amounts to between 150 and 175 tonnes per year.

According to a 1999 report, 1% to 3% of all European adults tried cocaine. The quantities of cocaine seized in the EU peaked 38 tonnes in 1997, with the largest seizures made in Spain. Cocaine was often used as a second drug by heroin addicts.

Whilst cocaine abuse used to be found more often among rich communities in the Americas and Europe, it now also threatens Africa, the Near and Middle East, South and Southeast Asia and Oceania, as noted in the report of the International Narcotics Control Board for 1991.

The excessive consumption of coca among South American Indians is most marked in the high plateau lands of Peru and Bolivia but is also noted in other South American countries. Coca is used mainly to dull the pangs of hunger, fatigue, disease and mental depression brought on by hard labour and inadequate wages. The traditional belief that coca is mainly beneficial is encouraged, and it is even declared a 'food' by certain Bolivian landowners. Urban youth are now smoking small brown rolls of coca paste mixed with tobacco, a habit that is spreading throughout rural areas in most countries where the coca bush is grown.

The proportion of US high school seniors who have used cocaine at least once in their lifetimes increased from 5.9 percent in 1994 to 9.8 percent in 1999, but reached a peak of 17.3 percent in 1985. Use of cocaine by seniors decreased from a high of 6.7 percent in 1985 to 2.6 percent in 1999. Also in 1999, 7.7 percent of 10th-graders had tried cocaine at least once, up from a low of 3.3 percent in 1992. The percentage of 8th-graders who had tried cocaine increased from a low of 2.3 percent in 1991 to 4.7 percent in 1999.

The legitimate medical use of cocaine as a local anaesthetic is extremely limited since it can, for the most part, be replaced by synthetic, non-addictive local anaesthetics.

Nearly one in four nonfatal heart attacks suffered by people between the ages of 18 and 45 may be attributed to regular cocaine use.