Saturday, March 29, 2008

Coca to Combat Opiate, Alcohol and Tobacco Addiction

From my unpublished manuscript "Coca- Forgotten Medicine"

Coca was regarded favorably in treating drug addictions involving physical withdrawal and debility (i.e. malnutrition and bodily metabolism), a stance advocated on both sides of the Atlantic.

W.H. Bentley, a Medical Doctor practicing in Oak Valley, Kentucky, authored the September 15, 1880 Therapeutic Gazette article "Erythroxloyn Coca and the Opium and Alcohol Habits" - an account of about half a dozen patients who relieved of their habit by drinking Coca preparations.

Bentley was not alone in his findings, in the U.S. nor abroad, with numerous reports of this efficacy appearing regularly in The Therapeutic Gazette as well as the Philadelphia Medical Times, New Remedies, Medical and Surgical Reporter, and New York Medical Record, and elsewhere.

Remember this was with Coca preparations, containing a low concentrations of cocaine alkaloid, akin to that customary for the alkaloid caffeine in Coffee and Tea, or the alkaloid nicotine in Tobacco. This was not the 100 X more potent use of isolated cocaine in the highly concentrated direct doses made possible with injections.

Mirroring this positive view of this efficacy of Coca in France, French Army Surgeon-in-Chief, Dr. Liberman wrote about the1884 observations of Dr. Villeneuve about the use of pate and in treating, amongst other things, "morphinomania":
"M. X....., barrister, 32 years of age, five years ago began to use morphine preparations as a remedy against a very alarming chronic bronchitis and granulation in the throat which were irritated constantly by cigarette smoking." "the patient at first only used morphine, but his physician committed the imprudence of treating him by hypodermic injection. A noticeable change for the better was produced during the first month, but unfortunately, abuse succeeded promptly the use of the medicament-- so much that when I commenced to treat the patient, he was taking daily from 1 gramme 50 centigrams to 1 gramme 80 centigrammes of morphine hypodermically. When he was four hours without his dose there appeared insomnia, hallucinations and delirium; constipation lasting sometimes for fifteen days, which brought on in the spring a very alarming perityplitis, jerking of the muscles, sudden frights, dyspepsia, and at last frightful congestion of the face whenever he drank a drop of wine or brandy.

"After a month's treatment I had succeeded in reducing the daily doses without causing alarming symptoms; the physiological functions seemed to awaken again. however, the congestion and especially the dyspepsia was very grave, and the cough which had been suppressed by morphine returned. It was then that I treated my patient with phosphate of lime, the pate and the . Lacking his habitual stimulant, he was plunged in a semi-coma from which he could not always be relieved with weaker daily doses of morphine. . . The danger I feared most was a relapse of bronchitis, and that the cough and expectoration might end fatally. But in about a week, during which he took ten doses of Pate de Coca daily, the cough became less fatiguing and disappeared entirely in about twenty days. The patient than commenced to take small doses of (two Mandeira-glasses a day). At first congestion appeared, but little by little, as digestion became more easy, my patient, who on account of his profound anemia could not tolerate any table wines, took at first a small glass, than two, than three glasses at a meal. Now he can go and take dinner in town, which he had not been able to do for three years; he regained his former vigor, is able to undertake anew his occupations, and has entirely given up his morphine habit."

In Paris, Mesureur, the French Ex-Minister of Commerce, and the current (in 1910) Director of Hygiene and Public Health, who approved and signed the French government's radical poster campaign against alcoholism, would state that:
“The dangers of alcoholism would be avoided if no other stimulant were taken for mental or physical trials than that offered by the generous."
The over lap in the popular use of opiates and alcohol, and that of opiates, alcohol and tobacco, brought about situations where coca’s use in combating the use of the first two led to the discovery of its efficacy in combating use of the third, with these being regarded favorably according to the account by Dr. Liberman and Villeneuve
“I have also employed it in cases, happily rare in our army, of chronic alcoholism resulting from the abuse of brandy, absinthe or strong liquors. The produced all the excitement sought by drinkers, but had at the same time a sedative influence on their nervous systems. I have frequently seen hardened drinkers renounce their fatal habit and return to a healthy condition." "I have also used to save smokers of exaggerated habits, from nicotinism. A few glasses of taken in small doses, either pure or mixed with water, acted as a substitute for pipes and cigars, because the smokers found in it the cerebral excitement which they sought in tobacco, wholly preserving their intellectual faculties."
The concept of Coca as a Tobacco substitute received a fair bit of attention in Europe and the U.S., where Coca leaf was introduced in comparable smokable forms: cigarettes, cheroots and cigarettes of Coca. Made in a variety of manners, sometimes mixed with Tobacco (usually involving Coca leaf innards wrapped in a Tobacco outer shell), these smokable forms of Coca -- including a pure Coca leaf pipe blend -- were reportedly found useful medicinally. According to an article by a Dr. F.E. Stewart appearing in the September 19, 1885 Philadelphia Medical Times, smoking Coca leaf had numerous medically useful applications with a basis in its established therapeutic applications, so noted:
"Coca has been used with great success in the treatment of the opium habit, it is also an excellent substitute for Tobacco [emphasis added]. It has been successfully used in dyspepsia, flatulency, colic, gastralgia, enteralgia, hysteria, hypochondria, spinal irritation, idiopathic convulsions , nervous erethism, and in the debility following severe acute affections. As it is a valuable restorative agent, checking tissue-waste, it is also a useful remedy in consumption [?] and wasting diseases generally. It is also of value in the nervous forms of sick-headache, migraine. It is also said to be an aphrodisiac."
Reporting on several cases of experiences with smoking Coca, Stewart found that most found them useful, with a high percentage finding Coca cigars as useful for stemming depression -- the "blues" -- and as a mild stimulant. Citing one example of a leading Wilmington, Delaware physician:
"After dinner, he smoked a couple of the cigars, with the effect that the blues were expelled and he felt the exhilarating effect of the drug in the same manner as after a dose of the wine. It is his opinion that the effect of the cigars is milder than that of the wine, but he is satisfied that he experienced the peculiar power of the coca by smoking it."
Citing others, a man suffering dyspepsia -- a digestive disorder -- and its attendant depression:
"smoked the cigars...the result being to dispel the depressed feeling and remove the fullness experienced after each meal. Repeated experiments confirm this. As coca is said to stimulate the gastric nerves and greatly facilitate digestion, the above experiment seems to prove that the cigar has a similar effect."
These experiments included Dr. Stewart's own use. Writing upon his personal discovery of Coca leaf smoking as a treatment for hay fever:
Personally, I have found the effect of smoking coca leaves to bear out the statement that the drug produces a general excitation of the circulatory and nervous systems. Smoking and inhaling the smoke of one or two cigars will increase my own pulse rate some eight or ten beats to the minute. It certainly relieves the scene of fatigue. Smoked at night, in my own case and in the cases of several of my patients, it produces wakefulness similar to strong coffee. The exaltation produced by it does not seem to be followed by any feeling of languor or depression. I find it a relief after a full meal, like a good tobacco cigar. It seems to impart increased vigor to the muscular system as well to the intellect, with an indescribable feeling of satisfaction. I have never experienced any intoxicating effects from smoking it. Dr. Bartholow says that coca, as in the case with tea and coffee, acts as an indirect nutrient by checking waste, and hence a less amount of food is necessary to maintain the bodily functions; and as I have just learned, in a letter from Messrs. Parke, Davis and Company, that "a Mr. Stevens, a citizen of Abilene, Kansas, who was afflicted with hay fever, and was about to go to the mountains, has concluded to remain at home, having obtained relief from the use of cigarettes of coca. Every morning he uses a cigarette and perfect relief. He uses three per day.
Information on Coca leaf smokables, their history and decline is rare- for records showing sales or later accounts are generally inaccessible. As these even included a pipe mixture, described in its day with the misnomer as a "smoking Tobacco", Coca leaf smoking presented some interesting parallels, for one the possibility they were a more benign substitute to smoke then Tobacco. Among “chewers” of these respective agricultural commodities, oral cancer is common with those using Tobacco, yet its rare among chewers of Coca. Given that these Coca leaf smokables were introduced only 30 years before Coca was banned by U.S. statute by the 1914 Harrison Act, they have less of a history to be fully aware of their long term chronic effects. Nor does it appear that this has been a topic of any study- baring any possible secret research, much like the cigarette companies' purported non-study of the pharmacological properties of nicotine.

added: July 25, 2012

I addition to smokable coca leaf, we had coca based extract and chewing gums, respectively used for treating alcoholism and the tobacco habit.

“A NEW METHOD IN THE TREATMENT OF THE ALCOHOL HABIT” By William F. Waugh, A.M., M.D. Professor of Practice and Clinical Medicine, medico-chirurgical College of Philadelphia, Read before the Pennsylvania State Medical Society and re-printed from Mitchell’s “Clinical Notes,” October, 1885


… in the fourth and fifth classes I desire to recommend the administration of Erythroxylon Coca. It is useless in the treatment of delirium tremens, but to relieve the depression resulting from the deprival of stimulants it has remarkable powers. Its effects in relieving one from the sense of fatigue are too well known to require more than a passing notice. I have frequently returned to my home after a hard day’s work only to find that a still harder night awaited me in the shape of a tenuous labor case. A dose of coca, however, removed the fatigue and left me as fresh as when starting out in the morning after a sound night’s sleep.

Some years ago I was consulted by a gigantic Irishman who worked as fireman in a rolling mill. He informed me that when he had finished his day’s work he was so fatigued that he was unable to find his way home unless fortified by a drink of whiskey. But unfortunately, the first taste fired poor Paddy’s heart and the inevitable result was “a spree”. I gave him some fluid extract of coca leaves, directing him to take a teaspoonful just as he quit work. The result was, as he afterwards informed me, that in five minutes the fatigue had so completely left him that he felt quite ready to go back to the shop and do a second day’s work at once.

This case was cured and the cure has remained for five years without a relapse. In repeating this experiment I found an obstacle in the fact that men did not like to be seen taking medicine. They could not be induced to carry a bottle and spoon around with them and withstand the badinage of their companions. Beside, the liquid preparations of coca contain alcohol, and I may say here, that in all experiments with coca, it is necessary to exclude carefully the effect of alcohol, which obscures and often counteracts the effect of the remedy.

After many trials I succeeded in having the coca put up as a masticatory in the form of plugs like tobacco. These were made at my suggestion by C.L. Mitchell, M.D. & Co., Pharmaceutical Chemists, of Ninth and Race Streets, Philadelphia. I have given this preparation the name of “Coca-Bola” from coca and bolus, a mass. Each plug is about the size of an ordinary plug of chewing tobacco, and contains about 200 grains (nearly half its weight) of coca leaves, besides a small quantity each of tea, coffee and coinchona bark. Each plug is marked off for convenience into squares, each square containing about 16 grains of coca leaves; this quantity is about sufficient for a single dose or chew and even a smaller portion my suffice. It is to be thoroughly masticated in the same manner when chewing tobacco, the saliva being swallowed, not ejected as in tobacco chewing. After the mass has been masticated for some time and the virtues of the coca leaf pretty well extracted, the residue is to be ejected. A chew of the “Coca-bola” take in this manner occasionally throughout the day will generally completely satisfy the craving for stimulants, and at the same time remove any feeling of depression or fatigue. The addition of the tea and coffee seem to assist considerably the sustaining and stimulating effect of the coca leaves without producing any injurious after effects.

The advantages of this method of administering were found to be many and removed completely all the difficulties previously referred to. It contained no alcohol, did not require the use of the objectionable bottle and spoon, was exceeding convenient, and as it so closely resembled tobacco, its continued use excited no remark. Besides it could be easily carried in the vest pocket and was always at hand when needed.

By the use of the “Coca-bola,” in the treatment of the class of cases previously referred to , we substitute for the objectionable habit of drinking liquor the harmless use of coca. So free is it from all injurious effects that I can say that in my opinion no greater boon could be conferred on humanity that in the conversion of all alcohol drinkers into coca chewers. At my request, Dr. Mitchell has now prepared the “Coca-bola” for sale and will shortly place it on the market, when I would ask its careful trial by such of my professional brethren as are interested in the treatment of this class of cases.

Coca-Bola will also be found to be a very valuable substitute for tobacco, especially in the treatment of those who are suffering from the pernicious effects of its excessive use in the habit of chewing. It is a well known fact in the treatment of the cases that the greatest obstacle, and the one which meets the physician at the very outset, is the difficulty experienced in providing a suitable substitute for the offending “quid.” The chewing of tobacco, soon leads almost unconsciously to the formation of a habit of chewing, and when the mouth becomes accustomed to the frequent regularity of the movements of mastication, and the continued presence of a foreign body, the action becomes in a certain sense an involuntary one, and any interruption or break in its regular performance adds a disturbing element which greatly enhances the depression naturally resulting from the withdrawal of the physiological stimulus of the tobacco. A habit soon becomes a second nature, and a habitual chewer of tobacco derives as much satisfaction, and from the “company” of the “chew”, to which he had accustomed himself, as he does from the drug itself.

The use of tobacco in chewing or smoking, as well as the frequent drinking of liquor, produces a catarrhal condition of the mouth which also adds to the desire for the presence of the quid. The oral mucosa are in a state of sub-acute congestion, and while the first result of the habit is to stimulate their secretions, this is soon followed by catarrhal changes, whereby the saliva and other juices become greatly diminished in quantity. An uncomfortable feeling of dryness and heat in the mouth soon results, only alleviated by the employment of the alcohol, or the tobacco. To relieve this condition of affairs in many different “tobacco substitutes” have been recommended, but with very little success. They are generally compounds containing large quantities of licorice-root, and while they partly satisfy the taste, they do not supply any stimulus or sustaining agent to take the place of the refreshing and almost nourishing tobacco, neither do they allay the congestion of the mouth.

Coca leaves should, theoretically, be an excellent substitute for tobacco.

They have an agreeable, bitter aromatic taste when chewed in the mouth; they greatly diminish the blood supply in the superficial capillaries of the mucous membrane, and should thus relieve the congestion of the oral mucosa; and the general tonic, stimulating and sustaining powers of the drug should render it a suitable and innocent substitute to take the place of tobacco. Moreover, it leaves behind it no injurious after effects, and its use can be at any time suspended after the patient has lost his desire for the former drug. When, therefore, the coca leaves can be presented in the form of a masticatory, and satisfy both the physiological requirements of the case and the “habit” of the chewer, it would seem as if every condition for a perfect substitute for chewing tobacco had been fulfilled. – [C.L. Mitchell, M.D. in “Clinical Notes”]

USDA Feared Coca as Tobacco Habit Cure

1 comment:

Anonymous said...

The smokers and the tobacco chewers residing in the district of South Carolina would pay additional taxes amounting to about $25 a month to the state health insurance. This law would come into affect from 2010.