In 1860, Albert Niemann, a chemistry graduate student at Göttingen University, published his doctoral dissertation, which described the isolation of cocaine from coca leaves and the numbness it caused when applied to his tongue. By 1880, reports of cocaine’s miraculous properties abounded. It was purported to cure morphine and alcohol addiction, tuberculosis, and even impotency. The young Viennese physician Sigmund Freud used cocaine in an attempt to cure a friend of morphine addiction; he succeeded in transferring the friend’s addiction to cocaine.
In 1884, Freud’s colleague, the Austrian ophthalmologist Carl Koller, discovered cocaine’s very potent local anesthetic effects on the eye. For the first time, it was possible to perform eye operations on a fully conscious patient. The medical community immediately embraced the significance of Koller’s report, but their enthusiasm was tempered by reports of its abuse.
In 1905, the nonaddicting synthetic local anesthetic Novocain replaced cocaine.
The abuse potential of cocaine is among the strongest of all behaviorally active substances. Cocaine produces intense stimulation and euphoric excitement, coupled with complete self-confidence in the user’s mental and physical capabilities. These effects result from dopamine activation in the brain’s reward center and persist for fifteen to thirty minutes. With high-dose or long-term use, extreme anxiety, paranoid feelings of persecution, and tactile hallucinations (cocaine bugs) may occur. Toxic doses can cause heart arrhythmias, potentially resulting in heart failure.
Many users develop dependence on cocaine. After abrupt drug stoppage, the user typically “crashes,” experiencing depression, exhaustion, and craving for more of the drug—feelings that may persist for months. Cocaine addiction is very difficult to treat, with more than 95 percent of addicts relapsing.
Cocaine is difficult to give up, but not impossible, as exemplified by such notable former users as Robert Downey Jr., Jerry Garcia, Elton John, Stephen King, Robin Williams, and my childhood hero, Sherlock Holmes. Some sources state that Robert Louis Stevenson wrote The Strange Case of Dr. Jekyll and Mr. Hyde in six cocaine-fueled days.