Abstract
Summary
Cocaine has been a heavily abused street drug over the last several decades. It is well-documented in the nineteenth and early twentieth century that the drug was used as a form of treatment for various psychiatric disorders due to its medicinal properties. More recently, the “psychedelic renaissance” has opened doors for many researchers and clinicians to explore the medical use of drugs that were previously thought to possess little to no therapeutic properties.
Purpose of review
This literature review was performed using PubMed and Google searches to explore the history and current medical use of cocaine. Although there has been some research some decades ago on cocaine’s effects on depression and anxiety, it has largely been ignored more recently as more attention has been diverted to compounds such as 3,4-methylenedioxy-methamphetamine (MDMA) and psilocybin.
Recent findings
Based on the literature, cocaine has been shown to reduce severity of depression and anxiety. However, the evidence is limited to scant experimentation conducted on patients several decades ago that reported a side effect profile similar to conventionally prescribed amphetamines. Further investigation, along with the possibility of decriminalization, is needed to evaluate risks and benefits of using cocaine to treat psychiatric disorders.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance
Brownlow HA, Pappachan J. Pathophysiology of cocaine abuse. Eur J Anesthesiol. 2002;19(06):395.
International convention relating to dangerous drugs, and protocol. Australian Treaty Series. Geneva, 19 February 1925.
Single convention of naroctic drugs, 1961. United Nations. New York. Amended 2021.
Comprehensive drug abuse prevention and control act of 1970. Controlled Substances Act, Title II. Drug Enforcement Administration and Food and Drug Administration. 1970.
McGrath J, McGrath A, Burdett J, et al. Investigation of topical intransal cocaine for sinonasal procedures: a randomized, phase III clinical trial. Int Forum Allergy Rhinol. 2020;10(8):981–90.
Brain PF, Coward GA. A review of the history, actions, and legitimate uses of cocaine. J Subst Abuse. 1989;1(4):431–51.
Boghdadi MS, Henning RJ. Cocaine: pathophysiology and clinical toxicology. Heart Lung. 1997;26(6):466–83.
Lee KC, Ladizinski B, Federman DG. Complications associated with use of levamisole-contaminated cocaine: an emerging public health challenge. Mayo Clin Proc. 2012;87(6):581–6.
Solomon N, Hayes J. Levamisole: a high performance cutting agent. Acad Forensic Pathol. 2017;7(3):469–76.
Biondich AS, Joslin JD. Coca: the history and medical significance of an ancient Andean tradition. Emerg Med Int. 2016.
Drake LR, Scott PJH. DARK classics in chemical neuroscience: cocaine. ACS Chem Neurosc. 2018.
Grinspoon L, Bakalar JB. Coca and cocaine as medicines: an historical review. J Ethnopharmacol. 1981;3(2–3):149–59.
Freud S. Uber Coca: Freud’s cocaine discoveries. J Subst Abuse Treat. 1984;1:205–17.
Tricot JP. Cocaine: half a century of therapeutic use (1880–1930). Verh K Acad Geneeskd Belg. 1991;53(5):487–96.
Bolton R. Andean coca chewing: a metabolic perspective. Am Anthropol. 1976;78(3):630–4.
Fabrega H, Manning PK. Health maintenance among Peruvian peasants. Hum Organ. 1973;31:243–56.
Alcohol and religion. Alimentarium. https://www.alimentarium.org/en/knowledge/alcohol-and-religion.
Mediavilla D. Cocaine and ancient hallucinogens discovered in 1000-year-old shamanic pouch. El Pais. 2019. https://english.elpais.com/elpais/2019/05/10/inenglish/1557480483_799380.html.
Lawler A. Did ancient Mesopotamians get high? Near eastern rituals may have included opium, cannabis. Science. 2018. https://www.science.org/content/article/did-ancient-mesopotamians-get-high-near-eastern-rituals-may-have-included-opium.
King SR. Opium Culture: The art & ritual of the Chinese tradition. HerbalGram: The Journal of the American Botanical Council. 2007;75:72–73.
Crocq MA. Historical and cultural aspects of man’s relationship with addictive drugs. Dialogues Clin Neurosci. 2007;9(4):355–61.
Desoxyn, methamphetamine hydrochloride tablets, USP. Desoxyn Label. Food and Drug Administration. 2013.
National Center for Biotechnology Information. 2021. PubChem compound summary for CID 1206. dl-Methamphetamine.
Miller MM, Hajdukovic R, Erman MK. Treatment of narcolepsy with methamphetamine. Sleep. 1993;16(4):306–17.
Abbruscato TJ, Trippier PC. DARK classics in chemical neuroscience: methamphetamine. ACS Chem Neurosci. 2018.
Courtney KE, Ray LA. Methamphetamine: an update on epidemiology, pharmacology, clinical phenomenology, and treatment literature. Drug Alcohol Depend. 2014;143:11–21.
National Center for Biotechnology Information. 2022. PubChem compound summary for CID 446220. Cocaine.
de Lange J, Baas EM, Horsthuis RBG, et al. The effect of nasal application of cocaine/adrenaline on blood loss in Le Fort I osteotomies. Int J Oral Maxillofac Surg. 2008;37(1):21–4.
Richards JR, Laurin EG. Methamphetamine toxicity. StatPearls. 2022.
Lucyk SN. Acute cardiovascular toxicity of cocaine. Can J Cardiol. 2022. S0828–282X(22)00287–2.
Lewis D, Kenneally M, denHeuvel C, et al. Methamphetamine deaths: changing trends and diagnostic issues. Med Sci Law. 2021;61(2):130–7.
Brody SL, Slovis CM, Wrenn KD. Cocaine-related medical problems: consecutive series of 233 patients. Am J Med. 1990;88(4):325–31.
• Arango-Merino L, Quevedo-Castro C, Mancera-Barros J, et al. Cutting agents in cocaine: a temporal study of the period of 2015–2017 in the northern region of Colombia. Forensic Sci Int. 2021;327:110911. Article highlights the multitude of cutting agents used in the illegal manufacture of cocaine that create a highly unsafe street drug that is then sold to consumers.
Strathdee SA, Case P, Lozada R, et al. The color of meth: is it related to adverse health outcomes? An exploratory study in Tijuana. Mexico Am J Addict. 2008;17(2):111–5.
Hofmaier T, Luf A, Seddik A, et al. Aminorex, a metabolite of the cocaine adulterant levamisole, exerts amphetamine like actions at monoamine transporters. Neurochem Int. 2014;73(100):32–41.
Skipper C. What if drugs aren’t as bad as we’ve been told? GQ. 2021.
Schwartz C. When getting high is a hobby, not a habit. The New York Times. 2021.
Leland J. This heroin-using professor wants to change how we think about drugs. April 10, 2021. https://www.nytimes.com/2021/04/10/nyregion/Carl-Hart-drugs.html.
• Measure 110: background brief. LPRO: Legislative Policy and Research Office. State of Oregon. December 9, 2020. Article highlights growing trend within the United States, specifically in the state of Oregon, towards decriminalization of substances that were previously regarded as exclusively illicit and non-medicinal.
Drug decriminalization in Portugal: challenges and limitations. Office of National Drug Control Policy. August 2010. https://obamawhitehouse.archives.gov/sites/default/files/ondcp/Fact_Sheets/portugal_fact_sheet_8-25-10.pdf.
• Silva L. Portugal drug laws under decriminalization: are drugs legal in Portugal? April 11, 2022. https://www.portugal.com/op-ed/portugal-drug-laws-under-decriminalization-are-drugs-legal-in-portugal. Reference highlights the growing trend of decriminalization of drugs previously seen as harmful and the beneficial effects these decisions have on those societies with reduced detrimental effects from the drugs themselves.
Holt G. Casting the devil out with beelzebub: the cocaine studies of Sigmund Freud. Lyceum. 2021.
Londono DE. From Freud’s cocaine to Kramer’s modern prozac: a look at an epistemic rupture from a Lacanian perspective. Rech Psychanal. 2014;1(17):35–45.
Freud S. Uber Coca. The cocaine papers. Ed, Byck R. Stonehill, New York. 1974.
Musto D. A Study in cocaine: Sherlock Holmes and Sigmund Freud. JAMA. 1968;204(1):27–32.
Teive HAG, Marques PT, Oliveira LP, et al. Overcoming bashfulness: how cocaine aided Freud to summon the courage to meet Charcot. Arq Neuropsiquiatr. 2019;77(11):825–7.
Mortimer WG. Peru: history of Coca. J.H. Vail, New York. 1901.
Mariani & Company. Portaits from Album Mariani. 1893. New York. University of California Libraries.
Post RM, Kotin JK, Goodwin FK. Effects of cocaine in depressed patients. Am J Psychiatry. 1974;131:511–7.
Fernandez-Castillo N, Cabana-Dominguez J, Corominas R, et al. Molecular genetics of cocaine use disorders in humans. Mol Psychiatry. 2022;27(1):624–39.
Acknowledgements
The authors wish to thank Dr. Herman Clements for reviewing their paper.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare no competing interests.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This manuscript represents original material and has not been previously published and is not under consideration for publication elsewhere. All authors have read and approved the final submitted version of this manuscript.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Hodge, A.T., Strayhan, R. & Sukpraprut-Braaten, S. Systematic Review: Is There a Medicinal Use of Cocaine in Psychiatry?. Curr Treat Options Psych 10, 50–58 (2023). https://doi.org/10.1007/s40501-023-00285-7
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s40501-023-00285-7