COCAINE: A Drug and its Social Evolution

Snow, blow, she, the lady. . . terms for cocaine new and old are once more surfacing as the Seventies witness a resurgence of cocaine use among superstars and others affluent enough to afford it. Harvard psychiatrist Grinspoon (who has already written books on marijuana and amphetamines) and co-author Bakalar trace the sociological roots of the current vogue as well as present an exhaustive account of the drug's history, pharmacology, and potential for use and abuse. Cocaine is similar to amphetamine, acting as a central nervous system stimulant, appetite depressant, energy booster, and fatigue suppressor. But its pharmacological action is different, and it appears to be less disorienting or disturbing in the long run. The authors report on the celebrated 19th-century users--Freud, Pope Leo XIII, Sherlock Holmes (or Doyle); summarize studies of South American Indians; tell of experimental uses in mental and physical illness; and present the testimony of contemporary users. None of this adds up to unequivocal or complete characterization of the drug, and the authors urge more research, especially of the effects of high dosages. An absorbing discussion of public policy toward all psychoactive drugs takes up the last section. The present quixotic legislation that pronounces some drugs illegal narcotics, sanctions others as medicine, and condones still others (tobacco, alcohol) as fun, resulted in part from the medical profession's need, at the turn of the century, to establish firm categories and tight control; an increasingly compartmentalized Society could no longer tolerate patients' self-medication or competition with patent-medicine purveyors. It is timely that a book so comprehensive and rational should appear now, before publicity and propaganda polarize public attitudes.