The recognition of identities of Amazonian and Andean peoples contributes to a movement of inclusion and respect for their cultural identity. Moreover, the symbolic values related to the use of this plant appear as allies of mental integrity and process of group integrity in favor of maintaining the cohesion of the so-called “coca growing culture”. This expression encompasses the Amazonian and Andean peoples’ comprehensive identity and every aspect related to their cosmologies and their ancestral practices related to the coca leaf and its derivatives.

This is a subject little studied, mainly because it relates primarily to Brazilian issues. Because Amazonian indigenous peoples make use of the plant in religious rituals – it is necessary that health professionals such as psychologists, nurses or even social scientists, be prepared to deal within these specific cultural issues, especially with regard to their actuation in mental health in the context of the Brazilian Unified Health System (SUS).

Indigenous communities … have repeatedly asked public agencies involved in mental health care by psychologists for professionals who know and respect their cultural specificities, their modes of subjectivity, the complexity of community life, cosmology and perspectives of each ethnic group, but especially the stories of their struggle for land and dignity (CRPRS, 2009).

The coca leaf, in its natural state, has cultural/ancestral use seemingly harmless to health. Generally, it is chewed or used in tea form. Because it contains quantities, albeit small, of cocaine in its natural properties, it is consistently associated with drug trafficking, and that image is magnified many times by indiscriminate media discourse.

These shared fantasies and irresponsible discussions about the alleged damage to health has generated political control of the production of coca leaf and produced the fight against drug trafficking. Among the principal control measures Francisco Thoumi (quoted in Gusmão, 2009) lists are: the eradication of illegal crops, incentives to replace illegal crops for alternative crops, interdiction and control of chemical inputs, strengthening interdiction in ports and international waters, extradition of the main Andean traffickers, programs to strengthen the justice and law enforcement and the military and police training program system.

Given this situation, we question the meaning and consequences of the criminalization of coca for people who maintain the coca-growing traditions and who have made therapeutic use of the plant for thousands of years. This article will address the basic properties of coca, its traditional use, the coca growers and drug trafficking movement, therapeutic uses of the plant, and the position of the World Health Organization (WHO) on the plant.

Cocaine: Alkaloid Miracle Drug Illegal

With the discovery of cocaine in 1860 by the German chemist Albert Niemann, the coca leaf and the youngest and miraculous alkaloid took a place of pride in the health sciences of those times. However, perceptions of cocaine have been transformed over more than a century, becoming an illicit drug and the target of prohibitionist international actions. The result of this process was not only a radical structural change with economic and political background in Peru, but especially the consequent stigmatization of coca leaf chewing, called picchado or chacchado, which is reflected to this day.

Paul Gootenberg (2003) illustrates three historical moments, building an interesting genealogy of cocaine (and thus the coca leaf), with emphasis on international relations which mainly involved the U.S. and Peru.

”The three phases explored in this cocaine genealogy are: 1) 1885-1910: the promotion of inter-American coca and cocaine networks (an initial period when the U.S. and Peru actively worked together to make cocaine into a modern medical and global commodity). 2) 1910-1940: an era of transition when the U.S. reversed itself and launched a domestic and worldly crusade to banish the drug (while Peru exhibited greater autonomy, ambivalence and cultural crisis towards its national coca and cocaine); 3 ) 1940-1980: when contemporary cocaine “prohibitions” came to fruition and with a global reach, accompanied by a high degree of U.S. – Peruvian collaboration. .

But this final period and process also witnessesed the birth of illicit international networks of the drug, and with them, as we also see, the persisting and paradox-laden North-American drug dilemmas of the late twentieth century (Gootenberg, 2001, p.3).

The discovery of cocaine in 1860 caused great excitement in the international scientific community of the time. Gootenberg (2010) commented on the enthusiasm generated in France, England and the U.S., regarding the possibility of the plant’s use in medical practice. Furthermore, the identification of its anesthetic properties by Austrian Carl Köller in 1884, created revolutionary surgical applications as it became the first truly effective local anesthetic.

Also, the famous Vin Mariani became increasingly popular in Europe and the United States with its promise to renew physical and mental vitality without causing depression. Legendary artists and others in the late nineteenth century approved of wine and lent their names to statements hailing its fantastic qualities. Dom Pedro II, the last monarch of the Empire of Brazil, reported to Mariani that he took great pleasure in consuming his product; Fredrick Bartholdi, creator of the Statue of Liberty, commented that if he had known the wine beforehand, he probably would have built it higher (Gagliano, 1994, p.112); Pope Leo XIII liked it so much that Mariani was awarded with a Papal medal of honor. Pope Pius X, Thomas Edison, Queen Victoria, Sarah Bernhardt, and Ulysses Grant, among others, were also great connoisseurs of Mariani’s Coca wine.

In the same period, the Franco-Peruvian pharmaceutical chemist Alfredo Bignon launched a series of scientific studies on cocaine, according to Gootenberg (2010), including nationalistic and commercial background studies. In nearly a dozen studies in three years (1884-1887) he developed new, authentic and economical methods of producing cocaine that revolutionized the medical and scientific community of the time.

With the growing interest generated by the expectation of a promising future of the new psychoactive substance, Peru was organized to meet the demands of the legal market that began to set up more intensely around Coca. Within about 15 years Peru was supplying much of the world market with coca and cocaine, and these exports served as an ally to national economic development until the mid first decade of the twentieth century.

”By 1900, the peak of the trade, coca products reached fifth place among Peru’s exports earners: some two million pounds of coca (mostly sent to Americans) and more than ten metric tons of cocaine (mainly to Germany)” (Gootenberg, 2001, p.11).

Coca cultivation was not restricted to South America, but was also cultivated in Asia. In 1878 the Dutch began to grow coca in Java, and by 1885 they were already considered significant competitors in the European market. European pharmaceutical companies preferred by the Javanese coca’s low price and the fact that it contained more alkaloids that Peruvian coca. By the late nineteenth century, the British had also entered the international market with coca plantations in Ceylon [Sri Lanka] and India. By 1912, there were 57 plantations in Ceylon with almost 3,800 acres [1537 hectares] of coca cultivation. (Gagliano, 1994, p.114).

However, by the late 1890s, as suggested Gootenberg (2010), cocaine had already lost the aura of miracle drug that it had enjoyed a decade earlier and had come to be considered drug with potentially dangerous side effects and worrying social consequences. Then came the first American efforts to implement measures of international regulation of the cocaine trade.

”The year 1906 marked the beginning of the end for the free and easy distribution of cocaine … By 1912 almost all of the states [U.S.] had prohibited the sale of cocaine except by prescription …

But neither the Pure Food and Drug Act of 1906, nor the various state anticocaine laws enacted prior to 1914 reduced the consumption of cocaine in America. Nor did the passage of the Harrison Act in 1914 (the first nacional antidrug law), which brought the power of the federal government to bear on anyone dispensing cocaine without a doctor’s prescription, reduce consumption. On the contrary, where in 1906 some 21,000 pounds of cocaine were floating around the country, by 1919 the amount of legally distributed cocaine had risen to 26,000 pounds – to say nothing of all the cocaine distributed by the brisk illicit traffic which had developed over the previous several years” ( Ashley, 1975 p.65-66).

Gootenberg (2003) mentions the Hague Convention in 1912 that aimed to regulate the production and sale of cocaine, heroin, morphine and opium, as well as the 1914 Harrison Act, the first federal law in the nations history of narcotics regulation. This restricted the use of cocaine to prescription. Later, in 1922, the U.S. Congress established the Jones-Miller Act, which would ban all imports of narcotics such as cocaine and coca leaves, with the lone exception of one of the largest soft drink industries of the world, a fact that only the media would be grasping a few decades later.

The very words “narcotic” or “dope”, which in their etymology signify a numbing effect or a substance that promotes falling asleep, demonstrate the misclassification of coca leaf and cocaine, which in fact are stimulants. Ashley (1975) argues that the intentionality of this (mis) classification is based on (1) art of lying, by any act or omission, for the purpose of influencing opinions, (2) technique used by governments, corporations and similar scoundrels working to separate citizens from the truth.

Throughout the U.S. prohibitionist period the big difference between coca and cocaine was neglected or distorted, and in addition the ancient habit of chewing coca was mis-characterized as a type of addiction, as stated Gootenberg (2003). Contradictory results can be widely found in newsletters and resolutions of the League of Nations, published by the major powers with irregular, discontinuous and summary statistics on cocaine. As one effect, Peru from 1910 to 1940 continued, even with its ongoing economic and political crises, to maintain its legal cocaine production although at a rate reduced to 5% compared to the 1910s.

Some decades later, the U.S. had already persuaded and arranged a global prohibitionist policy cocaine (and coca) also involving European and American countries, including Brazil. This phase was marked by the increasing organization of former coca grower groups in Peru that have traced new routes for production and distribution of illicit cocaine and broadened their networks by Bolivia, Argentina, Colombia and Venezuela in order to meet the demands of international markets.

”Between 1947 and 1964, in response to the imposition of global prohibition on cocaine, a large hemispheric network of illicit production and marketing appears. This integrated network for the first time, allied peasant coca growers from the Andean jungles with chemically sophisticated drug traffickers from Peru and Bolivia, creating a traffic bound for Chile, Cuba and Mexico, and for novice consumers in Havana and the United States” (Gootenberg 2010, p .68-69).

In 1952, the World Health Organization (WHO) concluded that the habit of chewing coca had all the characteristics of dependence and addiction, defined as a form of ‘cocaine addiction’. Since the last report in 1959 at the request of the Peruvian representative at the United Nations (UN), a commission made a whirlwind visit in Peru and Bolivia to investigate the effects of leaf chewing. Making hasty conclusions, the committee judged that chewing coca caused malnutrition, as well as the undesirable effects of deteriorating intellectual and mental character. The plant was also condemned as responsible for the poverty of the South American continent, since cocaine (not Coca leaf) consumption moderately decreases work capacity. Even today, the UN maintains supports the erroneous 1959 report as a determinant of most official attitudes that impact the traditional and medicinal use of the coca leaf (Levy, 2009).

The prohibitionist process in many ways culminated in 1961, with the Single Convention on Narcotic Drugs signed by members of the UN, including representatives of Peru and Bolivia. This agreement was intended to limit coca production only scientific and medical purposes and to eradicate opium within 15 years and the traditional custom of coca leaf chewing and cannabis within a period of 25 years. Another similar policy measure was more recently held in 2009, when the states of the UN Commission on Narcotic Drugs stipulated the term of a decade to eliminate or substantially reduce supply and demand for drugs until the year 2019. Of course, this ambitious project has not worked and certainly will not work until the time stipulated by the Commission members. Although representatives of Peru signed the agreement at the time, their action raises suspicions. Gagliano (1994) points out that the main antagonists of the discussions relating to coca over four centuries came from the coastal elite, among whom the use of Coca has been discarded since the sixteenth century.

Later, in the 1990s, WHO and Interregional Institute for Research in the UN Crime and Justice (WHO / UNICRI) launched a four-year program in 19 countries on five continents, with 45 researchers Institutional members, and produced a report that emphasized the benefits of the use of the coca leaf to human health. This study created concern in 48th World Health Assembly, held in Geneva in 1995. Neil Boyer, U.S. representative, accused the study of being “a defense of cocaine, arguing that the use of coca produced no noticeable damage to the physical or mental health” of their consumers (Forty-Eight World Health Assembly, 1995, cited in Levy, 2009). Boyer threatened to discontinue financial support for his government to the project if the conclusions drawn were officially adopted by that Assembly. The report was filed and largely forgotten. (Levy, 2009).

WHO highlights the herbal indications of coca leaf in traditional and alternative medicines, stating that there is not enough research to show that the coca leaf used alone has health benefits. However, it also does not say what, if any, the contraindications are. (WHO, 2006).

It is a fact that the prohibitionist measures have failed in their continuing attempt to curb the illegal production and distribution of cocaine, as well as the habit of chewing coca. In contrast, there has actually been a significant increase in coca growers groups motivated by the prospect of profit, also fueled by the illicit coca market.
The Coca Growers And Drug Trafficking Movement In Bolivia And Latin America

The relationship between coca growers and drug trafficking movement is a strong point of tension. At stake are traditions, customs, and developments with social, political and economic consequences. Whereas social movements fighting for their rights against corporate interests and the authorities, the coca growers’ movement is a current example of a people who struggle for recognition of their ideals and customs. This movement is strong and growing in countries such as Bolivia, Peru and Colombia.

The coca growers’ movement in Bolivia is representative of the overall movement. It is important to understand that this is one of the largest social movements in Latin America, due to its impact on a global level, and it is better organized compared to other growers movements in Peru and Colombia, for example.

Maciel and Pinheiro (2008) report that the initial organization of the coca grower movement occurred around the late 1980s and appeared initially in the sociopolitical context with the mass resignation of Bolivian miners. As Gonçalves and Santos (2008), the Quechua peasants moved to the Chapare, north of Cochabamba, to find a means of survival. The poverty of the Bolivian population caused other groups to migrate to the same region of the Chapare. These groups were engaged in the planting of coca as a means of survival. Besides ensuring the livelihood of thousands of Bolivians, coca is an ancient symbol of cultural unity between Andean and Amazonian peoples.

An Indian-based Bolivian party Movement Towards Socialism (MAS) emerged during the period of post-military dictatorship (1964-1982) and gained strength in the international arena, elected an Indian to the office of president for the first time in the history of Latin America, Evo Morales (Maciel and Pinheiro, 2008). This political move marks the shift from a strictly peasant organization to a recognized indigenous movement that supports the acullicu as a legitimate legal and cultural practice that is part of the Bolivian identity.

The MAS is directly linked to coca grower movement and has been active since the 1970s. Composed of recognized indigenous members and other supporters of the cause, the MAS struggles for recognition of the rights of manifestation of the Andean culture. The efforts of these groups to decriminalize coca becomes noticeably a fight for their identities (Maciel Pinheiro, 2008). The International Seminar for Decriminalization of Coca, which occurred in 2005, whose theme was ”Coca isn’t cocaine – it is medicine, food and culture”, was an example of an international mobilization around this issue.

These movements are motivated by the preservation of an ancient Indian practice – an integral part of the identity of the Andean and Amazonian peoples who used coca long before the appearance of the Spaniards. Censorship and repression of their use of coca has historical origins, primarily the attempts of the colonizers to impose deculturation on various peoples through the imposition of Western ideological bias on this phenomenon. The “Plan “Dignity”, for example, created as a result of the “War On Drugs” policy and sustained primarily by the U.S., endanger the cultural expression of these indigenous people.

It was in response to drug smuggling gangs that the United States launched a policy to combat coca cultivation with the so-called “Dignity, Colombia and Panama” plans. Maciel and Pinheiro (2008) point out that the U.S. action was mainly as a means of intervention in Latin America, criminalizing members of these movements in an attempt to ‘discredit’ them. In most cases, growers are configured as terrorists or drug traffickers – enabling the US to interfere in these countries economically and politically under the license of the “War On Drugs”.

Most indigenous peoples and peasants engaged in illicit cultivation of coca, poppy and cannabis are small farmers struggling to make a living and support their families. Proposals that create alternative livelihood opportunities are better approaches than the destruction of their only means of subsistence (Global Commission on Drug Policy, 2011, p.13). However, with the difficulty of offering these products on the legal market, growers accept offers that pay three times more for coca leaves.

Moreover, the farmers involved in illicit coca crops are not usually heard by political authorities, and their interests are not represented by the mainstream media. The lack of representation of these groups of indigenous peasants reflects the impact of the money spent by the US through its “war on drugs” policy. And although some of the Coca produced in the Andean countries is directed towards the traditional and industrial processes certainly a portion of it is also diverted for international illegal drug traffic.

According to Rippel (2006), communities that agreed to replace the traditional culture of coca with other crops experienced difficulties such as lack of markets for their products, poor communication routes to ensure the marketing of their production, insufficient credit, and adverse health effects caused by herbicides used to eradicate coca.

According to Barrientos and Schug (2006), farmers in the region of Cochabamba, Bolivia, decided to keep growing the plant because, besides the fact that coca is more robust than other plant in the region, it requires less care, fewer pesticides, etc. Most important, the cultivation technique was already quite familiar to the people of the region. Investments in Coca are four times cheaper in relation to the cultivation of bananas and cost twenty times less than the cultivation of peppers. Furthermore, expenditure involving new planting only appears after forty or sixty years, and the tools required are much more simple and traditional. Further, a new planting of Coca is productive after only after three to five years, all of which are significant advantages for farmers who have little capital available.

The official 12 hectares reserved by law to the legal coca in Bolivia (intended for chewing, pharmaceutical industry, teas etc.) contrasts with an estimated 30 thousand hectares that are actually cultivated. Most of the coca is frankly planted to the supply the illicit cocaine market. Measures to combat excess coca cultivation in Bolivia, although they have been more significant in recent years, are still insufficient to stem the illicit trafficking. This reality clearly sets up the conflict between culture and trafficking.

Efforts to eradicate illegal coca should be combined with the adoption of alternative development programs, strongly financed that address local realities in terms of viable products and access to markets on competitive terms. These efforts must speak not only of alternative crops, but of social development of alternative sources of labor, democratic education and finding solutions in a participatory context (the Latin American Commission on Drugs and Democracy, 2010, p.13).

On the other hand, attempts to eradicate coca in Andean and Amazonian areas can have serious consequences, not only because it is a form of aggression traditional cultural practices, eliminating the possibility of earning livelihood for many families who depend the cultivation of the coca leaf, but eradication programs also increase the risk of triggering a real identity and economic crisis of peasants and various communities involved in the coca-growing culture.

This scenario prompted the president of Bolivia, Evo Morales, to press the UN Convention to abandon the Single Narcotics regulations in 2011, and he returned again in 2013 when acullico was decriminalized and internationally recognized as part of the Bolivian identity. An amount of 15 countries were against the decision, like USA, United Kingdom, Portugal, France, Mexico, Italy, Germany, Japan, Canada and Russia. However, despite this small victory of Bolivian growers, the UN keeps ignoring the traditional use of coca leaves in some countries such as Peru, Colombia, Equador and Brazil. By the way, Coca Leaf remains in the list of controlled substances, that is why it is currently out of international free market, which ultimately stimulates further their illegal production and smuggling of cocaine base paste in Bolivia, Peru and Colombia.

According to Latin American Commission on Drugs and Democracy (2010, p.25) it is estimated that currently more than two million peasants were forced to migrate to other regions within their own countries and has created the presence of huge numbers of refugees in Colombia, both situations resulting from the repressive policy of “war on drugs” and the stigma imposed on traditional coca-growing cultures.

In Colombia, despite the reduction of coca cultivation area, farmers are now investing in species that are up to three times more productive. The drug cartels that were disconnected in Cali and Medellín simply migrated to Mexico, helping to maintain the supply of cocaine in the United States, the largest consumer of cocaine in the world, if considered in absolute numbers.

Other consequences of the war on drugs policy in Latin America are: 1) the development of parallel powers in areas of fragility in the nation states (poor neighborhoods of large cities and suburbs, distant inland regions, border regions, the Amazon territory); 2) the criminalization of political conflicts, 3) corruption in public life (particularly the police structure, justice and prison system), 4) the alienation of youth, especially poor youth (Latin American Commission on Drugs and Democracy 2010 , p.25.) The fact is that in Latin America, more people are dying due to the effects of the pernicious policy of “war on drugs” than from the consumption of substances that this “War” has made illegal. Similarly, Werb, Rowell , Guyatt et. al. (2010) suggested in a systematic survey conducted in several U.S. cities and in Sydney, Australia, that drug enforcement tends to contribute to increase violence associated with the illicit market and increase rates of homicide rather than resulting in what is supposedly its intent – reduce drug traffic and crime.

In Brazil, for example, in addition to generating feelings of insecurity and contributing to an infrastructure of poverty, crimes involving drug trafficking are marked by a horrifying increase of murders by firearms, beheadings, and what is called “micro – waving” – people burned alive on tires. Many corpses are still found with teeth and fingers removed, complicating the identification of the bodies by the technical police, besides the presence of large number of clandestine graves.. Our rulers have therefore created a huge detriment to society, criminalizing users (many prosecuted as drug dealers) and small dealers who do not exhibit violent behavior, which are then used to justify the time and cost of this repressive policy, which is always based not on scientific arguments but on moral or religious sentiments. Such policies invariably violate human rights, self autonomy, freedom and privacy of users of any substance that has been declared illegal by the authorities.

Finally, in 2014, the UN admitted for the first time that war on drugs objectives have not been complied so far and suggested for the first time the decriminalization of drugs as a measure that may be able to decongest the prisons, redistribute resources to assign then to treatment and facilitate rehabilitation for some addicted users – the same considerations that serious researchers have been warning for some decades.

The Culture Of Coca And Health Promotion

Forms of use of the coca leaf does not necessarily give the pharmacological action itself, but mostly by the sociocultural context in which it operates. In fact, the scientific understanding of psychoactive substances by those who evaluate the biochemistry has proved insufficient to understand and organize and measures of health, and education policies.

A reducionist biopharmacological perspective that takes the consumption of these substances as contact between an universal person and a molecule capable of always engendering the same effect, ignoring historical, symbolic, political and moral dimensions involved in the production of the senses of all human actions, ends by reducing the scientific debate about the use of ‘drugs’ to a sterile division of opinion between parties – between biological sciences and humanities, between realism and constructivism, between objectivity and subjectivity, and so on (Labate et al, 2008, p.37 , featured in the original).

Gagliano (1994) reports very well on the various social uses of coca, confirming the intrinsic value of that product in the identity of the Andean peoples. Coca, in this sense, is a symbol of camaraderie as when a host offers guests a toast as part of their expression of hospitality. It demonstrates trust and friendship when contracts are negotiated. It is present in wedding ceremonies. It is offered to the deities and used in the foundation trenches for the construction of houses to ensure good fortune and protection from evil spirits. Its use blesses walkers through the dangerous paths of the Incas mountains. Shamans use it in dream interpretation and prediction of events. It is used in funeral rites, celebration of new life, the gift of the nature to calm storms and earthquakes, to protect crops and provide abundant harvests.

The inseparability of culture and health is an important concept since the value of the recognition of an ancient culture in maintaining psychological integrity of these people is affirmed. The sense of belonging and meaning as to the identity, with customs, cuisine and rituals in the present context are reflected directly in the physical, psychological and social well-being of the subjects.

The identity also serves to designate the principle of permanence, which allows the individual to continue the ‘same’ from ‘persist in his being’, throughout his narrative existence, despite the changes it causes, suffers or those that may occur most unexpected and sudden manner (Grubits, Harris 2003, p.186; highlights in original).

The concept of ontological security refers to the sense of continuity and real existence of the subject. It is constituted by a network of meanings and perceptions relating to different aspects of one’s life and its consequent safety and subjective consistency. The idea of continuity in itself presupposes the notion of temporality. This means that the person standing in the world, recognizes itself and maintains their stability in the midst of change. Therefore, any intervention to remove certain aspect of the identity of an individual can be interpreted as a threat to the principle of permanence, which may trigger mental instability and be reflected in symptoms of anxiety, feelings of worthlessness, anger, lack of perspective etc.

The criminalization of the cultivation and use of coca is a serious act of reductionism, because it ignores the great number of uses that the coca leaf has for these communities (Maciel and Pinheiro, 2008). It points to rites involving, in most cases, the religiosity of these peoples, as in some communities in the Upper Rio Negro, near the border with Colombia. This is the case of people Arapado, Bara, Barasana, Cobeus, Desana Hupda (Makus), Miriti-Tapuya, Piratapuya, Wanano, Witoto, Yepamashã-Tucano. The Tuyuka, for example, use the coca leaf with a hallucinogenic vine to summon spirits of the forest and ask for their blessings.

The Amazonian indigenous peoples who use coca leaf are the Kampa (or Ashaninka), located in the Brazilian and Peruvian territories, consuming the leaves similar to that used in the Andean region form, putting them in the mouth, after roasting them in banana leaves, and adding a powder extracted from a stone to make alkaline mixture (Mendes, 2002 and Pinhanta Asheninka, 2001 apud Echeverri and Pereira, 2005).

The rescue and recovery of indigenous ancient traditions in the Andes is a fact that much of interest to all mankind. This is because the trajectory of the Andean culture was not constituted by theories or philosophical abstractions, but was forged in experience, experimentation and practice, in a long and slow journey of its inhabitants, in an ancient and perennial movement that always essentially shaped by ecological values (Ribas 2008, p.54).

In Brazil, the law 11.343 of 2006 establishing the National System of Public Policies on Drugs, based on the Vienna Convention at the United Nations on Psychotropic Substances of 1971 authorizes and regulates the use of plants in ritual-religious context. However, it is not what happens with the coca leaf, although anthropological and historical evidence confirms the existing use of the plant by diverse communities of Amazonian traditional peoples. The Brazilian authorities simply remain inert and silent facing this issue, ignoring the socio-cultural specificities in the country.

International prohibitionist measures for the coca leaf and other psychoactive substances in general are much more influenced by political and economic considerations than they are interested in preserving the lives of people. The act of criminalization of certain psychoactive substances over other transforms understandings involving health, culture and individual responsibilities in a discourse that reaches the criminal sphere through violence and stigmatization.

The purpose of this paper is not to establish the separation of types of substances (the coca leaf and cocaine) as justification to regulate or ban one or other as psychoactive. In this sense, Henman (2008) points out that the separation of substances is the tactic of the lower clergy, the fundamentalists who see themselves as good and others as sinful. Henman also comments regarding an ethnocentric model of the owners of the truth, those who believe that their own social context is the one who that defines whether or not the use of a psychoactive substance is determined to be evil.

What is in crisis is not only the rotten structure of the ban, but the principle of dualism itself, the division between good and evil. Against the separation of substances, against the qualification and disqualification of social contexts, against approval only uses due and criticism from misuse, we must respond with a model that respects the uniqueness of each moment and each place, and the particular character of each user and each experience (Henman, 2008, p.379).

The war on ‘drugs’ based on the prohibitionist model completed in 2012 marks one hundred years of failure since the International Opium Convention in The Hague. During this period, massive international efforts could not manage to reduce the consumption of psychoactive substances nor their production. The only result has been the increase in violence, the development of money laundering schemes, the rise in arms trafficking, the spread of corruption etc..

Mankind, in turn, always did and always will make use of psychoactive drugs. Moreover, with technological modernization, new substances can enter the market and be able to change perception of different forms, mood, behavior and consciousness. One must reflect, therefore, on what do to face this reality, since it is clearly unreasonable to base any new model on the discredited way of dealing with the issue of ‘drugs’ by going to war.

Unsurprisingly the current system of classification of psychoactive substances is obsolete and has nothing to do with the risks and damage that can cause to individual and collective health. The current interpretation is that the more well built something is, the more the event becomes ‘real’, justifying measures that elicit stigmatization, prejudice and misinformation.

Regardless of condemnation and censure of coca, the natural leaf is still used in many ways; in the production of a flour can be mixed into bread, rice, gum, or pies; it can be ingested as tea, wine, soft drinks, energy drinks; it is used as ointments, and there are many other medicinal uses already employed for millennia.

Freud (2004) distinguished two recommendations on coca use: for the successful treatment of diseases and those related to the psychological effects of the stimulant. As a stimulant, increases the physical ability for a certain short period of time, especially when external circumstances eliminates the possibility of rest and feed, normally required for a great effort. It can be used to remedy digestive disorders, eliminating dyspeptic ailments, resulting in a sense of physical well-being.

The Austrian doctor also advocated the use of coca in cachexia, in diseases that involve the degeneration of tissues such as severe anemia, pulmonary tuberculosis, febrile diseases of long duration, etc.. Coca Leaf is also widely used to prevent the symptoms of the “evil of the mountains” or soroche, including difficulty of breathing, heart palpitations and dizziness. There are numerous reports that asthmatic patients have been successfully treated with coca.

There are still inquiries being made, especially in mental health. It is the case of the study of the Peruvian Llosa Theobald – psychiatrist, doctor of medicine from the Federal University of Rio de Janeiro and a researcher of drug addiction by the U.S. NRA / Nida (Addiction Research Center of the National Institute on Drug Abuse) – which advocates use of the herb in the treatment of cocaine dependence (Gentleman, October 5. © 2006).

The researcher explains that there are two approved therapies of this type in the world: the nicotine patch for smoking control, and methadone, to alleviate the effects of abstinence from heroin. The use of the coca leaf, therefore, follows the same principle. Llosa said he had treated two hundred patients over 15 years with Coca infusions or capsules of coca flour, and effectiveness reaches more than 70% (Gentleman, October 5. © 2006).

In line with these studies, the Bolivian psychiatrist Jorge Gumusio, Research Institute of Coca, La Paz, undertakes research with the support of international organizations. According to their data, fifty-dependent accompanied in one study, about 60% were able to probation, and the number of those who needed psychotropic medication fell from 54 to 32%. Gumusio clarifies that the treatment is outpatient and these people are just encouraged to chew on coca. Furthermore, the monitoring done with people who chew coca leaf lifetime shows that no physical or mental injury (Biancarelli 17 March 1998) were recorded.

Asked what other benefits are present in the use of the coca leaf, Gumusio points to the local anesthetic property and nutritional value it contains high presence of vitamins, calcium, phosphorus and iron (Loewy, sd). Others currently recommended therapeutic uses, according to information contained in the Sacred, Magical and Medical Plants Museum, located in Cuzco-Peru, are: controlled gastritis, antidepressant, treatment of hypoglycemia and diabetes, helps in controlling high cholesterol, cardiopulmonary stimulant, hypertension control, improves the frames of osteoporosis and osteoarthritis, among others.

Final Thoughts

It is important to reflect on the psychosocial aspects of the use of coca leaves in the Andean and Amazon regions, in order not to be influenced by an indiscriminate association of coca leaf to cocaine. This research points to the various aspects of culture and health of people doing traditional use of the plant for thousands of years. However, political, social and economic approaches also become complementary to understanding the discussions on the subject.

All evidence suggests that further investigations regarding the use of Coca Leaf in the treatment of cocaine dependence. The difficulty in finding research in this field points to the taboo on the plant, which still exists in the scientific community in general. Its use in the pharmaceutical industry may still be valuable, isolating its components in order to make specific medicines to the population.

Contrary to the legitimacy of the use and cultivation of coca, prohibitions maintained in place by world political authority checkmate the socio-cultural roots of the Amazonian and Andean peoples. At the moment the communities that traditionally use coca are deprived of exercising their cultural practices, and they are at risk of lose references that comprise their identities and senses. That’s when you realize the inextricable link between culture and mental health.

This article contributes to the placing of a new look towards the use of coca, specifying the actions that fall under coca grower movement and forming part of the drug trade. Of course, coca growers and drug trafficking movement include terms that are often synonymous. However, the argument is a possible realization of social improvements to support specific legislation, encouraging the rational use of this plant, absorbing completely legalized throughout the planting for the pharmaceutical industry, while margins for the illegal marketing at the same time maintains space for preservation of customs of the communities that use coca.

Given this situation, the psychology, in a multidisciplinary context, presents its contribution to both the reformulation of public policy on the legalization of the use of coca leaf in Brazil and in the world as to mental health care actions for indigenous populations. These professionals are facing an emerging field of activity in which they are invited to consider and respect the particularities of each indigenous community, being caused to formulate new strategies in health promotion.