Editor’s Note: The following chapter from Dr. George Pettey’s 1913 book details the endgame of the process begun in the mid-1800s with Merck developing the technology for isolating and extracting the alkaloid Cocaine from pure Coca Leaf. The objective was, of course, to be able to patent Cocaine and dominate the market for a “new” pharmaceutical drug, and in the process to suppress the market for natural Coca Leaf as a medicinal herb. (And please keep in mind as you read this that although Dr. Pettey believes that Cocaine addiction is considerably less serious than Morphine addiction, nevertheless there is a world of difference between the healing power of pure, natural Coca Leaf and the man-made and deadly drug Cocaine.)

… However, within a short time the genii had escaped from the bottle and Cocaine was being manufactured widely in the US and Europe and its use had morphed from medical applications to a driving force for addicting users to patent “medicines’. The patent medicine industry then quickly morphed again into what has become, a hundred years later, the soft drink industry.

The process went something like this. Whereas Cocaine initially became popular primarily among hard working Black people in the South, enabling them to work at man-killing jobs all day without food or water, white businessmen quickly saw the potential for profit if Cocaine could be made acceptable to Whites. Looking around for a vehicle, these drug-pushing innovators quickly spotted the fact that the tonics and patent medicines that used to be peddled from the back of itinerant hawker’s wagons, but that were increasingly controlled by a few big companies, had evolved into products now sold in “respectable” drug store environments as soda fountain drinks.

They instantly concluded that by including Cocaine in syrups that they supplied to the soda fountain market they could ensure a loyal following among “respectable” white folks who almost instantly just had to have a jolt 5-10 times a day – and at the low, low price of just a nickel a pop. As you’ll see in the chapter cited below, this quickly resulted among other things in wholesale addiction of children, turning them into what the author terms “Soda Fountain Fiends”. While this may seem rather quaint and funny to us today, the enslavement of children to addictive drugs by these companies was a deliberate criminal act for which they have never been held accountable.

Is it any wonder that today 100 years later two of the richest companies in the world are Coca Cola and PepsiCo, building upon the enormous business war chest they were able to accumulate a nickel at a time before prohibition forced them to remove Cocaine from their list of ‘secret ingredients”? Interesting too how their advertising themes like “Things go better with Coke” and “Come Alive!” subliminally tie into these early days. Once you understand the dynamics of history, you can understand the cynical genius behind these peddlers of “The real thing”.

So, ya want a coke and fries with that burger? Really?

(From the book entitled) “The Narcotic Drug Diseases And Allied Ailments; Pathology, Pathogenesis, And Treatment”, by George Pettey, MD, Philadelphia 1913

Chapter XXIII: The Cocaine Habit

It will be noticed that the author here uses the word “habit,” instead of disease. This is done advisedly; that is to say, the word “habit,” as commonly understood, can be properly applied to the habitual use of cocaine, but it should not be used to signify the conditions growing out of the prolonged use of opiates. There is a wide difference between the morphine disease, and the cocaine habit.

The morphine disease may be acquired justifiably; that is, because of the legitimate use of morphine for relief of pain, or, inadvertently, by using it for support during excessively long working hours, or by one taking it in some remedy not known to contain it, or it may be taken up as a pure dissipation, but, no matter how its use is begun, when the addiction is fully established, it is a disease and the victim is helpless and cannot abandon the use of the drug or cure the disease by merely exercising his own volition. He is in the coils of a monster with whom he is unable to cope, but this is not true of the cocaine habit.

The use of cocaine is usually taken up by those already addicted to morphine. In the course of two or three years from the beginning of the use of morphine it ceases to exert a distinctly stimulating effect on the user. There is little, if any, pleasurable sensation from its use. It is continued because its disuse entails suffering which the victim is unable to bear. Morphine users who are inclined to dissipate, after reaching this stage, frequently add cocaine for the stimulating and pleasurable sensations produced by it, as they are not being satisfied with the effects of the morphine alone.

This is begun and continued as a pure dissipation. It could be abandoned any day without material suffering by merely dropping the cocaine and continuing the morphine. There is no more difficulty in sobering a man up from a cocaine spree, or from the habitual use of it, than in sobering him up after a temporary alcoholic indulgence; neither is there greater suffering incident to it.

The habitual use of cocaine does not bring on a disease in any way comparable to that of morphine. One is taken up and continued purely as a dissipation; the other is a calamity, and so enslaves the user that he cannot abandon it of his own volition.

Cocaine is seldom used alone habitually. Its use in the Southern sections of the United States is confined almost entirely to the Negro race, and the Negroes use it intermittently. The power of cocaine to sustain one under a prolonged strain is well understood by the laboring class of Negroes. Frequently those engaged in unloading and loading steamers will work forty-eight to sixty hours, continuously, by supporting themselves with cocaine. When the ship is loaded, then they go to their quarters and sleep two or three days before even rising to take food. In this time they have slept off the effects of the cocaine and are comparatively normal. Then no more is taken until another strain comes upon them and in this they again sustain themselves with the drug.

Others who take cocaine as a dissipation use it through the night, or probably through a day and night, and then abandon it for a time and later go on another spree. This is cheaper to them than alcoholic intoxication and is said to be much more delightful.

Persons who take cocaine alone are dangerous, both to themselves and others. Cocaine produces delusions of persecutions, and, acting under one of these delusions, one under the influence of cocaine is liable at any time to do violence to anyone near him, not that he would have any ill will toward the particular person; but believing that he is being pursued by some enemy, which is merely a phantom, he is liable at any time to turn and use a pistol or other weapon on such imaginary enemy, and an innocent party be maimed or killed. It is never safe to allow such a person to remain at liberty.

The most insidious and damaging manner in which cocaine is reaching our people, that is, the white people of this country, is through the carbonated drinks for which many have such a passion. It is in the manufacture of such drinks that the bulk of cocaine is used. The great increase in the importation of cocaine leaves is not due to the demand for cocaine as a medicine, or from its personal use by drug habitués, but it is because of the demand for the leaves as the one essential ingredient in establishing and perpetuating the use of these carbonated drinks.

Many of these drinks, some having a name very suggestive of this damaging, yet fascinating drug, have been skillfully and persistently advertised; but their use and the hold they have upon the public do not depend upon this skillful use of printers’ ink, but upon the fact that the effect of one drink creates a demand for another.

These drinks are advertised to relieve headache, overcome fatigue, and impart in its stead a sense of exhilaration and well-being, and they do this, but not by removing the cause of such conditions, nor by supplying the system with the physiological activity and the energy which are the counterpart of these unwelcome conditions; they do it by blunting the sensibilities, for a time, to their existence.

As the effects of the stimulant in the drink dies out the demand for another drink is strongly felt, and then a second drink is taken, and this is repeated several times a day. We have, as a result, thousands of young men and women depending upon the energy derived from these drinks to enable them to carry on their work. Many of them taking from three to a dozen or more of these medicated soda-fountain drinks each day. They will tell you that they feel totally unable to undertake their day’s work without their “coke.” They are, in fact, as really enslaved by the drugs these drinks contain as they would be were they using them in other form. It is to their enslaving properties that these drinks owe much of their enormous and continuous sale.

Doubtless, when the facts are ascertained as to the use of cocaine by the school children of Philadelphia, which has recently created such an uproar, it will be found to have had its origin in the medicated soda-fountain drinks rather than from the seductive influence of older persons used in a more direct manner. Children who are allowed to become soda-fountain fiends acquire a taint that, when opportunity presents, leads them to take to cocaine or other stimulants like a duck to water.

TREATMENT

Much misconception exists as to the nature and treatment of the cocaine habit. When cocaine is taken alone the treatment consists simply in cleaning out the system by an active cathartic, shutting off the cocaine, and allowing the patient to go to sleep. If the patient has been taking a considerable quantity of cocaine this sleep will continue for some eighteen to thirty-six hours, but it should not be interrupted.

When anyone is taking cocaine the system is kept constantly saturated with it by repeated doses. The effect of this drug is to keep the patient excited, in a wakeful state, and this will continue as long as the doses are regularly repeated, even if that be for forty-eight hours continuously without sleep. Most cocaine users sleep very late of mornings, but before they are able to rise from bed and dress themselves they must have one or more injections of their drug. This puts them on their feet and then they continue to take their doses at short intervals from that time until late the next night, or they may run even a day and night in succession before they stop their dosing again to such a degree as to give themselves a chance to sleep. But usually they will begin their day’s dosing about 10 to 12 o’clock and run until 2 or 3 the next morning, and then leave off their doses; then they soon become drowsy and go to sleep.

When once asleep they will sleep so heavily that the sleep will be continued until nature has sufficiently restored the system to enable them to arise again. As soon as they awake, their day’s work, which consists in repeatedly dosing themselves or injecting cocaine, again begins and nothing else is done. In fact, they are totally unfit for application to business of any kind.

If cocaine is taken in connection with morphine the condition is not quite so bad, but few people who take cocaine will do anything at all in the way of attention to business. After they get to taking cocaine in considerable quantities it requires all their time to keep the effects of that drug balanced with the morphine they are taking. In treating such a case a thorough course of elimination should be given so that the medicine will act early in the morning. Their cocaine should be given to them up to l0 or 12 o’clock at night and then taken away.

Within two or three hours after the last dose of cocaine the patient will go to sleep and sleep heavily until he is aroused, or until the cocaine effect has entirely worn away. By having the purgative ready to act, that is, by giving the purgative so it will be ready to act as soon as the patient awakens, the evacuation of this toxic matter relieves the nervous system to a considerable extent, and this usually quiets the patient so that he can tolerate his existence without the cocaine. A few free evacuations of the bowels give sufficient relief to enable him to go back to sleep and then twelve or eighteen hours more of sleep brings him to a condition of comparative quietude, in which no further real demand for the effects of cocaine exists.

Cocaine should be discontinued at bedtime on the first day of treatment and none of it given thereafter. It is true the patient will be nervous for a few hours, even after his prolonged sleep has passed, but any simple sedative will overcome this to such a degree as to enable him to bear it and within a day or two the nervousness disappears to such a degree that further medication is not necessary. There is no severe suffering; neither is there danger in withdrawing cocaine abruptly from the patient after the portal system has been disengorged and the bowel emptied. There is no reason whatever for a partial cutting off of the drug or for the reduction of the dose before it is abruptly stopped. This immediate withdrawal is not followed by a collapse or any other of the dangerous complications incident to the withdrawal of opiates, but it should not be practised until the portal system is disengorged, the bowel thoroughly cleared, and the heart relieved of the burden against which it would be called upon to work were these organs left in the contaminated, engorged state.

If the patient is taking cocaine and morphine together, then the treatment for the morphine disease may go hand in hand with the treatment for the cocaine habit. The author finds it much better to withdraw both drugs at once, so far as the physical condition of the patient is concerned, than otherwise, but that does not hold good when the prognosis is considered.

Patients after they are taken off of cocaine usually sleep even more than a normal person, and this, to a large extent, compensates for the absence of sleep due to the withdrawal of morphine. In many cases in which the author has withdrawn morphine and cocaine at the same time, the patient has slept more than a normal person would have slept during the first two or three weeks after such withdrawal. This is a very delightful experience to them.

PROGNOSIS

The prognosis in the cocaine habit is usually unfavorable. Very few indeed of those who have formed the cocaine habit will give it up and remain free from it. That is, very few of them will remain free if both the morphine and cocaine are taken away at once. The author for a number of years has pursued a different plan and one which is giving good results.

So far as the physical condition is concerned, there is no reason why the cocaine should be taken away before the opiate, but when the prognosis is considered there is a reason why the cocaine should be first discontinued. The use of cocaine is usually begun as a dissipation. The effect of the cocaine has most likely increased the tendency to dissipate rather than otherwise, but in some cases, in fact in many cases, the individual still retains sufficient reason to realize the damaging effects of the use of these drugs combined. When that is true and the patient can be led to abandon the cocaine and live as much as twelve months, taking morphine alone, the probability of his remaining free from both drugs is very much better than if both drugs are withdrawn at once.

The author now insists that a man who is using cocaine and morphine is not in condition for treatment with the expectation of his cure being at all permanent, unless he is taken off of cocaine and then required to continue the use of morphine, under the observation of some competent medical man, for a period of twelve months. If the individual has enough self-control left, and has determination sufficient to discipline himself into doing without the cocaine, this will fit him for treatment.

After a year of this kind of drilling and probation, he can be taken off the morphine and the results will almost certainly be a permanent cure; but if he be taken off the cocaine and morphine at once, the mental impressions left by the cocaine will so haunt him that the chances are very much in favor of his returning to either or both of the drugs in a very short time.

The author prefers not to take cases of cocaine habit, unless they place themselves under his care for a period of twelve months and are willing to pursue the course above outlined. Cocaine has an intensely fascinating effect, one that is extremely seductive to those who have been habituated to its use. It overcomes all sense of discomfort, of un- happiness, and brings about a state of satisfaction with the conditions that exist that is most delightful to many persons.

When a person has been addicted to morphine or other narcotic drug and has gotten to the “down and out” stage, the effects of cocaine appeal to him very strongly. It brings him surcease from all of his sorrows, and the fascination created on his mind is such as to dominate him, and it is a rare thing that he can be led to give it up. But if he still retains that degree of self-control that will enable him to give up the cocaine and continue the use of morphine in uniform and moderate quantities for as much as twelve months, he still retains sufficient self-control and moral purpose to make a good and successful fight against the morphine disease.

Persons who will faithfully carry out this disciplinary course are developed into a condition favorable for treatment. Cocaine was once lauded as a cure for the “morphine habit” and many began its use with this idea, only to find themselves enslaved by two drugs.

The use of cocaine as a nasal spray is another source from which its abuse has sprung in a few cases. The author has had several cases of this type who use the drug in no other way, but were continually spraying their nose and mucous surfaces with cocaine. These, evidently, obtained but little systemic effect from the cocaine, but if the author’s information is correct all but one of them resumed the use of the spray after treatment.

Keibler, in the U. S. Dept. of Agriculture, is quoted as saying: “Cocaine is fast taking the place of morphine.” The author cannot understand such a statement coming from one having knowledge of the effects of the two drugs. These effects are not at all similar and cannot be made to take the place one of the other; in fact, their effects are so different that cocaine is recognized as one of the antidotes in morphine poison. About 10 percent of morphinists use cocaine with their morphine.