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SYLLABUS

Cocaine is an alkaloid derived from the leaves of the coca plant (Erythroxylon coca). It is the only naturally occurring local anesthetic in medical use today. Indigenous to the Andes Mountains, West Indies, and Java, its use was touted over the centuries as a method of reducing fatigue and promoting a sense of well-being.

Cocaine was introduced into Europe in the 1800’s. Sigmund Freud used cocaine on his patients and became addicted himself through self-experimentation. Niemann first isolated and purified cocaine in 1859. In the latter half of the 1800’s, widespread interest in cocaine developed among the medical community, and, during this period, many of the pharmacologic actions and adverse effects were elucidated.

In the 1880s, Koller introduced cocaine into the practice of ophthalmology and Hall introduced it to dentistry.

Cocaine was widely available at the outset of the 20th century, and Coca-Cola then contained approximately 4.5 mg/180 mL. With widespread use, the problems of abuse and addiction became apparent, and the Harrison Narcotics Act of 1914 essentially banned distribution of cocaine in the United States, except by prescription.

Today, cocaine continues to be used (illegally) for recreational purposes and (legally) for medical purposes. Medical use is confined primarily to operative procedures of the nose and throat and treatment for dermal lacerations in children.