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Cocaine use by chewing coca leaves as a mood altering activity has been an ancient and relatively safe practice in South America. Its safety was assured by the very low cocaine concentration of 0.5% to 1% in the coca leaves. Thus, very large quantities of leaves needed to be consumed to approach high grade dependence or serious toxicity. Also, oral administration of cocaine is the least efficient means of delivering significant concentrations of cocaine rapidly to the brain.
Technological advances in the isolation of cocaine from coca leaves to produce cocaine HCl, cocaine freebase or "crack"; and technological advances in drug delivery paraphernalia (eg, needles, syringes, freebase pipes) turned a relatively innocuous practice of coca leaf chewing by the population of Colombia and Peru into a deadly destructive practice of crack and freebase cocaine dependence in the United States.
In this article, we will compare the various modes of cocaine use and their relative dependence producing potential and toxicity. The effects of the dose and route of administration will be investigated in relation to bioavailability, tolerance development, and serious toxicity. The principal questions are: If cocaine is the drug that makes crack a dangerously addictive substance, why is coca chewing a relatively safe practice? What is the difference? Is it the purity of cocaine, the size of the dose, the route of administration, or the bioavailabiliiy? These questions will be analyzed and the impact of crack and the practice of cocaine smoking on compulsive cocaine addiction will be examined.
COCA LEAF CHEWING
Two distinct methods of cocaine chewing have been practiced by the Indians of South America for centuries. The first involves toasting the coca leaves and chewing them along with an alkaline material. The pliable material called "wad" or "quid" is alternately held in the cheek and chewed, occasionally for hours. The second popular practice involves mixing the powder made out of the toasted coca leaves with the ashes of other burned leaves, which make the mixture alkaline.1 It is interesting that the Indians discovered by trial and error that better buccal absorption could be achieved under alkaline conditions, which produce the freebase form of cocaine. They also discovered that swallowing the coca leaves decreases the desired behavioral effects because much of the cocaine...