Coca loca

There doesn’t seem to be a plant surrounded with so many persistent misconceptions as Erythroxylum spp, better known as ‘coca’. This plant has been an essential part of the cultures around the Andes in South America for thousands of years. Coca is used in social interactions, as medicine, nutrition, in magic-religious rituals and much more. The leaf represents an identity for the people who use it and this cannot be easily eradicated. The problem? Coca contains cocaine.

Maaike van Kregten
For original Dutch text see:

When conducting literature research into the medicinal effect of coca, I encountered various problems. For example, there is bias among researchers. There are researchers who only seem to see that it contains cocaine, without taking into account the amount, nor other ingredients, nor the dosage and frequency with which the leaf is used. Thanks to research, we know that coca leaf contains very little cocaine.

The blood level of someone who uses (isolated) cocaine is almost fifty times higher than with the traditional use of the leaf. It has also been demonstrated that although coca can suppress hunger, it does not inhibit appetite. Coca is also not addictive.1 Prejudice has ensured that coca has entered the ‘list of forbidden plants’. The United Nations commissioned in 1949 a study which became known as the ECOSOC study. One of the conclusions was that the use of coca leads to malnutrition, because the leaf temporarily halts the feeling of hunger. Factors such as poverty were not taken into account. It was overlooked that it might also be possible the other way around, namely that poverty leads to malnutrition, which may lead to (more) use of coca. In addition, according to the same research, the use of coca would lead to “racial degradation of the Indians” … 2

In some cases, there is even sabotage: in 1995 the World Health Organization wanted to publish a global study that it had conducted in collaboration with the United Nations Interregional Crime and Justice Research Institute. It is considered to be the most comprehensive study of coca and its derivatives. The US has stopped its publication, with the threat of withdrawing the grant. One of the leaked conclusions from the study was that traditional use is not harmful to health and that it should be investigated how other countries can also gain access to the positive therapeutic effects of the coca leaf,3 for example against altitude sickness.

In addition to bias, there are other problems. For example, most research has been done on the cocaine content of the leaf. Moreover, the majority of research into medical applications has been done with isolated cocaine. This creates a distorted picture of the effect of coca leaf. However, the effects of coca are most likely a combination of multiple ingredients, many of which are not yet clear.4

What also strikes me is that little use has been made of the abundant empirical information. For example, coca is widely used for complaints of the digestive system and it would even have a regulatory effect on it. However, I cannot find any research into the gastrointestinal effects of coca.

Perhaps the biggest problem is that almost no author makes a distinction between the different types of Erythroxylum, which differ considerably in terms of composition of ingredients.5 It’s all ‘coca’. This makes the little interesting research that is available, virtually useless. As phytotherapists know, empirical knowledge is indispensable. Moreover, the effect of a plant depends, among other things, on the interaction of ingredients, the method of preparation and the dosage. In Bolivia they say: “La coca no es cocaína: es alimento y medicina“. (Coca is not cocaine: it is food and medicine).

1. Biondich AS and Joslin JD. Review Article Coca: The History and Medical Significance of an Ancient Andean Tradition. Emergency Medicine International. 2016; Torchetti, T. Coca Chewing and High Altitude Adaptation. Totem. 1994 1: 95-98; Hurtado Gumucio, J. Cocaine the Legend. About Coca Leaves and Cocaine. La Paz: Hisbol, 1995.
2. Burchard RE. Coca Chewing and Diet. Current Anthropology. 1992 3;(1): 1-24; Forsberg, A. The Wonders of the Coca Leaf. 2011; Hurtado Gumucio 1995; Torchetti 1994.
3. Forsberg 2011.
4. Biondich and Joslin 2016.
5. Plowman, T. The Ethnobotany of Coca (Erythroxylum spp.). Advances in Economic Botany. 1984 1:62-111.