Health risks and potential dangers of coca

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Health risks and potential dangers of coca

It is very important to understand why and how, for the reasons explained above, coca is differs from cocaine HCl.
If coca does include the cocaine alkaloid , the mode of use, alkaloid makeup and concentration levels makes the reality of coca use utterly distinct from that of cocaine HCl.
This fact was not well known, or at least rarely stated until the 1990’s, as it would probably have seemed detrimental to the radical actions undertaken in the name of U.S.A. backed “war on drugs”, which was also a “war on cocaine ( HCl)” and which turned out to be a “war on the coca plant” itself, with sometimes disastrous social and ecological consequences, such as
crop/water/food/human poisoning case linked to the spraying and fumigation of coca fields by helicopter for eradication…
Not to mention the role this particular agenda has played in creating and trying to manoeuvre political and military actors, closely related to the problematic situations of the coca producing countries in the early 21st century.
It is important to keep in mind that coca use has been stigmatised in many ways :
first by conquistadores and the Catholic Church, for being a ritualised practiced linked to the old social structure and religion, then by the new colonial and post-colonial authorities for being a symbol of native identity, a backwards relic symbolising lack of civilisation, then by the new middle-classes for being a symbol of low, working Indian, class. It was then further demonized as the international drug laws were established in the 20th century, were coca was assimilated or confused with cocaine.
Up to the 1980’s, it was difficult to find studies of coca which were no influenced by a palpable desire to condemn coca use for political reasons, be they domestic and linked to post-colonial issues of authority and class tension, or exterior, linked to pressure groups supporting prohibitionist drug policies. Since the 1980’s and 1990’s, coca is finally starting to be accepted and studied in a less biased way. In the light of this particular context, we can really ask the question : what are the real dangers of coca use ?

Hydrolysis of naturally occuring cocaine of the coca leaf : when coca leaf is chewed, cocaine alkaloids rapidly go through the process of hydrolysis, due to the alkaline nature of human saliva, which turns most of the cocaine into ecgonine.
Ecgonine is said to be 80 times weaker than cocaine, and does not have the euphoric effect of cocaine. It is a stimulant which helps regulate of the glycemia (concentration of glucose in the blood), which is why chewing coca is so recommended for altitude sickness issues.
Ecgonine, according to studies published in Paris in 1965, would re-establish a balanced glycemia, act on the glucose deposits stored in the liver, burning them and generate elemental glucose, which is then converted into a source of energy for muscular and cerebral work.

Can coca use be lethal ?

An important question, and yet the lethal dosage of coca leaves is still to be determined.
By using the cocaine (HCl) LD50, it is clear that according to the commonly reported cocaine alkaloid concentrations present in coca leaves, one would have to ingest a tremendous quantity of coca leaves to raise this alkaloid concentration to potentially lethal levels.
LD50 of cocaine HCl, based on mice, is said to be 95.1 mg/kg, ie 5706mg for a 60kg human, with the incertainty such a linear sca ling implies. With an average amount of 5.11 mg, and 4.86 mg cocaine ( and cocaine related alkaloids…) per 1 gm of dried coca leaves ( based on a 1996 survey), this would roughly imply a dose of 1116.6 gm of leaves with a 5.11gm cocaine concentration, hence very quickly ingesting over a kilo of leaves.

And this is practice which doesn’t correspond to the actual way coca leaves are used, via “chewing”, activity physically limited by the size of the user’s mouth, which could hardly accommodate more than 15 grams of leaves…
According to some sources, a LD50 of a coca extract is 3450 mg/kg, which seems lower than that of cocaine HCl.
However, this refers to an coca extract, and it is difficult to estimate what quantity of coca leaves this would correspond to,. The LD50 of the coca extract was apparently based on a cocaine content of 31.4 mg/kg… Found LD50 of cocaine seems to vary from study to study, to which one must add the conversion issues of moving from mice to human.
In any case, reaching such a cocaine concentration implies a large amount of coca leaves, amount quite difficult to absorb and digest if the coca leaves were to be consumed, and not extracted. Extracted coca is even harder to assess as one would need to measure an average cocnetration for the extractum.
Yet the measurement quoted above does have its value, as it might be indicating that the coca leaf contains active constituents, other than cocaine, that may contribute to a toxic effect of high doses of the coca plant. Little is known on this subject, as there are no reported death linked to coca or coca extracts.
Factually based evidence seems to point out that the specific alkaloid makeup of coca, along with the mode of use of the coca plant, actually contribute to the moderation of the potentially detrimental effects of the cocaine alkaloid itself, as regular users do not develop the physical or psychological issues linked to “cocainism”…
The fact that there are no known cases documenting coca leaf overdoses, or deaths, while coca use has a history going back over 4 millennia, and documented (by Westerners) since the 16th century, seems to prove that coca, unlike cocaine, does not have any direct lethal potential.

Yet what of the consequences associated with long time use ?
Coca is a stimulant, and as such does have an action on the cardiovascular system. This aspect of coca has not really been studied in detail, in order to determine what are the eventual cardiovascular consequences of chronic coca use ( which does include low cocaine concentration), if users face heart issues, and die more frequently of cardiac failure ? It seems that if this was the case, however, it would be a well known fact that would have been exploited in anti-coca propaganda, yet it was not.
Coca induced tachycardia is very mild, so the risk of arrhythmia or cardiac problems seems very limited. On the contrary, coca seems to have a rather beneficial effect on the cardiovascular system, on blood pressure and in dealing with oxygen and caloric expenditure, which make coca so useful in dealing with altitude sickness. A detailed study of old regular coca users would be useful, but until then, one would have to take note that not many long term coca users are reported to be experiencing specific cardiovascular problems.
As for the potentially harmful effects of alkaloids in coca, such as atropine and nicotine and coniine, they have not been assessed. However, the concentrations seem very low, and probably comparable to the nicotine found in other common plants of the solanaceae family which includes tomato, potato eggplant and green peppers, all of which include small concentrations of nicotine. Most analytical studies seemed to have focused on cocaine and cocaine-related alkaloids, rather than the full spectrum of the plant, which makes it more difficult to have a clear assessement of the plant composition per species.
Finally, one would also have to take into account the way alkaloids are processed and metabolised. If long-term coca chewers do seem to show signs of atropine, nicotine or other toxic alkaloid poisoning, this is probably linked to coca’s main traditional modes of use ( chewing and brewing). Which might imply that the relative innocuity of coca would have to be revised when dealing with extracts of coca leaves.

Is coca addictive ?

No. There is no physical addiction to coca ( a point in common with cocaine HCl). As for mental addiction, most sources point out that regular users get by with no coca without any difficulties, if they are hospitalised, or face financial difficulties for instance. Coca use can be stopped at once, with no cravings. In fact, it is reported that most users only chew coca in periods of activity, and do not use or want to use coca when not working. Coca does suppress hunger, but when offered a choice between a meal and chewing coca, users will choose the meal.
This is very different from the strong mental cravings, which can lead to obsession and self destructive behaviour, associated with cocaine HCl use, and is due to coca’s effects, gradual, and non euphoric effects, with no dopamine peak…
Perhaps one might associate coca and coffee, in that people would develop some form of coffee dependency / cravings could probably develop cravings for coca. However, in the traditional context, coca is not used as a “wake up call” or a way to start the day, and its consumption is mostly linked to periods of activity / physical labour, or ceremonial occasions.
Coca is not usually chewed when not active, or on “days off”, which could imply that coca use / dependency is actually distinct from that of coffee, as habitual coffee drinkers usually continue drinking coffee regardless of a day’s schedule…In this light, it is difficult to speak of coca related addictive cravings.

Not only is coca not addictive, but does not lead to the psychological problems of extreme cocainism, such as paranoia, delusion etc…Coca use does not seem to disturb sleep, at least once the effects have worn off, from 30 minutes to one hour after coca chewing has stopped.
It is also important to note that coca use ( i.e. not related to cocaine manufacture) is not associated with criminality. It is an ancient, socially integrated tradition ( if frown upon by higher classes as an Indian/low class custom). Coca leaves are bought from the grower, or from coca sellers on the town market, or from some shops and supermarkets, not from a criminal underground.
Coca is a natural product, not cut, adulterated or with additives, and usually cultivated using without artificial fertilizers or pesticides. There was the issue of the U.S.A. backed coca spraying, which could poison coca plants but also, other crops, water, and… users, but this practice seems to be on the decline.
Coca does not seem to cause gastric problems either, though it does stimulate bowel movement to some extent, not unlike coffee. Coca does not cause hyperactivity, and coca is actually a cleaner, and probably safer, stimulant than common coffee, at least with less of coffee’s reported physical side-effect.

Frankly speaking, the only attested potential dangers of intensive coca use are the following :
halitosis, i.e. bad breath, coca-breath, a specific stench linked to chronic coca chewing. Nothing much can be done apart from mouthwashes and a more thorough buccal hygiene, regular teeth washing…
And the question of possible mucosa damage, mostly linked to the basifying agents used in order to make the saliva more alkaline.
It is hard to get real information on this issue. Whereas coca leaves do contain the cocaine alkaloid, there are no known cases of perforated mouth mucosa, as in cocaine HCl insufflation septum related issues. Indeed, when cocaine HCl is regularly insufflated ( snorted), the vasoconstrive (which lead to decreased nutrients to the underlying cartilage) and abrasive /irritant ( notably from the adulterants / cuts present in the illicit substance) qualities of cocaine can dig a hole into the nose’s cartilage structure which separates each nostril from the other ( the septum), a permanent damage which requires reconstructive surgery.
Even though coca leaves contains a small concentration of cocaine, the mouth mucosa does not deteriorate as such. This is most likely due to the low cocaine concentrations and to the fact that the alkaloids freebases from the leaves and is absorbed into the mouth lining, whereas cocaine HCl itself is the hydrochloride salt, which has different qualities.
However, is alkaline saliva good for the mouth, teeth and gums ?
Reports vary, but this is also hard to estimate as coca users come from a culture where mouth hygiene is treated differently, and many do not use toothpaste for instance. Does coca cause decay and gum problems ? Or is this due to the alkaline agent, such as the vegetal ashes ? It is hard to tell. Sodium bicarbonate, on the other hand, is said to be relatively safe and not carcinogenic, and is probably safer to use than traditional ash-based alkalis.

In conclusion, if coca leaf is, to this day, the primary source from which cocaine is isolated and extracted, (though the alkaloid can be synthesized without coca leaves) confusing coca and cocaine is a questionable decision, which chooses to ignore the reality of coca use, and cultural tradition.
Indeed, apart from the specific problems linked to cocaine production, smuggling and dealing and use, the coca plant itself and the traditional uses such as brewing coca tea or chewing coca leaf cause no social or medical problem, and are actually recognized as rather beneficial to the populations of users…
Coca has been used for thousands of years and documented for over four centuries. It is clear that coca use is safe, non lethal and non addictive. Although more information would be needed on long-term cardiovascular issues, and possible mouth damage (liked to the coca leaves themselves of there mode of use), coca use is innocuous, and actually rather beneficial to humans, as it has a regulating metabolic effect and acts as a nutritional supplement.

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