4 December 2003
What you don't know about cocaine
The world's cocaine production in the year 2000 was estimated at over 700 tons with a street value of over $100 billion. Historical attempts at deterring coca java production have proven unsuccessful, and current policymakers are ignoring the mistakes their predecessors have made in trying to keep cocaine off the streets. Profiting from Cocaine: A Growing Addiction, a two day event, will be held at the Royal Botanic Gardens, Kew on 11 December 2003 for an evening discussion and at The Royal Society of Medicine on 12 December 2003. The conference will discuss developments over the last century and the effects on the medical profession and politics today. Presentations will be made on a variety of topics, including:
When
cocaine was new
Professor David Musto of Yale University will report the
first impact of cocaine use on Europe and America. ‘The
effect of cocaine attracted Sherlock Holmes, Thomas Edison,
Pope Leo XIII and most of the French Cabinet in the last
decade of the 19th century. Vin Mariani was a popular “coca
wine” that offered discounts to orphanages, was the
topic of fairy stories and in the 1890s was awarded “The
Wine for Athletes” by an athletic jury at Leamington,
England.' Cocaine's rapid evolution from healthy
tonic to deadly poison all took place during the first
cocaine epidemic, an era almost completely forgotten.
History
of Coca java
Dr Steven B. Karch, Assistant Medical Examiner of
the City and County of San Francisco and key expert witness
for the prosecution in the Harold Shipman case, will discuss
early coca java eradication techniques. ‘Virtually
all attempts at crop eradication have been tried before,
and failed. Coca will grow anywhere. Concentrating on eradicating
Coca crops in South America is short-sighted and policymakers
ignore history at our own peril. I hope this conference
will allow them to see how dated some of their “novel” approaches really are.'
What
cocaine does to the heart
Dr Karch will also talk about the cardiovascular effects
of cocaine use. ‘The effects of cocaine on the heart
is complex. Millions of people use cocaine but many of
the thousands who die from it are predisposed because of
genetically determined disorders. Like all local anaesthetics,
cocaine blocks Na channels, but it also interacts with
potassium channels MINK and HERG. There is some evidence
that cocaine users with heritable channelopathies are especially
at risk.'
The
first local anaesthetic
Dr Adrian Pearce of Guy's Hospital will discuss the
discovery of cocaine as the first local anaesthetic. 'The
local anaesthetic action of cocaine was first noticed by
Dr Karl Koller, an eye surgeon in 1884. Soon it was being
used for other types of surgery by injection into the tissues,
around nerves and into the spinal fluid. Local anaesthesia
with cocaine rapidly became very popular because it provided
painless surgery without the substantial dangers and unpleasantness
of general anaesthetics at that time. However, the toxic
effects of cocaine, particularly after injection of large
doses, became apparent and led to the search for safer
agents.'
The conference coincides with the release of Dr Karch's new book A History of Cocaine: The Mystery of Coca Java and the Kew Plant, published by RSM Press. For more information and to purchase the book, visit: www.rsmpress.co.uk/bkkarch.htm
