Cocaine, Amphetamine, and Related Stimulants – Historical Overview

Mimic activation of the sympathetic branch of the autonomic nervous system
- ↑ heart rate, blood pressure, respiratory rate
- ↑ sweating
- Blood flow: ↓ to internal organs & extremities, ↑ to large muscle groups
- ↑ body temperature
- Pupil dilation
Collectively termed “psychostimulant” because of their arousing, activating profile

Euphoria & giddiness
Heightened self-consciousness & confidence → sometimes forceful boastfulness
Anxiety, racing thoughts
Question: genuine enhancement of cognitive performance or only subjective? (empirical debate)

$1857$ – Cocaine isolated from coca leaves by Albert Nieman
$19^{th}$ -century technology allowed extraction of concentrated cocaine from Erythroxylon coca
Indigenous South American use: chewing coca leaves for centuries → ↓ fatigue, thirst, hunger; lime added to free base & mask bitterness
Spanish colonizers introduced coca to Europe

Vin Mariani: wine fortified with cocaine, became fashionable across Europe & U.S.
John Pemberton’s “French Wine of Cola” (wine + coca + kola nut with $2\%$ caffeine)
- Atlanta alcohol ban → reformulation minus wine + soda water = birth of Coca-Cola
- Marketed as a health tonic; sold in drugstores, prescribed by physicians, available OTC in patent medicines

$1885$ – Sigmund Freud publishes “Über Coca”
- Recommends cocaine for depression, chronic fatigue, & treatment of morphine addiction
$1887$ – Freud retracts enthusiasm, labels cocaine “the third scourge of humanity” (after alcohol & heroin)

Cocaine infused in countless remedies/toothache drops; advertising promised instantaneous cures
Dependency & overdose reports began to accumulate
$1910$ – U.S. President Taft: cocaine declared “Public Enemy Number One”
$1914$ – Harrison Narcotics Act bans cocaine in medicines & beverages
- Result: decline in use through $1930$ s; amphetamines emerge as cheaper substitute

$1930$ s – Pharmaceutical amphetamines marketed for asthma, nasal congestion, appetite suppression, mood, military fatigue
$1960$ s – Regulatory tightening on amphetamines → cocaine resurgence (viewed as natural, chic, non-addictive myth)
$1980$ s – Divergent user demographics:
- Crack (cheap, smokable) reaches impoverished urban communities
- Powder cocaine glamorized by Wall Street & fashion culture
$1990$ s–Present – Inexpensive methamphetamine stabilizes/reduces cocaine user base; media & research pivot to meth and prescription stimulants

ADHD prevalence → widespread use of methylphenidate & mixed amphetamine salts (Adderall)
Campus slang: “ $30\,\text{mg}$ Adderall tablets = study candy”
Popular press frames them as “smart drugs” or “cognitive enhancers”

Is history repeating? From coca tonics → Vin Mariani/Coca-Cola → amphetamines → modern ADHD drugs
Key ethical concerns:
- Fairness: academic & professional competition advantages
- Coercion: implicit pressure to use to keep up
- Safety: long-term neurodevelopmental effects, dependency risk
- Regulation: medicalization vs. enhancement distinction
Guiding question posed: “What SHOULD be done about the use of psychostimulants for cognitive enhancement?”

Sympathomimetic profile links all agents, whether natural (cocaine, ephedrine) or synthetic (amphetamine, modafinil)
Historical cycles illustrate repeated pattern: initial medical enthusiasm → commercial exploitation → social harms → regulatory backlash
Stimulant appeal tied to modern productivity culture—fatigue reduction, mood lift, cognitive sharpening perceived as tools for economic and social gain
Real-world relevance: current debates on workplace drug testing, prescription monitoring, and societal expectations of perpetual alertness

$30\,\text{mg}$ – Typical immediate-release Adderall tablet size highlighted in imagery
$2\%$ – Natural caffeine content of kola nut used in early Coca-Cola formulation
Years of landmark events explicitly referenced: $1857,\ 1885,\ 1887,\ 1910,\ 1914,\ 1930\text{s},\ 1960\text{s},\ 1980\text{s}$

Psychostimulants share potent sympathetic and mood-elevating effects that drive both medical utility and abuse liability.
Cocaine’s trajectory—from indigenous leaf to purified alkaloid to “public enemy”—foreshadows patterns later seen with amphetamines and today’s prescription stimulants.
Ethical discourse now centers less on outright prohibition and more on responsible, equitable management of enhancement technologies.