Chew it, Don’t Snort It: A Comparison and Commentary Between Coca Plant Use and Cocaine Use

Image Citation: [1]

Written by Raquel Mattos-Canedo ’26

Edited by Joanna Sohn ’28

Classified as a Schedule II drug (2) and banned from the US, coca leaves are a highly contentious–yet surprisingly unknown–plant. Grown in Bolivia, Peru, and other Andean regions (3), the oval-shaped leaves of this plant are the first ingredient in the synthesis of a considerably more recognizable Schedule II drug: cocaine. So why the contention? The debate sparks with the question of how similar coca is to cocaine and whether they are truly as harmful as their classification implies.

While coca may be viewed as unfamiliar and dangerous to many Americans, to Bolivians as well as other South Americans, coca is a part of daily life and integral to the economy. The leaves are dried and sold in plastic bags to be found at corner stores or bodegas. Individuals typically ball up the leaves and place them inside their cheek to chew. As saliva mixes with the leaves, it is swallowed to absorb the effects of the coca, while the leaves themselves are not ingested and are eventually spit out.

Chewing coca leaves is the most direct method of obtaining the effects of the coca plant, but in Andean regions, coca products like teas, candies, and juices are also popular. Coca provides a mild stimulating effect, similar to that of caffeine (4). Users of coca report a temporary numbing effect around the area where the leaves are being chewed, which is consistent with its historical use as an anesthetic in indigenous communities (5). It is believed that this particular effect is due to the presence of alkaloids in the plant, one of which does include the cocaine alkaloids, although it is found in concentrations of .24% and among 14 other major alkaloids in the plant (4). But what exactly are the effects of chewing coca? While there is limited scientific literature available on the exact physiological mechanisms of its effects, one thing is clear: it does not produce the euphoric effects and high that its much more concentrated offspring, cocaine, is associated with. Perhaps among its most popular uses, coca leaves and other products can be beneficial to the treatment of nausea and stomach discomfort (6), which is especially important in the high-altitude regions of Bolivia, where altitudes of 12,000 feet can cause “mountain sickness,” a side effect of the drop in oxygen levels available. Other reported uses of coca include acting as an anticoagulant, blood glucose reducer, cavity preventative, scar healing agent, and remedy for headaches (6). However, while all these uses have been studied and confirmed to produce statistically significant results, very little research has been conducted on the specific physiological mechanisms of the alkaloids in coca, and how they affect the body at a cell and molecular level.

In addition to the studies done on the effects of coca use, Studies have shown that long-term coca use is not strongly correlated with harmful health effects, and habitual users typically do not experience withdrawal symptoms when they stop consumption (7). Conversely, a plethora of research has been conducted on cocaine use and its effects on the human body and mind. Cocaine is produced using the coca plant after going through an arduous and dangerous process involving three steps. The first step is the extraction of crude coca paste from the coca leaf, then the paste must be purified into a coke base, and the final step is the conversion of the base into cocaine hydrochloride (8). This product acts as a powerful stimulant of the sympathetic nervous system, acting on catecholamine reuptake, as well as sensitivity to norepinephrine. Prolonged use of cocaine, unlike coca, has been shown to cause irreversible, damaging changes to the brain, heart, lungs, liver, and kidneys (9).

Clearly, there is a stark contrast between the short- and long-term effects of cocaine use compared to coca plant intake. While it is true that there is much more room for cell and molecular research concerning coca use, it is beyond evident that its effects are relatively mild and, as far as we know, not harmful. It begs the question as to why exactly coca is so strictly prohibited and regulated in the United States, why it is classified at the same level as substances such as cocaine, fentanyl, and methamphetamine, and what role our biases and assumptions about drug consumption in South America play in how we perceive coca use.

References

1. Gil M. Coca leaf. [Internet]. Shutterstock; [cited 2025 Apr 22]. Available from: https://www.shutterstock.com/image-photo/coca-leaf-123456789

2. United States Drug Enforcement Administration. Controlled Substances - Alphabetical Order - [Internet]. United States Drug Enforcement Administration; p. 21. Available from: https://www.deadiversion.usdoj.gov/schedules/orangebook/c_cs_alpha.pdf

3. Mallette JR, Casale JF, Jordan J, Morello DR, Beyer PM. Geographically Sourcing Cocaine’s Origin – Delineation of the Nineteen Major Coca Growing Regions in South America. Sci Rep. 2016 Mar 23;6(1):23520.

4. Plowman T. The role of coca in the history, religion, and medicine of South American Indians. Economic Botany. 1984;38(4):512–32. Available from: https://www.jstor.org/stable/4253177

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7. Duke JA, Aulik D, Plowman T. Nutritional value of coca. Botanical Museum Leaflets, Harvard University. 1975;24(6):113–119. Available from: https://www.jstor.org/stable/41762296​

8. Rhodium. Illicit production of cocaine. Erowid. [Accessed 2025 Apr 15]. Available from:https://www.erowid.org/archive/rhodium/chemistry/cocaine.illicit.production.html

9. Riezzo I, Fiore C, De Carlo D, Pascale N, Neri M, Turillazzi E, Fineschi V. Side effects of cocaine abuse: multiorgan toxicity and pathological consequences. ​Curr Med Chem.  2012;19(33):5624–46. Available from:     https://www.ingentaconnect.com/content/ben/cmc/2012/00000019/00000033/art00007