This article originally appeared on VICE UK.

As VICE revealed in March, cocaine hospitalizations in the UK have shot up by 90 percent since 2014. Why? Because coke is currently purer than it's been in decades and, throughout the country, is just as easy to order as pizza because the war on drugs is lost and British drug policy is trash.

Campaigners argue that the first step toward minimizing the harms caused by cocaine—both to humans and Earth—is decriminalization and regulation. Critics contend that this wouldn't work for a number of reasons, one of which being: How would you even start to go about building the infrastructure needed to produce and transport legal cocaine around the world?


The answer: It already exists, and the UK is its main beneficiary. The UK imported more cocaine for medical use in 2016 than any other country in the world.

"In Victorian times, cocaine used to be available in the UK, via a range of patent medicines, as a topical anesthesia and as an energy elixir—a sort of Victorian Red Bull," explains Steve Rolles, senior policy analyst at the drug think-tank, Transform. "While the energy [elixirs] fell by the wayside with tighter controls on patent medicines and fears about addiction, cocaine has continued to be used as a local anesthetic in some limited circumstances—mostly minor ENT surgery."

According to a report by the INCB (International Narcotics Control Board), in 2016, the UK imported 330kg of licit cocaine, accounting for 82.6 percent of all global imports. The UK was also the main exporting country, followed by the Netherlands, and the main consuming country, going through 90.5kg of legal coke—or 47.2 percent of all global stocks—in 2016.

These percentages are not small; so why is it that the UK is so keen on licit cocaine compared to every other country in the world?

"Other anesthetics have largely replaced cocaine, but it's still there in the locked controlled-drug cabinet of most UK hospitals, along with all the other 'high abuse potential' drugs—heroin, ketamine, fentanyl, amphetamines, and so on," adds Steve. "The fact that the UK uses so much more than anywhere else I can only assume is a historical artifact of our long history of medical use."


So the NHS is three pints (of human blood) down and needs to call in some medical-grade coke (for an extremely complex throat surgery). Who do they turn to?

"The UK has never grown coca leaf, which contains the cocaine alkaloid, so all coca and cocaine products have only ever been imported, almost exclusively from the Andean region," explains Steve. "A set of international treaties oversee the production and transit between countries of such drugs—the key aim being to avoid them being diverted for nonmedical use. UK cocaine starts its journey in Peru, the only country currently legally growing and exporting coca leaf for medical uses. This is shipped to the USA, by the DEA, where the cocaine is extracted—and then exported to the UK and elsewhere."

Wow, it's almost as if there's already an established global network that could easily facilitate the regulation of pretty much any drug, with no detrimental effects to anyone except the people who currently make money from it illegally.

Steve continues: "It's striking that this legal cocaine market is associated with none of the chaos, violence, and criminality of the parallel illegal market for nonmedical use. It's instructive when people ask how a legal cocaine market might work: We can just point to the existing legal market and say, 'well, like that—just a bit bigger.'"

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