Surprising as it sounds, Coca Cola gets its name from one of its original ingredients - cocaine. And although the drug's now illegal, this wasn't always the case. But how did it become popular, what led to its downfall, and how does Coca Cola come in to it?

Natural ingredient

Cocaine is produced naturally in the leaves of the coca plant, a shrub indigenous to the foothills of the Andes in Peru and Bolivia. The coca plant was very important to the South American Incas amongst whom its use was mostly reserved, at least initially, for royalty and in various ceremonies. But, as the power of the ruling classes diminished, coca use eventually spread throughout Inca society.

This was certainly the case when the Spanish conquistadores arrived in the 16th century and found that they could make the native people work harder and for longer hours in the rarefied atmosphere of the Andes if they allowed them to chew coca leaves. Typically the user made a ball-like quid from coca leaves and some alkaline material such as lime. The quid was then held in the cheek where the saliva leached the cocaine from the leaves, producing mild euphoria, suppression of hunger and increased physical stamina.

Coke is it

Sporadic attempts were made to bring the leaves to Europe over the next two centuries. But more often than not they didn't survive the journey and it was not until 1863 that Corsican chemist Angelo Mariani, having heard about coca leaves, devised what he called Vin Mariani by mixing coca leaves into Bordeaux wine. The alcohol in the wine helped to extract the cocaine and this fortified wine became immensely popular in Europe in the late 19th century. Queen Victoria tried it and it was even endorsed by the Pope who appeared on advertisements for the brew and gave it a papal medal!

In the US a pharmacist in Atlanta, John Pemberton, produced Pemberton's French Wine Coca, which was like Vin Mariani but flavoured with kola nut extract that also contributed another stimulant, caffeine, to the cocktail. This was popular, but when prohibition set in he devised a new drink in which sugar syrup replaced the alcohol. He called the drink Coca Cola and it was sold at the soda fountain mixed with carbonated water. Later, when the problems associated with cocaine emerged, it was removed and the drink became what it is today.

On cocaine

Although coca leaves contain cocaine, users typically ingest only small amounts of the drug, and the same was true of the wine concoctions. It might have stopped there had pure cocaine not subsequently appeared on the scene. This was largely down to increasing skill amongst late 19th Century chemists who were beginning to identify and isolate the active ingredients from many natural products and folk remedies, including cocaine.

A supply of the pure agent meant doctors could begin to test the medical effects of the drug and quickly two uses emerged. Experimenting on himself, an Austrian opthalmologist called Karl Koller showed that cocaine could be used as a powerful local anaesthetic, particularly in eye surgery and dentistry. Cocaine is still employed for these purposes under certain circumstances, including as a pain-killing mouthwash for patients undergoing bone marrow transplants, although nowadays safer synthetic forms of the drug, like lignocaine, which lack the psychoactive side-effects, tend to be used instead. Cocaine also triggers blood vessels to narrow (vasoconstrict), which made the drug very useful in minor surgery because an injection to the skin not only numbed sensation but also limited blood loss.

The drug was also prescribed for the treatment of psychiatric conditions, and a key cocaine-populariser at the time was Sigmund Freud. He had heard about the Incas and their use of the agent and began to use it in his medical practice for treating nervous exhaustion. He also tried it on himself and was very enthusiastic about its the effects. In an article he wrote about the experience, entitled "On cocaine", he extols the drug's virtues including its ability to induce feelings of euphoria, alertness, energy and lack of appetite.

Following Freud's endorsement cocaine was used widely by medical practitioners to treat anxiety and depression. Unfortunately this led to some patients developing psychosis, and Freud was heavily criticised. Contrary to popular belief the drug can induce a strong psychological dependence, which drives users to strive to repeat their experience of the cocaine "high". Then, following acute use of the drug, some users experience a "cocaine crash" with depressive symptoms that are the reverse of those experienced whilst on the drug. Prolonged use can also lead to severe craving and in some cases mental illness or death. The drug is also associated with vascular problems including heart disease and stroke due to the artery-narrowing effects of the agent, and people who snort cocaine regularly often develop necrosis (destruction) of the nasal septum for the same reason.

Such were the problems associated with its use that by the early to mid 20th century there was something of a moral panic associated with cocaine and it was eventually made illegal. But despite this ban it's still widely used, especially by those who can afford it. Indeed Robin Williams is famously quoted as saying "Cocaine is God's way of saying you're making too much money". It's been estimated that in Europe as much as £7.5 billion is spent on cocaine each year, fuelling cycles of crime, social deprivation, homelessness and unemployment.

How does cocaine work?

The psychological effects of cocaine, like euphoria, occur when the drug alters certain aspects of brain chemistry. Brain function depends on electrical and chemical signals that are transmitted between nerve cells. The chemical signals consist of the release and detection of a number of brain substances termed neurotransmitters. Cocaine interferes with the actions of one of these called dopamine, which is normally responsible for feelings of reward and pleasure. When dopamine is released in the brain it has its effects by binding to chemical docking stations called receptors, which are present on other nerve cells. The actions of dopamine are terminated by its being taken back up into cells by a dopamine transporter. Cocaine binds to this transporter and blocks it, preventing the dopamine from being taken up, so its signal is more prolonged and intense and users experience feelings of pleasure and euphoria.

What can we learn from the story of cocaine?

One of the most interesting aspects of the cocaine story is that it shows how the use of a plant-derived material like coca leaves can pose few problems because the levels of the active drug contained in the preparations are relatively low. But the availability of the pure drug, cocaine, allows consumption of the higher levels that provoke dependence, psychosis, social deprivation and crime. Yet despite this chequered history coca leaves continue to be used in parts of South America where they are an important part of the culture and are used as herbal teas and as a treatment for tourists suffering from soroche, otherwise known as altitude sickness.