For part one of this series click here.

As I noted in the last part of this series, cocaine became a “medical miracle” at the same time as medical science was legitimating itself as a modern form of enquiry. At first cocaine was lauded, especially between 1884 and 1899, as the first real topical anaesthetic and cure-all for ailments ranging from dandruff to toothache, and as a cure for morphine and opium addiction. For instance in 1884 it was reported in the New York Times that a Dr William Oliver Moore had described the coca plant “the most tonic plant in the vegetable world” and that he “made several interesting experiments on himself, both hypodermically and externally … as instancing the favour which cocaine at once commanded he said that out of 147 operations since Oct. 10, at the eye and ear infirmary, cocaine was used in 102 cases”.

However, with the increasing use of cocaine, a number of “medical men” became addicted to the substance. Known as habitués or what we might term addicts (although these two words are ontologically distinct), they were at first treated with sympathy. For instance, Sigmund Freud had a very close friend, Ernst von Fleischl-Marxow, who had become despondent and even suicidal because of the pain of a neuromata that had formed after he had cut himself. As was the tradition, he had begun using morphine to ease the pain, slowly but inevitably becoming addicted to the substance. Seeing his friend in such a condition, a friend who he described as “a most distinguished man, for both whom nature and upbringing have done their best” he began prescribing cocaine for the condition. Freud’s thought, based on his experimentations, was that the cocaine would not only provide respite from the pain of the neuromata but may also cure von Fleischl-Marxow’s morphine addiction. True to Freud’s word, for a brief time von Fleischl-Marxow’s consumption of morphine steadied and the pain of the neuromata was relieved.

The beneficial effect that cocaine was having was not to last however. Soon von Fleischl-Marxow’s consumption of both cocaine and morphine increased, so much so that the supposed respite offered by either substance was eliminated. Indeed, “within days Fleischl was consuming larger doses of cocaine, more and more often. He took so much he started to hallucinate. Terrified, he thought that snakes were slithering over his body”. It took six years for the man to die. Freud would later recant his liberal recommendation of cocaine to his friends and families, however at the time, for instance, he wrote to his girlfriend saying “Woe to you, my princess, when I come. I will kiss you quite red and feed you until you are plump. And if you are forward, you shall see who is the stronger, a gentle little girl who doesn’t eat enough, or a big wild man who has cocaine in his body”. Clearly the pervasive link between a specific form of reproductive sexuality and the use of drugs can be traced back to the very beginning.

Because the first habitués of cocaine were upstanding members of their communities — doctors, pharmacists and dentists — there was no moral panic around the use of cocaine. That would only arise when those who were already considered deviant, problematic or prone to “experiences of the flesh” began to become addicted to the substance, the “roustabout” labourers of the docks in New Orleans for instance. This still holds true today. The way in which we describe a drug as “good” or “bad” often has a lot to do with who we perceive are the main users of the drug — the “crack whore” of the 80s, the “hippy” of the 60s, and indeed here, the gangs of the “cape flats”.

Who was perceived to be using cocaine also affected how those first habitués were treated — almost all were taken to hospitals and infirmaries and treated with medical care. The idea of the criminal cocaine user, a user who is predatory on society, who spreads the “scourge” or “disease” of drug use had not become apparent and is actually a relatively recent phenomenon. As such there is another lesson to be learnt here — how we treat drug users is not only a function of the legal status of a drug, but of who we perceive them to be. At this juncture the upstanding medical men’s addiction was simply conceived of as a lapse or professional mistake, and not one upon which criminal charges could be laid.

In the next part of this series I want to explore how and why cocaine became illegal, and some of the reasons the US led the charge against the use of drugs, or what would eventually become known as the “war on drugs”.


  • Simon is a postdoctoral research fellow at the Centre of Criminology, UCT. He has a few interests, most of which seem to revolve around drugs, gangs, and violence in South Africa. He was awarded a PhD in 2012, and since then has published on a number of topics, ranging from gay bashing to the izikhothane phenomenon. At present his research is focussed on policing in South Africa, and how it might be made more effective (especially in regulating illegal drug use). He writes in his own capacity.


Simon Howell

Simon is a postdoctoral research fellow at the Centre of Criminology, UCT. He has a few interests, most of which seem to revolve around drugs, gangs, and violence in South Africa. He was awarded a PhD...

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