Pharmacology is not Destiny: The Contingent Character of Cocaine Abuse and Addiction

Abstract

Three studies of cocaine users in situ are summarized: a small ethnographic study of a naturally-occurring friendship network, a follow-up on these respondents a decade later, and a survey of a large sample of heavy users. Findings depart from those found in captive samples in treatment or the criminal justice system. While numerous cocaine-related problems were identified, long-term, non-problematic, controlled use was also common. These findings suggest that increased use, abuse, and addiction are not inevitable consequences of cocaine's pharmacological action on human physiology. Rather, both loss of control and controlled use are contingent upon the social circumstances of users and the conditions under which cocaine is ingested.