Sigmund Freud: Riding the Rise and Fall of Cocaine

Sigmund Freud’s relationship with cocaine began during a period of professional stagnation. Practicing in Vienna General Hospital’s psychiatric ward, Freud continued to read across various medical fields in search of a research topic with which he could make a name for himself (Markel, 2011). Freud encountered a small but growing American literature on cocaine and began experimenting on himself with the substance in 1883. Entranced with its euphoric effect, Freud measured his physical strength and reaction times quantitatively, but devoted much of his research to analyzing his thoughts and feelings while under the influence. Several scholars theorize that cocaine usage inspired his career as the father of psychoanalysis, given his intense introspective approach and some of his own dreams later submitted to analysis occurring during periods of cocaine use (Jay, 2023; Freud, 1976). Freud involved his colleagues in some experiments, giving them a solution of dissolved cocaine for them to drink and then interviewing them. One test subject, an opthalmologist named Dr. Karl Koller, noticed the solution numbed his mouth and throat and through his own experimentation discovered cocaine's ability to revolutionize eye surgery as an effective local anesthetic during procedures. Koller won widespread praise for his discovery, gaining more fame and prestige than Freud had with any of his publications to date. Freud was so embittered that he had not made the breakthrough when he saw himself as cocaine's pioneer that he dismissively referred to his colleague as "Coca Koller" and even blamed his own wife, who lived in Germany, for distracting him from his research (Jay, 2023).

1884 proved a watershed year for Freud’s cocaine research. Bereaved by his friend and mentor Ernst von Fleischl-Marxow’s debilitating morphine addiction, Freud offered to treat him by administering cocaine, which had been reported as effective in this regard. The promising initial reports, which returned Fleischl-Marxow to good spirits while drastically reducing his drug dependency, gave Freud the confidence to publish his first piece on cocaine, Über Coca (1884). The situation soon deteriorated, however. Fleischl-Marxow developed a tolerance for his low dose regimen and steadily increased intake of both morphine and cocaine to dangerous levels. Freud, aware of his own role in this outcome but helpless to stop it, could only watch as his friend died from a host of medical conditions related to his drug intake. This became Freud’s introduction to the defining issue of cocaine’s future: its addictive qualities.