Sigmund Freud's notorious “cocaine episode”, during which he wrote several glowing papers about the drug's effects and benefits while taking it regularly himself, is almost impossible to approach without the dubious benefit of hindsight. In 1884, when the episode took place, Freud was not yet a towering figure, nor cocaine a demonised drug: he was merely a young neurologist impatient to make his name, and the white crystalline powder a relatively obscure “research chemical” whose pharmaceutical properties had yet to be fully established. Within 20 years, however, Freud and cocaine would both be household names, and as a result the episode has been read in all kinds of ways unforeseeable at the time.
Broadly speaking, there are two well‐established schools of interpretation. The pro‐Freud camp, led by his champion and biographer Ernest Jones, have tended to minimise the episode as a juvenile aberration, a lapse of judgement understandable in an ambitious, talented and frustrated young scientist, but one with no bearing on his mature work. The anti‐Freudians, represented in extreme form by Elisabeth Thornton's polemic Freud and Cocaine, have used it to rubbish the entire project of psychoanalysis as drug‐addled degeneracy and delusion.
David Cohen, as his title makes clear, is more than happy to exploit hindsight to ramp up the controversial appeal of the subject; but he has two new and bold claims that differentiate his version of the story from those that precede it. First, he believes that Freud became, despite his veneer of scientific objectivity, a cocaine addict, and carried on using the drug for many years after he claimed to have abandoned it. Second, he argues that the “cocaine episode” set the template for the scientific and public perception of drugs that has led to today's “drug problem” and our failed policy responses to it.
Cohen's evidence for Freud's hidden addiction is wide‐ranging but circumstantial. He gives childhood examples of his risk‐taking character, and presents his habit of chewing on grasses during country walks as early evidence of oral fixation. He frames his cigar‐smoking as a parallel and equally unacknowledged addiction (Freud talked about it as a great pleasure, and a valued aid to productivity). He highlights the use of cocaine as a topical treatment in the eccentric theories of Freud's early associate Wilhelm Fliess, and its appearances in Freud's own dreams as recounted in his breakthrough work The Interpretation of Dreams. Cohen claims that Freud's readings overlook obvious clues that point to his subconscious awareness of his own addiction, but Cohen's dream interpretations, like Freud's own, seem anything but obvious.
Yet there is a straightforward case to be made that Freud's use of cocaine was not addictive but moderate and functional. He was correct in identifying its promise: although the pharmacy of the 1880s had a growing repertoire of sedatives, it had few effective stimulants, which is why it became such a popular “tonic” and energy booster. It also had wider applications (which Freud carefully enumerated) as a digestive, an asthma treatment and a local anaesthetic. In his personal trials, he took the drug only in oral solution, a much less‐compulsive delivery method than sniffing or injecting, and explicitly noted his lack of craving, recording “a slight revulsion” at the idea of taking a follow‐up dose. He was excited by his discovery, and particularly by its therapeutic possibilities: it was natural that he should wish to test it thoroughly on himself and offer it enthusiastically to his colleagues. His interest in it, however, remained secondary to his work: while it boosted his career he championed it, and when it became a liability he dropped it, though (as Robert Byck has previously shown) probably continuing to use it to some extent in private.
Without personal experiment he certainly could not have written his first cocaine paper in particular (Űber Coca, 1884), in many ways (as I have argued elsewhere) an exemplary monograph that combined ethnography, chemistry, physical measurement and subjective testimony in innovative ways to create a classic of drug reportage. Its glaring fault, with hindsight, is Freud's failure to identify cocaine's addictive properties; but this is because his experiments were too cautious rather than too reckless. Taking it in moderate oral doses, he experienced only its benign effects and missed its potential for addiction. When the first cases of chaotic and dependent use appeared, he was blamed for giving a clean bill of health to what was soon labelled “the third scourge of humanity”, after alcohol and opium.
This is the foundation of Cohen's second ambitious claim: that in Freud's cocaine episode can be found the seeds of the modern “drug problem”. It was, he claims, the first example of a pattern that has replicated itself ever since with the discovery of new psychoactive drugs. Cocaine was initially hailed as an elixir, and boosted irresponsibly by the pharmaceutical industry and the media. In this climate, its side‐effects and negative qualities were initially denied and suppressed before, in an inevitable backlash, it was reconceived as a dangerous substance with more potential for harm than good, and eventually prohibited. The same pattern, Cohen contends, has since been followed with every new psychoactive drug, with one of two outcomes. Either they have been co‐opted by the medical profession and their negative effects soft‐pedalled (antipsychotics, Ritalin, Prozac), or they have been demonised and criminalised (LSD, ecstasy, mephedrone).
The pattern is indeed clear, and cocaine is perhaps the first example of it (though this would have been the case without Freud's involvement); but what are the underlying dynamics that perpetuate it? Cohen links it to the disappearance of introspective psychology and the subjective understanding of drug states, but there are clearly wider cultural and political factors involved in the creation of social panics around some drugs and not others. His rather cursory survey of twentieth‐century drug research, taking in Albert Hofmann, Timothy Leary, MK‐ULTRA, psychiatric medications and Alexander Shulgin, concludes with a plea for wider licensing of currently illicit drugs, and a quirky speculation on what might have happened if Freud had taken LSD instead of cocaine.
Freud on Coke is wide‐ranging and vigorously opinionated, if rather scattershot in its focus and littered with minor inaccuracies. Cohen has plenty of axes to grind and, though neither of his two grand claims are entirely convincing, the result is a brisk and stimulating read.
