Coca-paste smoking in some Latin American countries: a severe and unabated form of addiction.

Coca paste is an intermediary product in the chemical extraction of cocaine from coca leaves. Abusers smoke coca paste in a dried form, which contains from 40 to 91 per cent cocaine. Over the past 10 years, this pattern of drug abuse has attained epidemic proportions in some Latin American countries, particularly in Bolivia, Colombia and Peru. Addiction to coca paste develops in a few months and has serious health, social and economic consequences. The problem is particularly acute in Latin American countries because of the high doses of coca paste involved. The smoking of coca paste causes four distinct successive phases of mental disorder: euphoria, dysphoria, hallucinosis and paranoid psychosis. It can produce severe intoxication, prolonged or relapsing psychosis and, in some cases, death. Cocaine has been found in the blood of coca-leaf chewers, coca-paste smokers and users of cocaine hydrochloride. Excessive coca-paste smoking is often resistant to therapeutic interventions and there is a high rate of relapse after treatment and rehabilitation.