High Times Greats: Lester Grinspoon

A 1977 interview with the late psychiatrist Dr. Lester Grinspoon, who died last year.
High Times Greats: Lester Grinspoon
Lester Grinspoon by Martha Stuart

From the February, 1977 issue of High Times comes Philip Nobile’s interview with Lester Grinspoon, who would have been 93 years old on June 24, and who died in 2020 one day after his birthday.

Cocaine suffers from a case of mistaken identity. The white-powdered euphoriant—once freely prescribed in patent medicines, generously consumed in turn-of-the-century wines and spirits, as well as in the first Coca-Cola formula—has been framed. Ignorant physicians and reformist legislators originally condemned cocaine for its association with the opiates. Nineteenth-century addicts often took cocaine with their opiates, and the physical addictiveness of the latter was ascribed, erroneously, to the former. In 1887, Dr. Albrecht Erlenmeyer wrote in a monograph entitled “Morphine Addiction and Its Treatment” that cocaine was “the third scourge of mankind,” after alcohol and morphine.

By 1890, reports of cocaine’s serious physical and psychological effects began flooding the medical literature. Although in his final cocaine paper, “Craving for and Fear of Cocaine” (1887), Freud had insisted that the drug claimed “no victim on its own,” the American public lost sympathy for the easy pleasures of the coca leaf. From the Harrison Narcotics Act of 1914 to the Comprehensive Drug Abuse, Prevention and Control Act, sale and possession of cocaine has been met with increasingly severe punishment. The sentence today is up to 15 years for illegal manufacture, distribution or possession with intent to sell, or a year and $1,000 for possession with intent to use; in the state of New York, it can mean life.

Such absurdity perdures, in great part, because cocaine lacks persuasive witnesses. But Dr. Lester Grinspoon of the Harvard Medical School has filled the expert testimony gap.

Dr. Grinspoon, a Pioneer of Debunking Myths About Cannabis

A psychiatrist best known for his upbeat 1971 book Marijuana Reconsidered, Grinspoon comes less to praise the substance than to bury misconceptions about it. In their eclectic new work, Cocaine: A Drug and Its Social Evolution, Dr. Grinspoon and Boston lawyer John Bakalar have coauthored an impressive treatise on the Andean treasure. Their reliance on primary sources and their own backgrounds give their arguments authority.

Yet after a learned exposition of the history, sociology, pharmacology and physical and psychological effects of the drug that lays to rest all of the popular fear and trembling, Grinspoon still won’t give cocaine a green light. Though he laces into his colleagues in white coats for defaming the character of cocaine, he does not advocate legalization. He wants it both ways—demythologized but controlled. In other words, Grinspoon appears content to let today’s anticocaine madness wither away naturally, as the culture takes its own sweet liberating course.

High Times: The Peruvian and Bolivian Indians who chew coca leaves have institutionalized their habit into something like the American coffee break. How does it work?

Grinspoon: They start off the work day at seven and take a two-hour coca break from nine to eleven. They take a wad of leaves, wet it, put it in their mouths, add some llipta, the alkaline substance, and then chew. This process is repeated in mid-afternoon and once again in early evening. All together, their work day may amount to something like five or six hours of heavy labor and almost as many hours of coca breaks. On the other hand, some coqueras, or coca chewers, just keep chewing it as they work.

High Times: Do you think this is necessary, or simply a cultural habit ?

Grinspoon: The distinction between necessity and habit is often not terribly clear. But when coqueras go into the army, for example, they give up coca without any difficulty. It’s true that the army provides a better diet than the one they’re used to, and that when they leave the army they resume coca chewing.

It’s very difficult to say how much coca these people would chew if they weren’t otherwise underfed and overworked. But, as it is, it’s clearly very important to them. One study estimated that 25 percent of a coquera’s income is spent on coca leaves; in fact, some are paid in leaves.

High Times: Can you tell me how this practice can go on when cocaine and coca are illegal substances in South American countries?

Grinspoon: Coca isn’t actually illegal, but authorities are supposed to discourage its use. Instead, they look the other way, just as the Catholic Church did during the post-Conquest period. Coca is an important and growing part of the economy. Some of the officials in these countries are certainly involved in illicit coca production.

High Times: Since the United Nations World Health Organization has officially condemned cocaine and coca as dangerous addictive substances, has there been any serious international attempt to destroy the coca plants in South America?

Grinspoon: Not as far as I know. As Mr. Bakalar and I say in our book, we are impressed with the ineptitude of the WHO drug groups in defining drug abuse and addiction. It appears that they define these things according to prevailing public prejudices rather than on the basis of inherent psychopharmacological properties.

For example, physicians were much more knowledgeable about marijuana in the nineteenth century. But, in this century, once it became a “bad drug,” they helped contribute to the ignorance. It’s the same with cocaine. The U.N. committees are made up of physicians and pharmacologists who are culturally biased.

High Times: What is the botany of the coca plant?

Grinspoon: It was first classified in 1756 by Patrick Browne, who called it Erythroxylum coca. The plant’s origin is unknown; it’s also found in other parts of the world. The coca bush grows naturally to a height of 12 feet or more and is usually trimmed back to about six. Its small white flower is of no great value. The important part is the light green oval leaf, about an inch and a half to two inches long. This leaf contains roughly one-half to two percent alkaloids, chemical substances of which perhaps 50 to 90 percent is cocaine or ecgonine, a precursor of cocaine.

There are conflicting views about whether the differences in effects are more than quantitative between coca—the whole leaf, including all the alkaloids—and cocaine. I am persuaded that the psychopharmacological effect of coca comes from the cocaine itself, and that the other alkaloids probably contribute very little to it. On the other hand, people like Richard T. Martin and Andrew Weil say the other alkaloids are significant. Mr. Bakalar and I believe that the difference between coca and cocaine is something like the difference between beer and champagne.

High Times: What does cocaine do to the body? What are its physiological effects?

Grinspoon: Cocaine has two main areas of physiological effect. Topically, it constricts blood vessels and affects nerve conduction. That’s why you get the numbness and why it was used as an early topical anesthetic.

Second, the high is apparently a function of the drug’s capacity to modify the activity of some of the cells of the central nervous system—particularly of the brain. It’s thought to affect certain substances known as neurotransmitters.

To be very brief about it, nerve cells in the brain communicate with adjacent brain cells over gaps called synapses. The mechanism by which a nerve impulse from one cell fiber is transmitted, across synapses, to other brain cells has to do with the release of these neurotransmitters—particularly, in the case of cocaine, the catecholamines norepinephrine and dopamine. The drug may stimulate the cells to release an excess of the catecholamine, or it may block reuptake and prevent reabsorption of the catecholamine, thus prolonging the stimulation.

High Times: Which is somehow expressed in a high. How is this high usually experienced?

Grinspoon: Well, commonly as a sense of alertness, heightened confidence about most things, including sexual potency, and general euphoria. You talk more than usual, find it more difficult to listen, have the sense that you can work longer, and feel that you work more efficiently. All depression disappears.

High Times: I was fascinated to learn that athletes in the nineteenth century used cocaine as a stimulant.

Grinspoon: Which resembles the use of amphetamines by modern athletes. The experiments of Beecher demonstrated that speed does seem to enhance athletic ability, especially in short-haul competition. The same is true of cocaine. Both drugs relieve fatigue. For example, using himself as a control, Freud used a dynamometer to test muscle strength before and after taking cocaine. And he demonstrated that cocaine enhanced his muscle strength, especially when he had been feeling very fatigued. When he was in top shape, it had less effect.

High Times: Why does cocaine improve performance?

Grinspoon: We simply don’t know the pharmacology on this point. But Golden Mortimer, who wrote the big book on cocaine in 1901 [Peru: History of Coca], believed it had to do with a saving of energy. That simply isn’t so. It’s probably a central effect. I mean, I think one can do better at any task if one doesn’t feel fatigued. Any time you minimize fatigue and enhance confidence, you improve performance; it isn’t necessarily that cocaine or amphetamines have a direct effect on performance.

High Times: Do we know how it reduces fatigue?

Grinspoon: No more than we know how it leads to the euphoria. Perhaps it’s just the other side of the same coin.

High Times: Is cocaine intake dangerous to health?

Grinspoon: It depends on how much is taken, by which route and over what period of time. The acute deleterious effects of large, especially intravenous or subcutaneous, doses are jitteriness, headache, pallor, cold sweats, rapid and weak pulse, shallow respiration, nausea, convulsions and loss of consciousness. If the dose is large enough, it can result in death. If a person uses cocaine in large doses for three or four days, he’ll have difficulty sleeping, lose his appetite and experience some jitteriness and anxiety.

As for chronic effects, the most prominent one is probably a runny nose. And, indeed, you know, it’s so common among coke heads that they’re called horners. Runny noses are a big joke in show business. However, this condition may also be more serious, if it involves ulcerations of the nasal mucosa. And, while perforations of the septum of the nose were recorded frequently in the medical literature around the turn of the century, we’ve been unable to document any contemporary instances. Perhaps this has to do with the way coke is cut today.

The other chronic effect—and probably the most important one—is the induction of a paranoid state. Again, there appears to have been more of this at the turn of the century. The state is very much like the paranoid psychosis with amphetamines, which, in turn, is all but clinically indistinguishable from acute paranoid schizophrenia. There are some differences, but they’re very subtle.

We tried to locate some cocaine paranoid psychotics and couldn’t. During the two years of our research on cocaine, we were unable to find a single case. The closest that we came was that gang of 150 people involved in a huge cocaine smuggling operation in Florida that was broken up last year. A number of the members of the gang apparently became paranoid, and 37 people—mostly the smugglers themselves—were murdered. Maybe you should be a little paranoid anyway if you’re in that kind of business. And, if you’re taking large and frequent doses of a drug that tends to work in that direction, the combination can be deadly. In any case, our impression is that cocaine-induced psychoses are rare.

High Times: Do you conclude that there is no sound medical reason to outlaw the free use of cocaine?

Grinspoon: From a strictly medical point of view, the answer is yes. But perhaps I can clarify this point by rephrasing the question: why should we allow the law to define disease and harm when the person using the drug doesn’t consider himself diseased or harmed? From a rational point of view, the best reason for invoking criminal law against a psychoactive drug is that the drug clearly leads to crime and violence. And I am convinced that cocaine fosters not nearly as much of that as do alcohol, barbiturates or amphetamines.

High Times: Do you happen to know whether production could match demand if cocaine were to be legalized around the world?

Grinspoon: First of all, I don’t know what the demand would be if it were legalized. That’s impossible to say. But certainly much more cocaine could be produced. Although most of the world supply is grown on the eastern slopes of the Andes in Peru, Bolivia and, to some extent, Colombia, remember that the coca leaf can thrive in many other areas as well.

Before World War II, large amounts were grown in Java. What’s important is a tropical climate with a mean temperature of about 65 degrees. And these conditions abound geographically. Even in South America, cocales— plantations that cultivate the coca bushes—constitute just a small fraction of the available acreage.

Between 1930 and 1960 most of the coca was consumed by the indigenous population, but in recent years the popularity of cocaine has forced the establishment of new routes into this country. In fact, I was informed by a DEA official recently that important networks are now being developed in Mexico, and they expect to see more cocaine in the U.S. in the near future.

I should also mention that only the Stepan Chemical Company of Maywood, New Jersey, is officially allowed to import coca leaves into this country. They extract the cocaine and the ecgonine (cocaine is methylbenzoylecgonine), send them to the drug companies and dispatch the rest of the product to the Coca-Cola Company in Atlanta, Georgia. So, Coca-Cola still has coca in it—coca minus the alkaloids.

High Times: Are researchers legally entitled to conduct cocaine experiments?

Grinspoon: Absolutely. In fact, the U.S. government has actively promoted research on cocaine in the past two or three years. I expect a crop of new studies to be published in the near future. Apparently the government realized that not enough is known about this rapidly proliferating drug. Information on cocaine, and marijuana, too, comes mostly from the nineteenth century and the early part of this one. When the drugs became defined as bad—in the Twenties and Thirties, particularly—research just stopped.

High Times: You seem to be pretty angry in your book about the prevailing medical and governmental attitudes toward cocaine use. At one point you compare the doctors to the Inca priests who were the first monopolizers of cocaine in South America and the Drug Enforcement Administration and American Medical Association to the Spanish crown and its intellectual arm, the Inquisition. Why so strong?

Grinspoon: The comparison with the Inquisition is not so much our attitude as one we attribute to people like Thomas Szasz. But we do think that doctors have contributed to some of the problem of so-called drug abuse. Before the Harrison Act of 1914, most drugs were patent medicines. Doctors as well as the patent medicine people would use these preparations—and with good reason, since we didn’t know very much about disease. If you could provide relief by giving somebody something with opium in it, that was about as much as you could do.

The distinction between medicine and pleasure wasn’t very precise. Then, influenced by the work of Koch and Pasteur, medicine learned that it could do more than just prescribe euphoric patent medicines. Through the wonders of microbiology, for instance, it could isolate the cause of an illness and treat it specifically. Physicians allied themselves with the forces of the law to decree that medicine and pleasure are separate. Now we define one means of drug-taking as therapy and the other as crime. If an opiate is prescribed by a doctor, it’s a medicine. But, if it’s used on the street in the form of heroin, it’s a felony.

High Times: But why did this distinction occur? Can you blame it solely on doctors?

Grinspoon: It seems to us that drugs are symbols of cultural tension. For example, South American shamans induce trances with tobacco. In the rites of Dionysus, alcohol induced what we would now call altered state of consciousness. In 1890 in the U.S., opium was a strictly upper-middle or upper-class habit, but by 1930 it had become identified with the lower classes.

High Times: Cocaine seems to have been used as a panacea in the United States in the late 19th century. How widespread was its intake?

Grinspoon: It was prescribed for any number of ailments—from depression to neurasthenia to gastric distress, to fatigue, to heaven knows what. It was popularly sold as cocainum muriaticum—that is, as a solution, taken orally. Like opium, it was prescribed because it made patients feel better. Although it wouldn’t cure an ulcer, it did give temporary relief of stomach ache and other minor pains. Patients would feel very much indebted to physicians who prescribed it.

But people could also buy coke from the patent medicine man. A Corsican pharmacist, Angelo Mariani, was the most famous of these, with his Vin Mariani, a solution of coca in wines. This concoction was the toast of Europe, and several similar products were available in the United States. Many famous figures imbibed it regularly—Pope Leo XIII, Jules Verne, Sarah Bernhardt, Ibsen, Zola, the czar of Russia, Edison and Ulysses S. Grant.

High Times: I presume the original Coca-Cola was a part of this cocaine cocktail trend.

Grinspoon: When John Pemberton, a Georgia pharmacist, created Coca-Cola in 1896 from a formula mixing the cola bean, coca leaves and ordinary water, later soda water, he was probably cashing in on the Vin Mariani appeal. In 1891 another pharmacist, Asa Candler, paid a total of something like $15,000 for the controlling rights to the drink. He really promoted it through drugstore soda fountains, where medicine and pleasure met. Folks would visit their local store to get “a shot in the arm,” as Coca-Cola was often called when it contained cocaine.

We came across a 1905 Saturday Evening Post advertisement for Coke that showed a man in his study over the caption “If you have a lot of brainwork to do between the hours of six and eleven, drink Coca-Cola.” It was clearly an antidepressant, antifatigue tonic. It really felt good to have Coca-Cola.

Incidentally, cocaine was dropped from Coke some time before 1906, when the Coca-Cola Company wisely anticipated the passage of the Pure Food and Drug Act of 1906. Coke still has the coca-leaf extract but no longer the cocaine. Caffeine was added to maintain the stimulant effect.

High Times: But did people realize that they were consuming psychoactive drugs with all those patent medicines and with Coca-Cola?

Grinspoon: Before the patent medicine people were required to label their products. the ingredients were secret. So, until 1906, people didn’t always know what they were taking. All they knew was “Hey, I [like] this and it makes me feel pretty good.”

High Times: Some South American Indian cultures, however, were devoted to and sometimes controlled by this leaf, were they not?

Grinspoon: Yes, coca had a very prominent part in their culture and was endowed with godlike qualities. It was very much a substance of the aristocracy and priesthood in Inca society. The lower classes weren’t allowed to use the drug very much before the Spanish Conquest.

High Times: Why doesn’t chewing the coca leaf afford the same high as cocaine ?

Grinspoon: The leaf is to cocaine as beer is to distilled liquor. You have to drink a lot of beer to get the kind of high you can get very quickly with a glass of 86-proof scotch. But you can certainly chew enough to get a low high.

High Times: Is coke in any sense an aphrodisiac?

Grinspoon: Like so many other things, if it’s thought to be an aphrodisiac, it may have that effect. It’s the champagne of the psychoactive drugs. It’s expensive and it’s associated with movie stars, jet-setters, and their sex lives are thought to be especially interesting. If one has that image of cocaine, then it’s likely to have an aphrodisiac effect. But it seems to us that that’s more likely to be on the basis of suggestion than on the basis of any necessarily psychopharmacological properties. On the other hand, one cannot dismiss the possibility that it does have at least some direct aphrodisiac effect.

High Times: Is it true that Stevenson wrote “Dr. Jekyll and Mr. Hyde” in a cocaine stupor?

Grinspoon: Well, it’s possible, although there’s no substantial evidence. He wrote the story in six days of frantic work. Apparently Stevenson had been taking morphine—a drug not conducive to the production of 60,000 words in six days.

High Times: What kind of crash is there from extended cocaine use?

Grinspoon: It’s like an attenuated amphetamine crash, which can be pretty brutal. However, it’s a rare person who will coke up for three or four days continuously and then crash. It’s difficult to get that much of the drug, it’s expensive and it’s short acting. So a cocaine crash usually comes from just sniffing the stuff for part of a day and night. You may feel some slight degree of depression and lethargy, but probably nothing more serious.

High Times: Why doesn’t cocaine create physiological craving, like the opiates ?

Grinspoon: Cocaine is a stimulant, whereas the opiates, like barbiturates and alcohol, are depressants. Apparently the body gradually gets used to a depressant. It compensates by becoming increasingly hyperexcitable. If you suddenly take the barbiturate, the alcohol or the opium away, you’re left with the hyperexcited body and the consequent effects of withdrawal. Whereas when cocaine—a stimulant—is taken away, the body comes down. There may be some depression, possibly compensation, but nothing that gets played out in physical symptoms.

High Times: What is the price of cocaine on the pharmaceuticals market?

Grinspoon: Something like a dollar a gram. And at a dollar a gram, you can be sure the companies make a fair amount of profit. It isn’t as though that represents the total cost of production.

High Times: What happened to cocaine as an anesthetic? Why did it go out of vogue in the operating room?

Grinspoon: Because better things came along. The synthetic anesthetics, like Novocain, came along and just pushed it right out of the way. That’s part of what happened to marijuana. Marijuana used to be the anesthetic of choice on the Civil War fields until, with the introduction of the hypodermic syringe, it became possible to inject the opiates. The two most common medical uses of cannabis in the nineteenth century were analgesic and soporific. At the end of the century aspirin and barbiturates were synthesized and, since they were easier to administer and more reliable, they displaced cannabis as the drugs most commonly used for these purposes.

Similarly, the synthetics proved more reliable than cocaine in surgery. When you’re doing an operation where you want a local anesthetic, you want one without central nervous system effects. Cocaine can be applied topically, and the vasoconstriction it produces retards its own absorption: still, some of it does seep into the central nervous system. But synthetic local anesthetics have no central stimulant effect.

In the early twentieth century, people died from the surgical use of cocaine. As an anesthetic it often led to a lethal outcome, so that doctors developed a healthy respect for its toxic effects. But just as doctors have in the past underplayed the harmfulness of amphetamines, which are very similar to cocaine, I think they’ve exaggerated the dangers of cocaine. And, in our view, cocaine is probably less harmful than the amphetamines in almost every dimension.

High Times: Do you suppose that the outlawing of cocaine has blocked potential medical breakthroughs in its use?

Grinspoon: No one can be sure that that hasn’t happened. But that possibility is greater with cannabis than with cocaine. In the case of cannabis, I’m convinced that within five years there will be analogues and congeners of tetrahydrocannabinol and other cannabinols that will be used in medicine. And this kind of research is something that should have been begun in 1942, when tetrahydrocannabinol was first isolated. Yet because marijuana was deemed a bad drug, this wasn’t done. Medically, I think that cocaine will be more important for teaching us about such conditions as schizophrenia.

Now, in the case of cannabis, it’s simply no longer in the pharmacopoeia. If you come to me with glaucoma and say “Hey, I’d like to be able to have tetrahydrocannabinol,” I can’t prescribe it even though it’s clearly useful. You might also want to treat your migraine by smoking some grass, but there’s no way I can prescribe it. I could prescribe cocaine, because it’s in the pharmacopoeia, although perhaps under-used.

I believe that cannabis is someday going to be recognized as helpful for natural childbirth. That is, it’s a mild anesthetic, yet the mother remains conscious, and anecdotal reports tell us that the baby is born nice and pink, rather than blue from the respiratory depressant effects of some of the anesthetics that we give for pain now. And it must be quite an experience for the mother, too. It will be used in the treatment of asthma, too, before very long.

High Times: Why is it that narcotics and cocaine can be prescribed under controlled conditions, and not cannabis?

Grinspoon: Because the 1937 Marijuana Tax Act made it difficult for physicians to fill out the required forms. Since you could use morphine for pain and barbiturates for sleep, cannabis didn’t seem worth the effort. Therefore physicians allowed it to go out of the pharmacopoeia and allowed themselves to remain ignorant about it.

High Times: Can you tell me what a toxic dose of cocaine would be? What would you have to do to kill yourself?

Grinspoon: That’s guesswork—it’s quite uncertain and variable—but the guess is that it takes about 1.5 grams at one time, taken orally, and less, by injection, in order to kill someone.

High Times: So, as far as its psychoactive qualities are concerned, cocaine is just recreational?

Grinspoon: Nowadays it’s used primarily as a fun drug.

High Times: Does it follow that you endorse the legalization of cocaine?

Grinspoon: Well, let me put it this way. I don’t think that the use of cocaine should be the criminal offense that it is now. Criminal law is not an appropriate means of dealing with recreational drugs, even though some people abuse them. Of course some of these substances are abused. It’s a risk-benefit situation. But no inherent psychopharmacological property of pot, for example, is in any way as harmful to users as is the experience of being arrested and its implications.

There was far more opium addiction at the turn of the century than there is now. But the attendant individual and social harm has multiplied fantastically today, when you consider the wretched health of our addicts and the crime they foster.

There are eight to 12 million alcoholics in this country. The damage they do to themselves and to society isn’t considered sufficient to deprive the majority of the pleasure they get from drinking. Yet we adopt an entirely different attitude toward drugs that at worst have much less capacity for harm. Now how is one to understand that? It doesn’t make any sense. I believe that as we continue to synthesize new drugs in the laboratories it will become increasingly imperative that we learn to live comfortably with them.

Ninety-five percent of people handle liquor quite well. We have to concentrate on why those five percent do not. Insofar as it’s possible to estimate, Mr. Bakalar and I are inclined to say that cocaine abuse will not become the social problem that some other, less restricted and potentially more dangerous, instruments—like alcohol and guns—are already.

High Times: What do you want? What should we do about cocaine in America?

Grinspoon: Are you putting me in the position of making a choice between the present prohibition and the legal availability of the drugs?

High Times: What is the ideal state?

Grinspoon: Well, to tell you the truth, I don’t know.

High Times: After all you’ve said on the subject, after writing a massive book?

Grinspoon: I can’t deny that I’m concerned about what would happen if cocaine were freely available. I don’t like prohibition. Most prohibitions do more harm than good. But it’s also true that between 1920 and 1933, when the Volstead Act was in force, alcoholism dropped significantly, and SO did cirrhosis of the liver.

Now, you could argue that the social price wasn’t worth the medical benefit. But the fact of the matter is that Prohibition did accomplish something. And, you know, the constraints on the availability of cocaine, much like our traffic laws—few people obey them all the time, and they’re seldom enforced—still have a moderating effect. If there weren’t any traffic laws at all, would some people go at 150 miles an hour?

So I do worry. And if you ask me whether I’m in favor of legalizing cocaine, as I am with cannabis, I would have to reply that I’m not certain. I’m not sure just what should be done. We are concerned about what would happen if you and I could buy a gram of coke for a dollar. The people who have told us over and over again that they can’t leave it alone have made an impression on me.

High Times: But if coke only makes them feel good and if we could all get a daily “shot in the arm” as our grandfathers did, what difference would it make?

Grinspoon: I’ll tell you what difference it would make. There just wasn’t that much cocaine in Coca-Cola. If we all chewed coca, maybe that would be O.K. But cocaine itself is much stronger, and correspondingly more dangerous, when sniffed in sure form.

High Times: Why are you so rough on your medical colleagues and the DEA if you don’t have the answer either?

Grinspoon: Well, by admitting that I don’t have the answer, I don’t perpetuate the myths. In order for us to move toward a more rational approach, part of what we have to do is get a better understanding of how these drugs are defined, what they actually do and how they are used. For example, we should do careful studies allowing people to take cocaine ad libitum, and see what happens. Will cocaine interfere with their functioning as individuals and as social beings? We can’t do an experiment that actually simulates unimpeded availability, but we can come a lot closer than we have.

High Times: But how could you ever decide a priori whether cocaine abuse would resemble alcohol abuse?

Grinspoon: There is no way, as a psychiatrist, that I could identify the abuse population for any drug.

High Times: So how would you arrive at the stage of approving legalization?

Grinspoon: Marijuana laws weren’t reformed on a rational basis, and neither will the law on cocaine be. It’s going to be a cultural change. In other words, if more and more people use it, as they appear to be doing, and it becomes clear that it doesn’t have devastating effects and not too many people abuse it—as in the case of cannabis—there will be increasing pressure to stop throwing people in jail for sniffing and to make it available to the public with reasonable safeguards.

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