Personal Doses of Cocaine and Coca Paste are Adulterated in Cartagena de Indias (Colombia).

Knowledge of drug composition consumed on the streets and the identification and quantification of their adulterants is essential for understanding unexpected side effects, tracking routes, and drug profiling. Therefore, this work aimed to determine the purity and to identify and quantify the main adulterants found in personal doses of cocaine (perico) and coca paste (bazuco) in Cartagena de Indias (Colombia). The data collected in this study describe a first attempt to introduce the qualitative and quantitative analyses of adulterants present in street drugs in Cartagena de Indias to improve surveillance. Through gas chromatography coupled to mass spectrometry (GC-MS), the purity and adulterants were quantified in 45 personal doses of cocaine powder and coca paste. 100% of the personal doses in the city were adulterated; caffeine, phenacetin, and levamisole were the main adulterants identified in cocaine. Besides the above, lidocaine was also found in coca paste. The purity of cocaine varied from 8% to almost 70%, with caffeine ranging from 6% to 42%. In the case of coca paste, the maximum content of cocaine found was 60%, while some samples contained as little as 14%. The results are consistent with other research in terms of the widespread use of caffeine as an adulterant, but they also follow the growing trend of the use of levamisole and phenacetin. The wide range of cocaine content in samples sold in the illicit market could cause undesirable effects on cocaine users who do not know the exact intended dose for consumption; so, this study intends to make these results available not only to academic, public health, and national security agencies but also to tourists entering Cartagena de Indias, so that they are aware of what they are consuming and the risks to which they are exposed.

Miracle or Menace?: The Arrival of Cocaine 1860-1900.

The arrival of cocaine was the formative episode in the modern understanding of the benefits and dangers of neurostimulants. European culture and medicine had historically been poor in stimulant plants and drugs. When coca and cocaine appeared in nineteenth-century Europe, doctors, pharmacists, and the public struggled to understand their benefits and risks, and to formulate a distinction between use and abuse.

Induction of nuclear anomalies in exfoliated buccal cells of coca chewers: results of a field study.

The leaves of coca (Erythroxylum coca var. coca), a South American shrub which contains cocaine, other alkaloids and phenolics are widely used by indigenous populations of the Andes. It is currently not known if coca consumption causes genotoxic effects in humans. This information is important to predict potential long-term toxic effects such as cancer induction. Therefore, the buccal cytome assay was used to analyze oral cells from 45 uni- and bilateral chewers and 23 controls living in the Altiplano of the Peruvian Andes. In total, 123,471 cells were evaluated from chewers and 57,916 from controls. Information concerning the consumption levels and habits and also use of lime were collected with questionnaires. Chewing of the leaves did not induce nuclear anomalies reflecting genetic damage such as micronuclei (MNi) and nuclear buds; in the highest exposure group (but not in the overall group) even a significant decrease in the frequencies of cells with MNi (by 64 %) was observed. However, we found significantly elevated levels of other nuclear anomalies (karyorrhexis and karyolysis) which reflect cytotoxic effects in the coca users. The frequencies of these anomalies increased with the daily consumption and when lime was used to improve the release of the alkaloids. In contrast to other chewing habits (betel, tobacco and khat), consumption of coca leaves does not induce genetic instability in cells from the oral cavity and our findings indicate that no adverse health effects take place in chewers which are associated with DNA damage. However, the significant increase in certain anomalies shows that acute toxic effects are caused by coca consumption.

Os vícios de 'comer coca' e da 'borracheira' no mundo andino do cronista indígena Guaman Poma / The vices of eating cocaine and of the 'borracheira' in the Andean world of the aboriginal cronicler Guaman Poma

A coca surge, na crônica-carta de Guaman Poma de Ayala ao rei da Espanha, a partir de peculiares eventos da história do Peru. Na visão do escritor indígena e cristão (entre os sécs. XVI e XVII), a planta psicoativa aparece num passado não muito distante, por meio dos índios da montaña (as serras orientais cobertas pela selva quevem da planície amazônica), numa história de idolatria do arbusto. Mas o vício de mastigar a folha da coca é inventado pelos incas na conquista dessa região (o Antisuyo). A história de Guaman Poma pode entreter, mas também demonstra a seriedade do cronista em apontar para a relação entre os vícios mundanos com umgrande pecado, a idolatria de alguns índios – mas são exceções para o fato, segundo o cronista, da verdadeira cristandade desde muito tempo na serra (nas altitudes mais temperadas), que recebe de fora o “vício de comer coca”. É interessante notar que essas histórias de Guaman Poma também indicam códigos indígenas de compreensão e manipulação dos eventos, como será discutido abaixo, com apoio, ainda, da análise da crônica de outro indígena do Peru, e contemporâneo, Santa Cruz Pachacuti.

Os vícios de 'comer coca' e da 'borracheira' no mundo andino do cronista indígena Guaman Poma / The vices of eating cocaine and of the 'borracheira' in the Andean world of the aboriginal cronicler Guaman Poma

A coca surge, na crônica-carta de Guaman Poma de Ayala ao rei da Espanha, a partir de peculiares eventos da história do Peru. Na visão do escritor indígena e cristão (entre os sécs. XVI e XVII), a planta psicoativa aparece num passado não muito distante, por meio dos índios da montaña (as serras orientais cobertas pela selva quevem da planície amazônica), numa história de idolatria do arbusto. Mas o vício de mastigar a folha da coca é inventado pelos incas na conquista dessa região (o Antisuyo). A história de Guaman Poma pode entreter, mas também demonstra a seriedade do cronista em apontar para a relação entre os vícios mundanos com umgrande pecado, a idolatria de alguns índios – mas são exceções para o fato, segundo o cronista, da verdadeira cristandade desde muito tempo na serra (nas altitudes mais temperadas), que recebe de fora o “vício de comer coca”. É interessante notar que essas histórias de Guaman Poma também indicam códigos indígenas de compreensão e manipulação dos eventos, como será discutido abaixo, com apoio, ainda, da análise da crônica de outro indígena do Peru, e contemporâneo, Santa Cruz Pachacuti. [AU]

Sobre la influencia del acullico de coca en la capacidad física / On the influence of coca acullico in the physical ability

El objetivo del presente estudio fue de evaluar el efecto del acullico de coca en la capacidad física de consumidores habituales de coca. La población del estudio fueron 22 hombres sanos del Altiplano Boliviano, 14 de los cuales no consumían coca más de 3 veces al año (grupo NC) y 8 acullicaban 3-4 veces por semana (grupo C). La metodología consistió en la medición del consumo máximo de oxígeno y parámetros relacionados así como variables bioquímicas en dos pruebas de esfuerzo en bicicleta ergométrica: La primera fue una prueba de esfuerzo controlado progresivo hasta el máximo y la segunda una prueba de esfuerzo submáximo prolongado a una carga de trabajo de 60-70% de la carga máxima alcanzada en la primera prueba. El grupo C hizo ambas pruebas después de haber acullicado coca durante una hora previa. Se obtuvieron varias muestras de sangre venosa de ambos grupos de sujetos para obtener valores sanguíneos de lactato, adrenalina, noradrenalina, glucosa, insulina y ácidos grasos libres. Los resultados de la prueba máxima evidenciaron un consumo máximo de oxígeno similar en ambos grupos. La única diferencia signifi cativa fue una mayor desaturación de oxígeno en el grupo C que en el grupo NC. Las diferencias entre C y NC se evidenciaron en la prueba submáxima de esfuerzo prolongado donde C mantuvo el consumo de oxígeno estable mientras que NC incremento este parámetro signifi cativamente. Además el grupo C tuvo niveles mayores de adrenalina, noradrenalina y de glucosa y de ácidos grasos circulantes así como niveles menores de insulina. Concluimos que los acullicadores no pueden realizar un trabajo más intenso que los no-acullicadores, pero que pueden tolerar mejor el esfuerzo prolongado como demuestra el consumo de oxígeno estable. El incremento del nivel de glucosa y de los ácidos grasos libres circulantes en C indica que la mejor tolerancia...

The aim of our study was to assess the effects of coca chewing on the exercise capacity of habitual coca chewers. The study population were 22 healthy men from the Bolivian Altiplano, 14 of which did not chew coca more than 3 times per year (group NC) and 8 used coca 3-4 times per week. The methodology consisted in measuring maximal oxygen uptake and related parameters as well as biochemical variables during 2 exercise tests on a bicycle ergometer. The fi rst test was of controlled progressive exercise up to maximal level, and the second consisted of prolonged submaximal exercise during one hour at 60-70% of the maximal level reached in the fi rst test. Group C did both tests after having chewed coca during one hour previously. Various venous blood samples were obtained from both groups for measuring blood levels of lactate, epinephrine, nor-epinephrine, glucose, insulin and free fatty acids. The results of the maximal exercise test showed similar values of maximal oxygen uptake in both groups. The only signifi cant difference was a greater oxygen desaturation in group C than in NC. The differences between C and NC became evident in the prolonged submaximal test, where C maintained the oxygen uptake whereas NC increased the oxygen consumption signifi cantly. Additionally, group C had higher levels of epinephrine, norepinephrine, glucose and free fatty acids and lower levels of insulin. We concluded that coca chewers are not able to do more intensive work than non-chewers, but that they tolerate effort better as shown by their stable oxygen uptake. The increase of glucose levels and circulating free fatty acids indicates that the better tolerance of prolonged effort in C might be due to a belated decrease of the glycogen stores.

Historical trends in the production and consumption of illicit drugs in Mexico: implications for the prevention of blood borne infections.

Mexico has cultivated opium poppy since before the 1900's and has been an important transit route for South American cocaine for decades. However, only recently has drug use, particularly injection drug use, been documented as an important problem. Heroin is the most common drug used by Mexican injection drug users (IDUs). Increased cultivation of opium poppy in some Mexican states, lower prices for black tar heroin and increased security at U.S.-Mexican border crossings may be contributing factors to heroin use, especially in border cities. Risky practices among IDUs, including needle sharing and shooting gallery attendance are common, whereas perceived risk for acquiring blood borne infections is low. Although reported AIDS cases attributed to IDU in Mexico have been low, data from sentinel populations, such as pregnant women in the Mexican-U.S. border city of Tijuana, suggest an increase in HIV prevalence associated with drug use. Given widespread risk behaviors and rising numbers of blood borne infections among IDUs in Mexican-U.S. border cities, there is an urgent need for increased disease surveillance and culturally appropriate interventions to prevent potential epidemics of blood borne infections. We review available literature on the history of opium production in Mexico, recent trends in drug use and its implications, and the Mexican response, with special emphasis on the border cities of Ciudad Juarez and Tijuana.

Perfil emocional de los consumidores de 'revuelto' en comparación con consumidores de heroína y de cocaína / Emotional profile of 'speed-ball' abusers white regard to heroin and cocaine abusers

En los últimos años se está dando un cambio en el patrón de consumo, con un descenso en el consumo de heroína y un aumento en el de cocaína. Por otra parte, aparece una forma de consumir ambas sustancias juntas, heroína y cocaína, bajo las denominaciones de “revuelto”, “rebujo”, “speed-ball”, etc. Clínicamente se encuentran claras semejanzas entre estos consumidores de “revuelto” con los de heroína y ambos, diferentes con los de cocaína. Este estudio trata de comprobar si también la respuesta emocional está influenciada por el tipo de sustancia consumida y si dicha respuesta emocional en los sujetos consumidores de “revuelto” se asemeja más a la de los consumidores de cocaína o a los de heroína. Para esto se han estudiado 75 sujetos (34 sujetos consumidores de cocaína, 11 de heroína y 30 de “revuelto”) utilizando el I.C.E.R.E. (Instrumento Clínico de Evaluación de la Respuesta Emocional) basado en el modelo de emoción de Peter J. Lang. El I.C.E.R.E. está compuesto por 25 imágenes seleccionadas del Internacional Affective Picture System (IAPS) y la modalidad de respuesta es el Self Assessment Maniky (SAM). Los resultados obtenidos muestran que existen diferencias en la respuesta, ante estímulos emocionales, de los sujetos drogodependientes en función de la sustancia de consumo preferente, no existiendo diferencias entre los consumidores de “revuelto” y heroína y sí de estos con los consumidores de cocaína

A new trend is to be seen in the drug use profile over the last few years, with a fall in heroin use and a rise in that of cocaine. However, a new use has appeared, simultaneously taking heroin and cocaine, known as a speedball. Clinically, there are clear similarities between speedball users and heroin users and both differ from those taking cocaine. This study endeavours to ascertain if the emotional response is also influenced by the kind of substance used and if said emotional response in those taking speedball is more similar to that of cocaine users or that of heroin users. We studied 75 subjects (34 using cocaine, 11 heroin and 30 speedball), using the Instrumento Clínico de Evaluación de la Respuesta Emocional (ICERE), which is based on the emotional response model by Peter J. Lang. The ICERE comprises 25 images selected from the International Affective Picture System (IAPS) and the response was measured using the Self Assessment Maniky (SAM). The results show that differences exist in the response of drug dependent individuals to emotional stimuli in respect of their preferred substance use, no differences exist between speedball and heroin users, and differences do exist between both these groups and cocaine users

¿Es posible diferenciar analíticamente un consumidor de coca de uno de cocaína? / Is it possible to differentiate analitically a coca user from a coccaine user?

El objetivo del estudio fue ver si a través del análisis de orina se podría determinar el tipo de consumo de coca o cocaína que realizaban los consumidores. El estudio se llevó a cabo en la ciudad de La Paz (Bolivia). Para ello se reclutaron consumidores voluntarios y se dividieron en tres grupos: los consumidores de coca masticada (acullicadores), los consumidores de cocaína y los consumidores de coca en forma de mates. A todos ellos se les tomó muestras de orina con el fin de detectar la cantidad de benzoilecgonina y verificar si se podían establecer diferencias entre los individuos o los grupos. Cuando las concentraciones de benzoilecgonina en orina fluctuaban entre 220 a 450 ng/ml correspondían a cualquiera de los tres grupos consumidores sin poder descartar, ni diferenciar, ninguna de estas posibilidades. Cuando las concentraciones de benzoilecgonina en orina eran más altas y fluctuaban entre 451 a 560 ng/ml, correspondían a consumidores de hoja de coca que la masticaban (“acullicaban”) o a los consumidores de cocaína, sin poder descartar, ni diferenciar, ninguna de las dos posibilidades. La eliminación de benzoilecgonina por la orina, depende de la cantidad de coca/cocaína ingerida, de la forma de consumo de la coca, del metabolismo de la persona y de la cantidad de líquidos ingeridos/eliminados; pero no fue posible mediante esta prueba, saber a qué grupo pertenecía un individuo, pero sí se pudieron establecer diferencias grupales significativas entre las distintas formas de consumo

The objective of the study was to ascertain if urine analysis could be used to determine whether substance users were taking coca or cocaine. The study was carried out in the city of La Paz in Bolivia. Volunteer users were recruited and divided into three groups: those who chewed coca leaves, cocaine users and coca tea drinkers. Urine samples were taken from all of them, with the objective of detecting the amount of benzoylecgonine, and ascertaining if differences could be established between individuals or groups. When benzoylecgonine concentrations in urine fluctuated between 220 and 450 ng/ml, they corresponded to users in any of the three groups, it being impossible to discard or differentiate any one of them. When benzoylecgonine concentrations in urine were higher, and fluctuated between 451 and 560 ng/ml, they corresponded to those who chewed coca leaves or to cocaine users, without it being possible to discard or differentiate either of these two groups. The elimination of benzoylecgonine in the urine depends on the quantity of coca/cocaine ingested, the cocaine consumption method, personal metabolism and the quantity of liquid ingested/ eliminated but, on the basis of this study, it was not possible to ascertain to which group an individual belonged, although it was possible to establish significant group differences in accordance with the specific methods of use

Cambios histopatológicos de la mucosa gingival en masticadores de hoja de coca varones del distrito de Laraos, Provincia de Yauyos / Hystopathological changes of the gingival mucosa in the coca leaves chewer's males of district of Laraos, Province of Yauyos

El presente estudio tuvo como objetivo describir los cambios histopatológicos de la mucosa gingival. El estudio se realizó en el Puesto de Salud del Distrito de Laraos, provincia de Yauyos, en donde el hábito de la masticación de hojas de coca sigue vigente. El grupo de estudio estuvo conformado por 30 masticadores de hoja de coca, varones de 40 a 61 años de edad y el grupo control por 30 no masticadores de hoja de coca, cuyas edades y características fueron similares al grupo de estudio. Para la selección de la muestra se utilizó una ficha de selección de acuerdo a los criterios establecidos. Los datos encontrados se registraron en una ficha de Registro Histológico. La prueba Chi cuadrada para variables cualitativas con un nivel de significancia de 95 por ciento nos indican una asociación altamente significativa entre acantosis e hiperparaqueratosis (p = 0,010, p = 0,020 respectivamente) y el hábito de la masticación de hojas de coca. Es decir, el epitelio del masticador de hoja de coca pasa de un epitelio paraqueratinizado o queratinizado a un epitelio hiperparaqueratósico sin mostrar cambios malignos. No se encontró diferencia significativa (p mayor que 0,05) entre los cambios histopatológicos a nivel del tejido conectivo con el hábito de la masticación de hojas de coca.

The present study had the objective to describe the hystopathological changes of the gingival mucosa. The study was made at the “Puesto de Salud Laraos”, province of Yauyos, in where the habit of the coca leaves chewing follows effective. The study group was conformed by 30 men coca leaves chewers of 40 to 61 years old and the control group by 30 men non coca leaves chewers, whose ages and characteristics were similar to the study group. For the selection of the sample, a card of selection according to the established criteria was used. The found data were registered in an Histological Data card. The Chi Square test for qualitative variables with a level a significance of 95% indicates a high significant association between acanthosis and hyperparakeratosis (p=0,010, p=0,020 respectively) and the habit of the coca leaves chewing. Consequently, the coca leaves chewers’ epithelia go from a parakeratinized or queratinized epithelia to a hiperparakeratosic epithelia without showing malignant changes. There was no significant difference (p > 0,05) between the histopathological changes in the connective tissue with the habit of coca leaves chewing.

Cambios histológicos en el epitelio de la mucosa del carrillo en sujetos masticadores de hojas de coca / Histologic changes in the cheek mucosal epithelium of coca leaves chewing subjects

El propósito del presente trabajo de investigación es describir las características histológias del epitelio de la mucosa del carrillo relacionadas con el hábito de masticación de hojas de coca, determinado según edad y tiempo total de exposición de la mucosa al bolo de coca. Los criterios de evaluación para describir las características del epitelio fueron observados a nivel de las cuatro capas (basal, espinosa, intermedia y superficial). La muestra estuvo constituida por 43 biopsias (30 pertenecientes a masticadores de hojas de coca y 13 sujetos que no presentaban el hábito) entre 40 y 70 años ed edad, de una comunidad andina de Huánuco, Perú. Se encontró acantosis en el 100 por ciento de los sujetos con el hábito, así como células eosinófilas en las capas espinosa e intermedia enel 76,6 por ciento y el 53,3 por ciento respectivamente, e hiperqueratosis en el 96,6 por ciento. No se encontraron cambios correspondientes a displasia epitelial y en todas las capas del epitelio se halló inflamación crónica de grado leve a moderado, observándose que el epitelio de la mucosa del carrillo de los masticadores de coca sufre un proceso de adaptación que corresponde al cambio de un epitelio no queratinizado a paraqueratinizado, el cual se mantiene sin progresar a cambios histológicos mayores. No se encontró diferencia estadísticamente significativa (>0,05) entre los hallazgos histológicos y la edad ni con el tiempo total de exposición de la mucosa al bolo de coca

Investigación del efecto sobre la salud mental del uso tradicional de la coca: primera aproximación / Research on mental health effects of traditional coca use: first approximation

Existe discusión pública de personas, sobre los efectos que tiene el consume de Coca sobre la salud mental; unos dicen que la deteriora y otro la niegan. Para contribuir a su definición, hicimos una encuesta sobre 388 personas vinculadas al consumo de coca en forma de chachado, en 65 localidades de la Sierra del Perú. La encuesta concluyó, que el consumo de coca en forma tradicional no compromete la salud mental ni social de sus consumidores.

Exist discuss public above the effect of health mental by consumption of Coca in form tradition and some apeak that the deterioration an another the deny. For contribute your explanation we to do investigation in 388 persons chain the consumption of coca in 65 locations of mountains of Peru. The investigation to conclude what the consumption of coca in form tradition not compromised health mental and social.

Niveles sanguineos de plomo en neonatos hijos de madres consumidoras de "basuco": estudio comparativo / Lead blood levels in newborns of \"basuco\" consumer mothers: comparative study

La obtencion del clorhidrato de cocaina a partir de la hoja de coca requiere el uso de gasolina; residuos de esta pueden permanecer en la pasta base(basuca); al fumar esta, mezclada con cigarrillo o marihuana (basuco) el consumidor puede captar residuos de plomo e incrementar sus concentraciones sanguineas del mismo; quisimos saber si el uso del basuco durante el embarazo podria tener tal efecto en los recien nacidos de madres consumidoras. Se midieron las concentraciones de plomo serico en 19 recien nacidos hijos de gestantes consumidoras de basuco y en 18 de sus madres, asi como en 20 parturientas no consumidoras y en 19 de sus hijos. Se utilizo un espectrofotometro de absorcion atomica Perkin-Elmer modelo 2380. Las madres se dividieron en 4 grupos segun el grado de consumo, asi: leve, moderado, intenso y ninguno. Las cifras promedio y las DE encontradas fueron respectivamente: en los hijos:13.5 mas o menos 9.4; 15.8 mas o menos 6.5; 16.6 mas o menos 7.8; 6.9 mas o menos 5.0 ug/dl, y en las madres, 13.3 mas o menos 4.6; 13.5 mas o menos 6.9; 16.2 mas o menos 4.9; 8.4 mas o menos 4.6 ug/dl. Las pruebas estadisticas demostraron diferencias altamente significativas entre las madres e hijos expuestos al basuco y la cohorte no expuesta; no existio diferencia entre las concentraciones segun el grado de consumo. Los altos niveles de plomo detectados ameritan seguimiento de los recien nacidos y estudios adicionales, con el fin de evaluar su repercusion a largo plazo

Obtention of cocaine clorhydrate from coca leaves requires the use of gasoline; therefore residues such as lead may remain in the base paste (basuca); the latter is smoked, under the name basuco, mixed with tobacco or marijuana; It is conceivable that the smoker takes up lead residues that Increase lead blood levels; we wanted to determine whether the use of basuco during pregnancy could produce such effect In the newborninfant. Serum lead concentrations were measured In 19 newborn children and In 18 of their mothers. The latter were basuco consumers. They were compared to those of 20 non consuming delivering women along with 19 of their newborn Infants. Measurements were performed on a Perkin-Palmer model 2380 atomic absorptionspectrophotometer. Women were divided in four groups according to the degree of consumption, as follows: mild, moderate, Intense or non existent. Mean levels and SDs in the children were respectively: 13.5 ± 9.4; 15.8 ± 6.5; 16.6 ± 7.8; 6.9 ± 5.0 ug/dl; and In their mothers: 13.3 ± 4.6; 13.5 ± 6.9; 16.2 ± 4.9; 8.4 ± 4.6 ug/dl Statistic analysis revealed highly significant differences between mothers and children exposed to basuco and those that were not exposed. No difference was observed ac. cording to the degree of consumption. In conclusion: newborn from basuco consuming mothers have Increased lead blood levels; the long term effects of such alteration should be the subject of further studies

Capítulo de la historia de la coca: ayer y hoy / Chapter of the history of the coca: yesterday and today

In the first part of this article well-researched history of coca leaf use in the American the author provides a brief comment on the social problem of coca in Peru. based on information taken from sources published in the last 100 years, the author presents historic data on the use of coca leaf in the American,, beginning with the observation of Christopher Columbus in 1492; the writing of the Dominican missionary Tomas Ortiz in 1499, the letter of Americo Vespucci in 1504, as well as other authors who signal its use up to Central America.

En la primera parte del artículo el autor hace un breve comentario al problema social de la coca en el Perú. Luego basado en la información obtenida de 29 referencias bibiográficas publicadas en los últimos 100 años señala datos históricos sobre el uso de la coca en América desde las anotaciones de Cristobal Colón en 1492. Las referencias del misionero dominico Tomas Ortiz en 1499. Las cartas de Américo Vespuciano en 1504 y otros autores que señalan su uso hasta Centro América. Se trata pues de un artículo muy bien documentado sobre la historia del uso de la coca en América.

Los problemas médicos y sociales generados por el abuso de drogas en el Perú / Medical and social problemas as a consequence of drug abuse in Peru

Se presentan los resultados de investigaciones recientes, hechas en el Perú, acerca del uso de drogas en la población general así como en escuelas, colegios, universidades y prisiones. Descríbense las consecuencias físicas, psicológicas y sociales del abuso de fármacos, especialmente las relacionadas con la pasta y el clorhidrato de cocaína. Finalmente se sugieren cambios estratégicos y tácticos para solucionar los múltiples problemas del consumo excesivo y tráfico ilícito de estupefacientes