A Modest Proposal to Clarify the Status of Coca in the United Nations Conventions

The implementation of anti-drug policies that focus on illicit crops in the Andean countries faces many significant obstacles, one of which is the cultural clash it generates between the main stakeholders. On the one hand one finds the governments and agencies that attempt to implement crop substitution and eradication policies and on the other the peasant and natives communities that have traditionally grown and used coca or those peasants who have found in coca an instrument of power and political leverage that they never had before. The confrontation about coca eradication, alternative development and other anti-drug policies in coca growing areas transcends drug related issues and is part of a wider and deeper confrontation that reflects the long-term unsolved conflicts of the Andean societies. All Andean countries have stratified and fragmented societies in which peasants and Indians have been excluded from power. In Bolivia, Ecuador and Peru most peasants belong to native communities many of which have remained segregated from “white” society. The mixing of the races (mestizaje) in Colombia occurred early during the Conquest and Colony. Those of Indian descent became subservient to the Spanish and Creoles. The society that evolved was (and still is) highly hierarchical, authoritarian, and has subjacent racist values. The resulting political system has been exclusionary of large portions of the population. Among Indian communities coca has been used for millennia and its use has become an identity symbol of their resistance against what may be looked at as foreign invasion. “The Andean Indian chews coca because that way he affirms his identity as son and owner of the land that yesterday the Spaniard took away and today the landowner keeps away from him. To chew coca is to be Indian...and to quietly and obstinately challenge the contemporary lords that descend from the old encomenderos and the older conquistadors” (Vidart, 1991: 61, author’s translation). In Andean literature on illegal drugs as well as in seminars, colloquia and other meetings where drug policies are debated, complaints are frequently expressed about the treatment of coca in the same category as cocaine, heroin, morphine amphetamines and other “hard” drugs. The complainants assert that “coca is not cocaine” and that it is unfair to classify coca, a nature given plant which has been used for millennia in the Andes without significant negative effects on users, in the same category as man made psychotropic drugs. They also argue that coca has manifold social and religious meanings in indigenous cultures, that coca is sacred and that the requirement of the1961 Single Convention demanding that Bolivia and Peru completely eradicate coca within 25 years is limiting Indigenous communities in their freedom to practice their religions. In most debates about drug interdiction, the views of those who oppose that approach are not accepted as legitimate. Indeed, “prohibitionists” demonize drugs and those who oppose drug policies in Latin America frequently demonize the United States as the imperialist power that imposes them. This dual polarization is a main obstacle to establish a meaningful policy debate aimed at broadening the policy consensus necessary for successful policy implementation. This essay surveys the status of coca in the United Nations Conventions, explains why it is confusing, and how a few changes would eliminate some of the sources of conflict and help organize and control licit coca markets in the Andes. The current disorganized and weakly controlled legal coca market in Peru has been analyzed to demonstrate its deficiencies and to illustrate possible improvements in international drug control policies.

The causes of illegal drug industry growth in the Andes, Anti-Drug Policies and their effectiveness

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Polimorfismos del gen Butirilcolinesterasa responsables de reacciones adversas en pacientes consumidores de “cocaína”

La butirilcolinesterasa humana (BChE; EC 3.1.1.8) es una enzima polimórfica sintetizada en el hígado y en el tejido adiposo, ampliamente distribuida en el organismo y encargada de hidrolizar algunos ésteres de colina como la procaína, ésteres alifáticos como el ácido acetilsalicílico, fármacos como la metilprednisolona, el mivacurium y la succinilcolina y drogas de uso y/o abuso como la heroína y la cocaína. Es codificada por el gen BCHE (OMIM 177400), habiéndose identificado más de 100 variantes, algunas no estudiadas plenamente, además de la forma más frecuente, llamada usual o silvestre. Diferentes polimorfismos del gen BCHE se han relacionado con la síntesis de enzimas con niveles variados de actividad catalítica. Las bases moleculares de algunas de esas variantes genéticas han sido reportadas, entre las que se encuentra las variantes Atípica (A), fluoruro-resistente del tipo 1 y 2 (F-1 y F-2), silente (S), Kalow (K), James (J) y Hammersmith (H). En este estudio, en un grupo de pacientes se aplicó el instrumento validado Lifetime Severity Index for Cocaine Use Disorder (LSI-C) para evaluar la gravedad del consumo de “cocaína” a lo largo de la vida. Además, se determinaron Polimorfismos de Nucleótido Simple (SNPs) en el gen BCHE conocidos como responsables de reacciones adversas en pacientes consumidores de “cocaína” mediante secuenciación del gen y se predijo el efecto delos SNPs sobre la función y la estructura de la proteína, mediante el uso de herramientas bio-informáticas. El instrumento LSI-C ofreció resultados en cuatro dimensiones: consumo a lo largo de la vida, consumo reciente, dependencia psicológica e intento de abandono del consumo. Los estudios de análisis molecular permitieron observar dos SNPs codificantes (cSNPs) no sinónimos en el 27.3% de la muestra, c.293A>G (p.Asp98Gly) y c.1699G>A (p.Ala567Thr), localizados en los exones 2 y 4, que corresponden, desde el punto de vista funcional, a la variante Atípica (A) [dbSNP: rs1799807] y a la variante Kalow (K) [dbSNP: rs1803274] de la enzima BChE, respectivamente. Los estudios de predicción In silico establecieron para el SNP p.Asp98Gly un carácter patogénico, mientras que para el SNP p.Ala567Thr, mostraron un comportamiento neutro. El análisis de los resultados permite proponer la existencia de una relación entre polimorfismos o variantes genéticas responsables de una baja actividad catalítica y/o baja concentración plasmática de la enzima BChE y algunas de las reacciones adversas ocurridas en pacientes consumidores de cocaína.