Cannabis, cocaine, and heroin are not just infamous substances with a reputation for ruin—they also share a unique journey. Each started as a legal, even celebrated, tool in medicine and culture. Over time, shifting societal norms, political maneuvering, and racial prejudices changed how these substances were perceived, eventually leading to their prohibition. Yet, in a surprising twist, elements of these drugs are finding their way back into legal medicine today.
Cannabis: From Sacred Plant to “Public Enemy”
Cannabis has ancient roots, stretching back to Central Asia before spreading to Africa and the Americas. Initially valued for its hemp fibers, it also held a sacred place in spiritual practices. Hindu texts from as early as 1700 BCE praise the plant, referring to it as “bhang.” It remains a ritualistic element in Indian festivals like Holi and Shivratri.
By the 19th century, cannabis was part of Western medicine, used to treat conditions like tetanus, migraines, and delirium. However, concerns about its side effects and inconsistent dosages started to emerge. In British-colonized India, there were reports of “Indian hemp insanity,” which we now recognize as cannabis-induced psychosis. Despite these warnings, cannabis remained a popular ingredient in medicines and tonics across Europe and the United States.
Then came the backlash. Racism played a significant role in cannabis’ demonization. In the United States, the term “marihuana,” derived from Spanish, linked the drug to poor Mexican immigrants. By the 1930s, cannabis was widely banned across the U.S. and Europe. The notorious propaganda film Reefer Madness cemented the drug’s reputation as a menace.
Fast forward to today, and cannabis is making a medical comeback. Cannabidiol (CBD) and tetrahydrocannabinol (THC), active components in cannabis, are now prescribed for chronic pain, multiple sclerosis, and even cancer-related symptoms. However, the effectiveness of medicinal cannabis for various conditions is still under scrutiny. While not a miracle cure, its therapeutic potential offers relief for patients with serious illnesses.
Cocaine: A Stimulant with a Tarnished Legacy
For centuries, coca plants were chewed or brewed into tea by Andean cultures to combat fatigue and hunger. The isolated active ingredient, cocaine, was first extracted in 1860 by German scientist Albert Niemann. It was initially celebrated as a marvel—an anesthetic and a tonic. Coca-Cola famously contained cocaine in its original recipe, and Pope Leo XIII endorsed a cocaine-infused wine called Vin Mariani.
However, the drug’s addictive properties quickly became evident. It gained notoriety in entertainment and literature, with cultural icons like Sherlock Holmes fictionalizing its use. By the early 20th century, the U.S. outlawed cocaine, though it remained a favored recreational drug, notably during the 1980s yuppie era and the devastating crack epidemic in Black urban communities.
Despite its illegal status for recreational use, cocaine still serves medical purposes. Its vasoconstrictive properties make it a valuable tool in surgeries to minimize bleeding. But outside of controlled settings, its abuse continues to cause heart problems, organ damage, and even death.
Heroin: From Cough Medicine to Crisis
Heroin’s story begins with good intentions. In 1874, English chemist Charles Romley Alder Wright synthesized diamorphine, later branded by Bayer as “Heroin.” Marketed as a less addictive alternative to opium, it was included in cough medicines and pain relief products. However, the drug proved to be just as addictive as its predecessors.
Heroin soon infiltrated popular culture, gaining a foothold in jazz clubs and the beatnik movement. By the 20th century, it became synonymous with addiction and death, claiming the lives of stars like Janis Joplin and Jim Morrison.
Today, heroin faces competition from synthetic opioids like fentanyl and oxycodone, which are driving overdose crises in countries like the United States and Australia. Despite its illicit reputation, heroin derivatives are used in controlled medical settings for severe pain management, particularly in terminal illnesses.
A Common Thread: Racism, Politics, and Medicine
The trajectories of cannabis, cocaine, and heroin share striking similarities. All were celebrated for their medicinal properties before societal shifts, influenced by racism and political agendas, turned them into illegal substances.
The war on drugs disproportionately affected marginalized communities, particularly Black and Latino populations in the U.S., as laws targeted substances associated with these groups. Today’s reevaluation of these drugs for medical use represents not only scientific progress but also a chance to confront the prejudices and policies of the past.
