Scientific distinctions between coca and cocaine support policy reform.

Ongoing review of international drug policy should correct long-standing, misguided, and harmful conflation The coca bush, a sacred South American crop plant, is classified alongside cocaine and heroin as a Schedule I controlled substance under international law. This scheduling, and the myriad effects of prohibition, have fostered a general perception that coca and its purified alkaloid cocaine are one and the same. Yet this conflation obscures a striking contrast: Whereas cocaine’s 165-year history is marked by health risks and social disruption, the use of coca leaf has played a positive role in Andean and Amazonian societies for thousands of years. Studies across the biological and social sciences corroborate coca leaf as a benign, nonaddictive stimulant and a culturally vital plant, profoundly different from its purified derivative. The World Health Organization (WHO)’s Expert Committee on Drug Dependence (ECDD) is now reviewing the health effects of coca ( ), offering a rare opportunity to correct this misclassification and align international drug policy with scientific evidence and social reality.