Coca Chewing and High-Altitude Stress: A Spurious Correlation [and Comments and Reply]

Because the main present-day centres of coca chewing are in the high altiplano regions of Peru and Bolivia, it has been widely assumed that the habit evolved primarily as a response to the stresses of life at high altitudes. When archaeological, ethnohistorical, and botanical sources of evidence are considered, a different emphasis emerges. Before the European conquest, coca was chewed everywhere from Nicaragua to Chile and at all altitudes. This pattern goes back to at least 2000 B.C. in coastal Peru and Ecuador and has considerable time-depth elsewhere. Even today, coca taking is linked not primarily with high-altitude life, but with the survival of traditional Indian culture. Apart from its role in indigenous culture, coca is everywhere regarded as a stimulant conferring resistance against hunger, thirst, and fatigue, none of which is specifically a high-altitude problem. Pharmacological data confirm that coca acts as a general stimulant by preventing the removal of the neurotransmitter noradrenaline f...