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Ashoka Fellow since 2000   |   Bolivia

Jorge Hurtado Gumucio

Museo de la Coca
Dr. Jorge Hurtado is testing the effectiveness of and establishing credibility for the use of the coca leaf to treat cocaine addiction. Through scientific research and by advocating for changes in…
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This description of Jorge Hurtado Gumucio's work was prepared when Jorge Hurtado Gumucio was elected to the Ashoka Fellowship in 2000.

Introduction

Dr. Jorge Hurtado is testing the effectiveness of and establishing credibility for the use of the coca leaf to treat cocaine addiction. Through scientific research and by advocating for changes in international laws, he is promoting a more effective alternative to traditional hospital treatment.

The New Idea

A psychiatrist by profession, Jorge Hurtado is systematically promoting the use of coca leaves as a means to diminish cocaine addiction. The coca plant is the only known effective substitute for cocaine that does not harm the patient. The main components of his plan involve research to fine-tune dosage levels, advocacy work to demystify and legalize the use of coca internationally, and a treatment program for institutionalized Bolivian addicts in La Paz. Jorge is also highly involved in determining psychological methods that help predict and measure patients' rehabilitation progress.

The Problem

Cocaine is a drug that was discovered by Western science more than a century ago. Its early use as an anesthetic was eventually surpassed by its other use as stimulant. As a result of its addictive nature and abuse as a recreational drug, cocaine was declared illegal by the 1961 Geneva Convention, which set forth international laws to regulate the production and importation of coca and its derivatives worldwide. However, these laws have been a greater detriment than aid as narcotic cocaine remains available through various clandestine and illegal channels while medical and homeopathic coca are practically inaccessible in Europe and North America. The number of people suffering from cocaine addiction is unknown, although some experts estimate that dependency afflicts millions of people around the world. In 1993, the American National Survey on Drug Abuse estimated that 4.3 million people in the United States alone consumed cocaine in 1992, with more than thirty thousand people admitted to hospital emergency rooms for overdose every three months. Perhaps a more accurate barometer of the enormity of cocaine consumption is the $1.7 billion recently allocated by the U.S. Congress to combat drug trafficking in Colombia. Studies show that although relatively low, cocaine consumption is steadily rising in Bolivia, increasing from an estimated 0.2 percent of the population in 1992 to 2.6 percent in 1996. In 1998, Bolivian narcotic agents seized ten tons of cocaine, while an estimated one hundred ten tons were sold on the street. The effects of drug use are especially damaging in countries like Bolivia, where the drug is produced and sold cheaply and hospitals are ill-equipped to handle addiction cases.

The Strategy

The coca leaf has been chewed by people in Bolivia, Peru, Colombia, Ecuador, Northern Argentina and Chile as a homeopathic remedy for nearly five thousand years without posing health hazards. Coca was used as the first local anesthetic by the Inca civilization centuries ago and is used today by miners and textile artisans as a mild stimulant to improve alertness and attention to detail. Unlike processed coca made into narcotic cocaine, coca leaves demonstrate no addictive qualities, pose no social or health threat, and are rich in nutrients. Jorge's project is unique in the annals of medical treatment for cocaine addiction, although institutions in other countries, including Holland and France, have begun to experiment with and replicate his methods. Past treatments have focused primarily on the use of tranquilizers, anti-depressants, rehabilitation units, or expensive psychological treatment to convince the user to abandon consumption. Coca leaves are not only inexpensive and easy to grow, but the technique of chewing the herb as a means to treat dependency allows patients to move freely about society without incurring the incidental cost of hospitalization and social marginalization.Jorge concentrates on research, treatment, and advocacy for legalization of medicinal coca. His research is primarily directed at standardizing dosages for the production of coca tablets, whose distribution and effectiveness are easy to track and manage. Jorge's program for treatment is based at the Center for Treatment of Drug Addiction in La Paz, from which he can treat up to fifty new patients each year. He also established a Coca Museum to educate the public about the dangers of cocaine and its distinction from ordinary coca, recount the history of the coca plant, and provide addicts with an informal setting to seek help. Jorge's unique treatment begins with psychiatric and medical exams to determine if other sicknesses explain or aggravate dependency. Each patient is required to commit to treatment before being initiated in the program. The patient undergoes a series of medical interviews after learning, practicing, and mastering the technique of chewing coca leaf. Jorge regularly evaluates the patient's progress, utilizing a new set of standards that he created and that have already been accepted in international drug rehabilitation circles, based not on the number of relapses but on the patient's mental state and level of social adaptation, both of which are determined through psychological evaluation. Jorge's patients typically reintegrate into society, work, school, and family with a mental equilibrium aligned with a healthy, low-risk lifestyle. The final and most important step in implementation of his rehabilitation method is the demystification of the coca leaf and the dissolution of current legal barriers to its export. In addition to the Center for Treatment of Drug Addiction and the Coca Museum, Jorge also founded the Andean Action think tank, the International Harm Reduction Association, and the International Coca Research Institute to provide scientific evidence and mobilize popular support for the use of coca in the treatment of cocaine addiction. He is currently heading legal action before the International Court of Human Rights in Geneva in defense of coca's use in Andean cultures. Though he hasn't yet successfully altered narcotics laws in the United States and Europe, where cocaine is most commonly abused and poses the greatest public health threat, several Brazilian and Andean regulations have been lifted to allow the limited use of coca for treatment purposes.

The Person

Dr. Jorge Hurtado was born in Oruro, Bolivia, where he first began experimenting with chemistry after visits to his father's medical office. He observed alcohol abuse in the streets around his home at night and learned that miners chewed coca leaves to suppress narcotic dependency and focus on hard work and safety during the day. Jorge studied medicine at San Andres University in La Paz, where he was introduced in a pharmaceuticals class to various forms of anesthetics, including coca. He further experimented with coca as a therapeutic tool during his training as a psychiatrist at Bolivia's Hospital Psiquiátrico Caja Nacional de Salud, where he also studied the legality of coca in a social psychology class. Finally, while directing a project in Yungas and Chapare, two coca-growing regions in Bolivia, his idea to use coca as a method of treatment for cocaine dependency became concrete. Most of the cocaine users Jorge saw worked in the illegal cocaine trade and were not familiar with coca in its unprocessed, legal form. As a result of his progressive and effective work, Jorge has been invited to a number of prestigious international conferences devoted to finding solutions to the drug epidemic, notably the New York Academy of Medicine, the World Congress of Psychiatry in Madrid, and the Drug and Development Conference in Brussels. He is also former Secretary General of the Bolivian Psychiatry Society and founder and former director of the Bolivian Psychotherapy Society.

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