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Sigmund Freud (1856-1939), Austrian neurologist and founder of PSYCHOANALYSIS, became interested in COCAINE in the early 1880s. At the time he was in his late twenties and was a medical house officer at the Vienna hospital called the Allgemeine Krankenhaus. He was able both to gain access to the literature about cocaine and, at some expense, to the substance itself (which was not illegal at that time). There had been articles in the American medical literature describing cocaine used in the treatment of various ills and for drug dependencies as almost a panacea. The ability of cocaine to fend off fatigue and enhance mood also came to Freud's attention. He was particularly taken by suggestions that cocaine might be an adjunct to, or even a cure for, ALCOHOL or OPIOID dependencies. His interest was heightened because one of his close teachers and friends, Ernst von Fleischl-Marxow, had become an opiate addict. Using cocaine, Freud treated him with almost disastrous results. At the time, there was no opprobrium attached to the use of cocaine and relatively little concern about any adverse effects.

Freud performed a number of cocaine experiments on himself and reported the results in his experimental paper, "Contribution to Knowledge of the Effects of Cocaine." These were reasonable studies that provided useful data about the physiological and psychological effects of cocaine. Biographies of Freud, such as Ernest Jones's The Life and Work of Sigmund Freud, have tended to disparage his experimental paper and other works on cocaine. Although his work was done on himself and was limited in its scope, it has been confirmed in modern replications. Freud was initially skeptical about the possible "addictive" properties of cocaine in normal individuals, but later, in the face of evidence and criticism, he was less vehement on the subject. He became, in later life, very sensitive to criticism of his earlier views on cocaine.

From 1884 to 1887 Freud wrote four papers concerning cocaine, including a definitive review ("Über Coca") in 1884. He obviously felt comfortable in both taking cocaine and writing about it in his letters. He mentions and discusses his use of and dreams about cocaine in the Interpretation of Dreams (1889). The true extent and duration of his self-experiments is not known, since access to his correspondence has been severely restricted.

Freud is sometimes credited with the discovery of local anesthesia because of his proposal in his cocaine review paper that the substance could be used for this purpose. He also claims suggesting the idea to both Koenigstein and Carl Koller prior to their experiments in ophthalmology, which led to the initial papers on local or topical anesthesia. There is a semantic problem in understanding these claims. Almost all investigators of cocaine had noticed the numbing properties of the drug when placed on the tongue. The idea that this property had a practical use in ophthalmological surgery does belong to Carl Koller, a friend and colleague of Freud's, who did the proper experiments and published them promptly. The controversy about the discovery between Koller and Koenigstein with Freud's mediation is well covered in the article by Hortense Koller Becker, "Carl Koller and Cocaine," in Psychoanalytic Quarterly.

Extreme viewpoints that attribute Freud's behavior and writings to the influence of the toxic effects of cocaine are unsubstantiated by evidence. Clearly, he used cocaine as a psychotropic agent on himself and this experience led to his faith in its relative safety. Despite this, there is no real support for a viewpoint that he was an addict or that his thought was markedly affected by his drug usage. The combined notoriety of both Freud and cocaine has led to speculative exaggerations that make better newspaper headlines than history.