Cocaine and Sigmund Freud, A Long Friendship.
- Jun 28, 2022
- 5 min read
It is worth pausing over a curious moment in the intellectual history of the late nineteenth century, when one man confidently placed himself alongside Copernicus and Darwin as the architect of a world changing humiliation. Sigmund Freud did not lack ambition. In a series of essays written around the turn of the century, he argued that humanity had suffered three successive blows to its self regard.
First, Nicolaus Copernicus demonstrated that the Earth was not the centre of the universe but a modest planet orbiting the Sun. Then Charles Darwin showed that humans were not divinely set apart from the rest of nature but descended from animals, “implying an ineradicable animal nature in him”. Finally, Freud declared, modern psychology had delivered the most painful revelation of all. Human beings were not even masters of their own minds. The ego, he wrote, “is not even master in its own house”, condemned to scraps of knowledge about unconscious forces operating beyond conscious control.
It is a grand story, and Freud told it with relish. It is also bound up with one of the more uncomfortable facts of his early career.
When Cocaine Was a Medical Marvel
At the moment Freud encountered cocaine, it was not an illicit drug but a fashionable pharmaceutical novelty. For several thousand years, coca leaves had been chewed by Indigenous communities in the Andes, valued for suppressing hunger, easing fatigue, and dulling pain at high altitudes. The leaves themselves did not travel well, however, and only in 1855 did the German chemist Friedrich Gaedcke succeed in isolating the active alkaloid.
Initially named erythroxyline, the substance was refined over subsequent decades. By the mid 1880s it had acquired the simpler name cocaine and a growing reputation as a medical cure all. Pharmaceutical companies promoted it enthusiastically, advertising its supposed effectiveness against depression, indigestion, asthma, alcoholism, and morphine addiction.
A Young Doctor Looking for a Breakthrough
Freud, then in his late twenties, was professionally restless. He had published respectable but unglamorous research, including a staining technique for nerve tissue and a speculative paper on the location of eel testes. These achievements did little to distinguish him within Vienna’s crowded medical world.
Cocaine appeared at precisely the right moment. Freud learned of the drug through the Therapeutic Gazette, a medical journal owned by the American pharmaceutical firm Parke Davis. Both Parke Davis and Merck supplied him with samples, and Parke Davis paid him 24 dollars to endorse their product. For a young academic on the margins of recognition, the opportunity was difficult to resist.
The Paper That Started It All
In April 1884, Freud obtained his first supply of cocaine from Angel’s Pharmacy in Vienna and began experimenting on himself. In letters, he described using it “against depression and against indigestion, and with the most brilliant success”. He reported heightened energy, improved concentration, and an absence of fatigue.
These experiences culminated in his paper Über Coca, published later that year. Freud described an initial “gorgeous excitement”, followed by sustained euphoria and the suppression of hunger. Cocaine, he argued, enhanced mental clarity rather than dulling it, a quality he found especially valuable.
Getting Addiction Very Wrong
What Freud failed to understand was cocaine’s capacity to create dependence. In Über Coca, he insisted that neither first nor repeated doses produced any compulsive desire for continued use. Users, he claimed, often felt a mild aversion after the effects wore off.
Elsewhere, however, Freud revealed a different reality. After three to five hours of intensive work under cocaine, he wrote, “a further dose of coca is necessary in order to ward off fatigue”. The contradiction is striking, and with hindsight, deeply revealing.
Freud was soon sending samples to friends in the medical profession, citing its potential application as a mental stimulant, a treatment for asthma, eating disorders, an aphrodisiac (you have to wonder if Freud's celebrated interest in sexual fetishism was crystallized during a blow-fuelled four-hour masturbation marathon), and, alarmingly, as a cure for morphine and alcohol addiction.
He introduced it to Ernst von Fleischl-Marxow, a physiologist friend who took morphine for the chronic pain he suffered from a thumb injury he got while dissecting a corpse. Rather than neutralizing his addiction, it added another to the pot. Fleischl-Marxow was soon spending 6,000 marks a month on his habit and was dead seven years later at age 45.
A Friend, a Cure, and a Fatal Outcome
Freud did not confine his enthusiasm to his own use. He promoted cocaine to colleagues as a treatment for a wide range of conditions, including morphine addiction. One of those persuaded was Ernst von Fleischl Marxow, a gifted physiologist suffering chronic pain after a dissection injury.
Rather than curing Fleischl Marxow’s dependence on morphine, cocaine compounded it. He developed severe addiction, experienced hallucinations, and spent vast sums sustaining his habit. He died in 1891 at the age of 45. Freud was reportedly shaken by the episode, though he never publicly acknowledged responsibility.
The One Time Cocaine Actually Worked
Amid the damage, one genuine medical success emerged. Karl Koller, an ophthalmologist and friend of Freud, realised that cocaine’s numbing properties could be used as a local anaesthetic in eye surgery. His 1884 demonstration revolutionised ophthalmology and remains cocaine’s most enduring legitimate contribution to medicine.
Koller himself did not develop a personal habit. When an unopened sample of cocaine was discovered among his papers in the Library of Congress in 1995, it appeared unused. Freud, by contrast, rarely left such opportunities untouched.
Nose Surgery and Dangerous Ideas
The culture of self experimentation surrounding cocaine also encouraged speculative excess. Wilhelm Fliess, a close friend of Freud and an ear, nose, and throat specialist, developed a theory linking the nose to the female reproductive organs. He believed that nearly any illness could be treated through nasal intervention.
Freud entertained these ideas seriously. Both men underwent nasal operations themselves. Their collaboration culminated in a disastrous attempt to treat a female patient diagnosed with hysteria, a condition then believed to originate in the uterus. The procedure nearly killed her through catastrophic bleeding.
Freud later transformed the incident into the famous “Irma” dream in The Interpretation of Dreams, subtly shifting blame and responsibility.
The Talking Cure Takes Shape
As Freud distanced himself from cocaine in the mid 1890s, he turned his attention toward developing the ideas that would define psychoanalysis. Concepts such as repression, libido, and the unconscious took shape. Patients reclined on couches and spoke freely, often for years, in what became known as the talking cure.
Critics later argued that psychoanalysis individualised distress while leaving social structures untouched, making it a discipline particularly suited to bourgeois society.
Philosophers Take Freud Apart
In the 1970s, French philosophers Gilles Deleuze and Félix Guattari offered one of the most influential critiques of Freud. They divided his career into three phases: the early explorer of desire, the theorist who confined it within the family through the Oedipus complex, and the clinician who institutionalised endless analysis.
They described Freud as “a fantastic Christopher Columbus” and “a masked Al Capone”, recognising both his originality and his disciplinary control.
What they did not emphasise was how closely early psychoanalysis resembled the structure of addiction itself: long monologues, circular thinking, and compulsive introspection, all emerging from a cocaine fuelled intellectual environment.
The Day Freud Walked Away
Freud appears to have stopped using cocaine in 1896, shortly after his father’s death. He never explained the timing, but the coincidence is suggestive. By then, cocaine’s reputation was deteriorating, and reports of addiction and psychosis were becoming increasingly difficult to ignore.
Freud rarely mentioned the drug again.
What Cocaine Left Behind
Today, psychoanalysis occupies an ambiguous position. It remains influential in literature, film, and cultural theory, yet its scientific status is widely questioned. Freud himself hoped his ideas would eventually be confirmed by neuroscience. Instead, many have been revised, absorbed, or rejected.
Freud’s cocaine use has not undone his legacy, but it has complicated it. The unconscious entered modern thought during a period of heightened stimulation, intellectual risk, and chemical assistance. That, too, is part of the story.
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