We owe to Freud fundamental concepts such as the psychic unconscious, sexual repression, and the method of psychoanalysis. One thing for which he is probably less famous is his role in the recreational dissemination of cocaine. In 1884, a dangerously ambitious young Freud discovered cocaine and saw in this seemingly miraculous drug the path to fame, wealth, and recognition from his peers… but at what cost?

Young Freud

Freud was born in 1856 in Freiberg, Moravia, which is now part of the Czech Republic. From a young age, it was evident that the child would be a genius. Freud’s mother met an old woman in a pastry shop who « prophesied » that he would be one of the brightest men of his time. Freud’s mother, Amalia, returned home and told her husband, « Jacob, Jacob, our child will be a genius! » From that moment on, the parents were convinced and placed their child on a pedestal from which he would never descend.

The Freuds were a Jewish family, but more importantly, a poor family. Jacob was a textile merchant, but in the 1850s, the textile industry was in crisis due to industrialization and globalization, leaving many unemployed. Jacob decided to move to Vienna for better opportunities. At that time, Freud was only four years old.

In their new home, Freud was the only child who had his own room, where he spent long hours reading anything he could get his hands on. Young Freud, known as Sigi, was a great enthusiast of mythology and dreamed of becoming a hero. Later, he would compare his work to that of a conquistador who had discovered a new continent. He hadn’t discovered anything. Philosopher Michel Onfray summarizes it thus: he stole almost everything from others.

Here, a word of caution is necessary. Writing a biography of Freud is inevitably polarizing. There are two schools of thought: the worshipers of Freud, who see him as the Messiah of psychology, and on the other hand, those who view him as a thief, a fraud, and a perverse cocaine addict. We will come back to this.

What is certain, however, is that Freud was ambitious and brilliant. When he entered university at the age of 17, he was already fluent in French, English, German, Spanish, and Italian. Even before turning 20, he was a workaholic. Initially, Sigi had chosen the path of law, but in 1873, he made a 90-degree turn toward medicine, a field undergoing significant upheaval at the time.

The hottest medical trends of the day were neurasthenia and neurosis. Everybody was rushing the find the golden key to mental stress. The early 1880s was an unprecedented wave of interest in the human brain, mental illnesses, anatomy, and neurology. It wasn’t so much that these topics were new, but the outlook was now radically different. For the first time, entire academic communities were keen on finding rationale, and physical reasons in the real world, based on evidence. Or so they thought…Scientific methods were slowly but steadily advancing, riding on the weakening influence of a declining Church.

The biggest, most trending mental problem was neurasthenia, a generic term that encompassed almost everything that went awry in households: depression, bipolar disorder, attention disorders, panic attacks, and many more. In short, the soul’s afflictions accompany the rise of industrialization, the breakdown of families, increasing proximity among singles, and the stress of urban life.

It might not seem like it, but this marked a significant advancement in the fight against hysteria, a set of mental disorders previously believed to exclusively afflict females. Indeed, since ancient times, the term « hysteria » was used to describe women’s illnesses. It was thought that women were the only ones suffering from mental illnesses and that these issues stemmed from the uterus. To solve the problem, hysterectomy, the removal of the uterus, was practiced. Charcot, Freud’s mentor in Paris, proposed the idea that mental illnesses could affect both sexes.

Drugged on Ambition

Unfortunately, Freud was too young and too junior to make any contribution to that. He watched the medial, flourishing Vienna medical scene with impatience from the tiny little room of his hospital wing. His first job at the university is in a laboratory. At the time, Freud was busy studying the nervous system of eels, discovering great things like the genitals of eels.

For Freud, it simply wasn’t enough. He yearned for more and felt confined in his anatomical studies. At the Vienna General Hospital, he managed to secure an internship, essentially serving as a physician’s assistant. His days were long, often exceeding ten hours, supplemented by an additional two to three hours of intensive reading each evening at home. With a decade of studies already under his belt, and facing another ten years in Vienna’s bourgeois, competitive environment—a major hub for medical studies—he was determined to make something of his life.

Freud looked worn out, and to complicate matters, he was hopelessly in love with Martha, a young woman his sister had introduced to him one fine April evening in 1882. He fell for her instantly and began to court her. Unfortunately, Martha’s mother disapproved of him, which was hardly surprising. Even then, Freud was known to be rude, impolite, and mean, with frequent mood swings. It remains unclear how Martha came to reciprocate his feelings.

However, what is clear is that Martha’s mother found Freud unsuitable, deeming him too impoverished for her daughter. Despite this, the young couple became engaged but saw each other infrequently, almost not at all, for nearly six years.

Thus, Freud found himself thwarted in his professional ambitions and love life, and likely frustrated in more personal aspects as well.

For him, the answer lay in a scientific breakthrough: he needed to achieve fame through a revolutionary discovery that would not only bring him glory but also enable him to marry his beloved.

Everything changed for Freud around 1884 when he stumbled upon a document that turned his life upside down. It was written by a German doctor who had conducted an experiment on soldiers, administering a highly stimulating substance that significantly boosted morale and endurance. This substance was cocaine.

How Freud Create the First Cocaine Addictions

Freud’s encounter with cocaine marked a significant turning point in his life. In a moment of excitement, he wrote to his fiancée, enthusing about the financial prospects the drug promised, proclaiming, « With this, we can buy a house. Yes! Cocaine will make us rich! »

Indeed, 1884 was a pivotal year for Freud. On June 2nd of that year, he penned another letter to his fiancée, playfully warning her of his imminent return: « Beware, my Princess! When I come, I will kiss you until you turn all red (…) And if you show disobedience, you will see who among us is stronger: the sweet little girl who doesn’t eat enough or the spirited gentleman with cocaine in his veins. »

In the same year, Freud authored « Über Coca » (About Cocaine), a paper where he briefly mentioned cocaine’s anesthetic properties on skin and mucous membranes. Despite the brevity of the mention, Freud, young and ambitious, was convinced of its potential, predicting it « should yield many more results. » This publication significantly elevated his profile, attracting the attention of pharmaceutical giants of the time, Merck and Park Davis, who endorsed cocaine following the paper’s release.

Cocaine was relatively obscure at this point. It was only in 1857 that coca leaves were transported back in a condition suitable for serious study, and the drug itself was isolated from these leaves around 1860. During this period, pharmacists and chemists began to explore tonics made from alcohol and coca leaves, even though the full effects on the body and brain were not yet understood.

Freud, embodying the spirit of his time, embarked on self-experimentation with cocaine, driven by a profound belief in its miraculous properties. This early engagement with cocaine is a fascinating aspect for those interested in the origins of psychoanalysis, as « Über Coca » stands as Freud’s first major publication that positioned him on the global stage.

Freud ordered a gram of cocaine from a local pharmacy called Angel’s and received it during the week of April 24th. Despite his concerns about the cost of the drug (he had miscalculated the quantity, and it ended up costing him a tenth of his monthly salary), the first thing he did was to take a twentieth of a gram himself.

Cocaine: an unauthorized biography

The results were immediate: Freud felt much better about money, his research project, and life in general. He wondered if it could be useful in treating melancholy. Moreover, since it had suppressed his hunger, he thought it might be useful as a gastric anesthetic. Another promising area was the treatment of morphine addiction. If cocaine made people happy and eased their pains, perhaps they finally had something to combat morphine addiction?

The first cocaine addict?

It was the era of artificial paradises. All major European artists struggled with one addiction or another. Toulouse-Lautrec, the painter of Moulin Rouge posters, was under the influence of absinthe, a wormwood-based liqueur nicknamed the Green Fairy, popular among French soldiers traumatized by the war and returning from Algeria.

However, the worst was opium. Long before the fentanyl crisis, Europe experienced its first opioid crisis—a true epidemic. Opium became popular in Europe under the British Empire, which waged war against China to force it to buy opium. Chinese immigrants, who arrived in the United States en masse through California, brought opium with them. In Europe, the elite and the bourgeoisie quickly adopted the poppy nectar for recreational purposes.

Freud began recommending this drug to all his acquaintances, unaware that he was becoming a public danger. One of Freud’s colleagues took a keen interest in it. His name was Carl Koller. He was an ophthalmologist. But the researcher had a problem: he ran out of anesthetics. He had to operate on patients with their eyes wide open, strapped to the operating table with leather straps.

This was complicated because he had to numb the pain while keeping the patient conscious, instructing them to move their eyes during the operation. So, Freud showed the article to Koller, who promptly tested it on a patient’s eye, and it was a revelation. Unknowingly, Freud had solved one of the most significant problems in modern medicine: a reliable anesthetic.

When Brettauer read the article and demonstrated the anesthetic properties of cocaine at the congress on September 15, 1884, the result was stunned silence: Koller, a 27-year-old Viennese intern, had solved one of the most important problems in medicine. When Freud returned from Wandsbek, his friend had become an international celebrity. Freud was furious, but he knew it was his fault. How could he, who knew cocaine and anatomy so well, not see the anesthetic potential of the miracle drug?

The Fleischl-Marxow Incident: A Cure that Kills

While working at a Vienna hospital, Freud became friends with a young researcher named Ernst von Fleischl-Marxow. Ernst and Freud had much in common: they were both hardworking individuals with remarkable intelligence.

But Fleisch had a problem: he suffered every day from a thumb deformity that made his life a living hell. At the time, amputations were much less effective and far less hygienic. The amputation of his thumb had led to the constant regrowth of a cluster of nerves, causing Fleisch excruciating pain that kept him from sleeping. It was the researcher’s stoicism, Freud wrote in his correspondence, that drew him to Fleisch.

Freud, who had just discovered cocaine, thought: this could help my poor friend. Two weeks later, Von Fleischl believed he was cured. Freud proudly announced to his colleagues that cocaine had healed his friend. Yet, nothing could be further from the truth. Fleischl-Marxhov felt better for a while, but he started getting used to it and became a cocaine addict himself. Worse, he combined morphine and cocaine to prolong the euphoria.

After a few days of radio silence, Freud found the brilliant researcher collapsed upon himself in a semi-comatose state. The relapse was even worse than what Freud had previously treated. Fleischl returned to morphine, sinking into melancholy and oblivion. His best years were now behind him, and he took his own life six years later.

Freud somewhat ambiguously defended himself by saying that the problem was that his friend was taking cocaine orally, whereas cocaine injection is perfectly safe! But that’s a lie. We know, thanks to the publication of « Über Coca, » that Freud advocated for the hypodermic syringe, then a novel method.

The Nasal Reflex Necrosis and Its Solution: Cocaine

Freud meets Fliess in 1887 and forms a deep and tender friendship that will last until 1904, when the relationship definitively sours. As with almost all his mentors and colleagues, Freud goes from a honeymoon phase to declaring war. He himself acknowledges that he ends up turning every friend into an enemy.

Both Jewish, roughly the same age, and driven by ambition, they form a friendship, even a bromance, that reaches epic proportions in the 1890s. In his correspondence with Fliess, Freud literally flirts through his dear friend (at that time, Freud had suspended his physical relationship with Martha). For a while, the two men sport the same beard, haircut, and clothes of the same color, all to give the impression that they are twins.

Both of them explored unconventional research methods while consuming unimaginable amounts of cocaine. At that time, Freud had numerous theories that he would later disown. But Fliess also had wild ideas. When they met at conferences, in the euphoria of the white powder, they theorized about the most bizarre things, wholeheartedly believing in what ultimately were nothing more than hallucinations fueled by coca leaves.

One of Fliess’s theories was the « nasal reflex necrosis. » Fliess was convinced that the secret to all mental and physical problems lay in the nose. He also believed that the nose was directly connected to the genital organs, in a sort of nasogenital connection. Thus, the nose was also the key to sexual, mental, and neurological issues!

Freud was completely taken in and, probably under the influence of cocaine, supported his symbolic twin.

To explain what happened next, three things must be remembered: at this point, no one knew the real effects of cocaine, all doctors were full of bad ideas that cost thousands of lives each year, and Freud was completely dependent on cocaine. On June 12, 1895, he wrote to Fliess plainly stating, « I need a lot of cocaine. »

The stage was finally set for the worst mishap of his career. Freud was entrusted with a patient, Emma Eckstein, suffering from a multitude of problems ranging from chest pains to depression. Freud quickly diagnosed hysteria and excessive masturbation. He brought Fliess from Berlin for a nose operation. Fliess, confident after performing dozens of nasal surgeries, removed a piece of the young woman’s nose and cauterized the wound with cocaine. He took the opportunity to do the same for Freud.

For a few days, everything seemed fine for the young woman, and then suddenly, there was a hemorrhage. Emma started bleeding profusely, turning pale. It was too late to summon back Fliess, who had already left. Horrified, Freud asked another doctor to intervene urgently. He began digging into the dying woman’s nose and pulled out a medical dressing soaked in iodine several meters long that Fliess had forgotten in her nose! Unable to witness the scene, Freud fetched a glass of cognac while the unconscious woman finally began to stop bleeding. Irreparably disfigured, she would live half-paralyzed for the rest of her life.

Was Freud Really a Cocaine Addict?

Two schools of thought clash on this subject. Freud’s supporters, especially in France, historically downplay the role of cocaine, considering it at best as a youthful experiment during his formative years.

On the other hand, those more skeptical of the Freudian approach draw a direct connection between Freud’s excessive and impulsive habits and his regular consumption of cocaine between 1884 and 1896. It’s not precisely known when Freud ended his relationship with the drug, but it’s documented that his enthusiasm for the white powder waned in the early 1900s due to significant health complications that eventually cost him his life.

Medical historian Howard Markel asserts that by 1895, Freud was consuming enough cocaine to experience chest pains and his nasal passages were so clogged that he had to undergo surgery to open them up for breathing. This could explain Freud’s love-hate relationships with his friends and his sudden changes of ideas. As is often the case with cocaine addicts, he had a grandiose temperament.

In an essay that is both historical and controversial, David Cohen explores the shadows and vulnerabilities of Freud’s character, which he believes make him a perfect candidate for addiction: depressive, obsessive, sexually repressed, and unhappy.

Death by Morphine

The combination of tobacco and cocaine proved fatal for Freud. Smoking over 20 cigarettes a day, the psychoanalyst eventually developed mouth cancer in 1923. He was 67 years old, and his life was about to become a living hell.

In total, Freud underwent more than 30 jaw surgeries. To restore his mouth ravaged by the disease, he was fitted with a kind of metal prosthesis, which he affectionately called « the Monster. »

The combined consumption of cocaine and nicotine proved deadly. By snorting cocaine, Freud spent ten years needlessly constricting the blood vessels in his nose, leading to the formation of hard plaques of mucous membrane narrowing his nasal passages.

Around 1900, the addictive properties of cocaine became widely known, leading various governments to begin restricting and eventually banning its use outside of rare medical purposes (cocaine is still used as an anesthetic in otolaryngology).

In 1912, American pharmacists called for restrictions on the sale of cocaine, and the substance was prohibited by the Harrison Narcotics Act in 1914. France, in turn, criminalized cocaine in 1916.

Bibliography

• The cocaine papers, Anna Freud
• “Cocaine: An Unauthorized Biography” par Dominic Streatfeild (2003)
• “White Gold: The Extraordinary Story of Thomas Lipton and His Revolutionizing of Tea” par Giles Milton (2005)
• “Snowblind: A Brief Career in the Cocaine Trade” par Robert Sabbag (1976)
• “Cocaine: Global Histories” édité par Paul Gootenberg (1999)
• “An Anatomy of Addiction” Sigmund Freud, William Halsted, and the Miracle Drug Cocaine, par Howard Markel, 2000
• “Between Coca and Cocaine: A Century or More of U.S.-Peruvian Drug Paradoxes, 1860-1980” par Paul Gootenberg, 2001, The Woodrow Wilson Center
• “Sigmund Freud en son temps et dans le nôtre“. par Élizabeth Roudinesco (2014)
• “History of Coca: “The Divine Plant” of the Incas” par W Golden Mortimer (1901) J H Vail & Company
• “Riches from Potosi: The Silver of the Spanish Main” par Kris Lane (2021)
• “Freud, le moment venu”, Suzanne Leclair et William Roy (2023)
• N. Balier, « Freud et la cocaïne : du mythe à la réalité, » Revue Française de Psychanalyse, 66(2), 371-378, 2002.
• « Freud and His Biggest Addiction, » Psych Central
• G. Vighetto, F. Robert, and P. Kabengele, « Freud and Cocaine: A Fatal Attraction, » Front Psychiatry, 7, 61, 2016. Lien vers l’article

Pierre-Olivier Bussieres is the author of the podcast Le Temps d’une Bière, producer of Hoppy History and editor-in-chief of Le Temps d’une Bière media. He holds a graduate degree in political science from Carleton University.