Luis A. López Chau, MD MSc, Medical Research, Clinica Llosa, Jiron Supe 222, Santa Marina, Callao, Peru, 51 1 4290585, aleph@telefonica.net.pe and Teobaldo Llosa, MD PhD, Direccion, Clinica Llosa, Los Olivos, San Isidro, Lima, Peru.

Oral routed cocaine has been used by Andes population since ancient times in a way called chacchado. (Coca chewing). This form of use is very common among the miners that work in very stressful conditions that include the majority of risk factors of work-related stress. This people uses cocaine (coca leaf) for daily-shift work and night-shift work very frequently and during years. A gram of coca leaf contains an average of 5mg of alkaloid cocaine besides other alkaloids. Our study was carried out with a sample of 30 miners, of which 20 were habitual coca users and 10 were not consumers of cocaine. The quantity in grams of coca leaf consumed per day by the chewers group where determined by means of a precision scale to obtain the amount of alkaloid consumed. Diverse biological tests were carried out to determine the presence of benzoylecgonine in urine, the effects of cocaine metabolism over the liver tissue (AST, ALT) as well as the biochemical levels that could be indicative of coronary risk (triglycerides and cholesterol). We also evaluate the Hypothalamic-Pituitary-Adrenal (HPA) axis that can be malfunctioning under chronic work-related stressors. Volunteers also were asked to complete a brief survey to evaluate their coca-leaf consumption patterns in connection with all the diagnostic approaches of substances abuse and dependence of the DSM IV TR. None of the subject consumers of oral cocaine had any of the diagnostic approaches of abuse and dependence. The results related to work-related stress they were variable.

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