The Question (ID Number 18)...

Ishmael says "Among Leavers, crime, mental illness, suicide, and drug addiction are great rarities." What about cultures like the South American Indians who chew coca leaves constantly in order to survive the hard work of their lifestyle?

...and the response:

As virtual slaves of the Taker economy, their lifestyle is not remotely that of their original (Leaver) culture. I think it's clear from the context of his remarks that Ishmael was speaking not of culturally destroyed Leavers but of culturally intact Leavers.