Fatal Excited Delirium Following Cocaine Use: Epidemiologic Findings Provide New Evidence for Mechanisms of Cocaine Toxicity

• NCJ Number: 238232
• Journal: Journal of Forensic Sciences Volume: 42 Issue: 1 Dated: January 1997 Pages: 25-31
• Author(s): A. James Ruttenber M.D., Ph.D.; Janet Lawler-Heavner M.S.P.H.; Ming Yin M.S.; Charles V. Wetli M.D.; W. Lee Hearn Ph.D.; Deborah C. Mash Ph.D.
• Date Published: January 1997
• Length: 7 pages
• Grant Number(s): DA 06227
• Sponsoring Agency: National Institute on Drug Abuse
• Publication Format: Article
• Publication Type: Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

This study described an outbreak of deaths from cocaine-induced excited delirium (EDDs) in Dade County, FL between 1979 and 1990.

Abstract

From a registry of all cocaine-related deaths in Dade County, FL, from 1969-1990, 58 EDDs were compared with 125 victims of accidental cocaine overdose without excited delirium. Compared with controls, EDDs were more frequently Black, male, and younger. They were less likely to have a low body mass index, and more likely to have died in police custody, to have received medical treatment immediately before death, to have survived for a longer period, to have developed hyperthermia, and to have died in summer months. EDDs had concentrations of cocaine and benzoylecgonine in autopsy blood that were similar to those for controls. The epidemiologic findings are most consistent with the hypothesis that chronic cocaine use disrupts dopaminergic function and, when coupled with recent cocaine use, may precipitate agitation, delirium, aberrant thermoregulation, rhabdomyolysis, and sudden death. (Published Abstract)