ISSN: 0022-1198
CODEN: JFSCA
Page Count: 7

Fatal Excited Delirium Following Cocaine Use: Epidemiologic Findings Provide New Evidence for Mechanisms of Cocaine Toxicity
Ruttenber, AJ
Associate professor, senior research assistant, and professional research assistant, The University of Colorado School of Medicine, Department of Preventive Medicine and Biometrics, CO

Wetli, CV
Chief medical examiner, Office of the Chief Medical Examiner, Suffolk County,

Mash, DC
Associate professor, The University of Miami School of Medicine, Department of Neurology,

Lawler-Heavner, J
Associate professor, senior research assistant, and professional research assistant, The University of Colorado School of Medicine, Department of Preventive Medicine and Biometrics, CO

Yin, M
Associate professor, senior research assistant, and professional research assistant, The University of Colorado School of Medicine, Department of Preventive Medicine and Biometrics, CO

Hearn, WL
Forensic Laboratory Director, The Metropolitan Dade County Medical Examiner Department,

(Received 28 March 1996; accepted 23 July 1996)

Abstract

We describe an outbreak of deaths from cocaine-induced excited delirium (EDDs) in Dade County, Florida between 1979 and 1990. From a registry of all cocaine-related deaths in Dade County, Florida, 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.

Keywords:
forensic science, cocaine, crack, excited delirium, neuroleptic malignant syndrome, rhabdomyolysis, epidemiology

Paper ID: JFS14064J
DOI: 10.1520/JFS14064J
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