Fatal excited delirium following cocaine use: Epidemiologic findings provide new evidence for mechanisms of cocaine toxicity

A. James Ruttenber, Janet Lawler-Heavner, Ming Yin, Charles V. Wetli, W. Lee Hearn, Deborah C. Mash

Research output: Contribution to journalArticle

99 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)25-31
Number of pages7
JournalJournal of Forensic Sciences
Volume42
Issue number1
DOIs
StatePublished - Jan 1997

Keywords

  • cocaine
  • crack
  • epidemiology
  • excited delirium
  • forensic science
  • neuroleptic malignant syndrome
  • rhabdomyolysis

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Law

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