FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 332:1753-1757 June 29, 1995 Number 26 Next

	Full Text PDF Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Cocaine intoxication can lead to fatal cardiovascular and cerebrovascular events. In addition, the neurobehavioral effects of cocaine may increase the likelihood that a user will receive violent fatal injuries. Since New York City is a center for the importation and distribution of cocaine, we sought to determine the extent of cocaine use among city residents with fatal injuries.

Methods Among a total of 14,843 residents of New York City who received fatal injuries from 1990 through 1992, we determined the proportion who had used cocaine shortly before their deaths. We also determined the population-based rates of fatal injuries that were known to follow cocaine use and the proportion of all deaths of New York City residents that was represented by these cases for each demographic stratum. For people 15 to 44 years of age, fatal injury after cocaine use was ranked with other causes of death as though it was a separate cause.

Results Cocaine use, as measured by the detection of the metabolite benzoylecgonine in urine or blood, was found in 26.7 percent of all New York City residents receiving fatal injuries; free cocaine was detected in 18.3 percent. Approximately one third of deaths after cocaine use were the result of drug intoxication, but two thirds involved traumatic injuries resulting from homicides, suicides, traffic accidents, and falls. If fatal injury after cocaine use was considered as a separate cause of death, it would rank among the five leading causes of death among those 15 to 44 years of age in New York City.

Conclusions Fatal injuries among cocaine users account for a substantial proportion of all deaths among young adults in New York City.

Source Information

From the Section of Epidemiology, Department of Psychiatry (P.M.M., K.T., A.C.L., L.P., N.H., M.I.I.), and the Department of Public Health (K.T.), Cornell University Medical College, New York; and the Office of Chief Medical Examiner, City of New York, and the Department of Forensic Medicine, New York University School of Medicine, New York (C.S.H., M.S.).

Address reprint requests to Dr. Marzuk at the Department of Psychiatry, Box 147, New York Hospital–Cornell Medical Center, 525 E. 68th St., New York, NY 10021.

Full Text of this Article

This article has been cited by other articles:

• Elman, I., Chi, W. H., Gurvits, T. V., Ryan, E. T., Lasko, N. B., Lukas, S. E., Pitman, R. K. (2008). Impaired Reproduction of Three-Dimensional Objects by Cocaine-Dependent Subjects. J. Neuropsychiatry Clin. Neurosi. 20: 478-484 [Abstract] [Full Text]  
• Jaffe, J. A., Kimmel, P. L. (2006). Chronic Nephropathies of Cocaine and Heroin Abuse: A Critical Review. CJASN 1: 655-667 [Abstract] [Full Text]  
• Bargagli, A. M., Hickman, M., Davoli, M., Perucci, C. A., Schifano, P., Buster, M., Brugal, T., Vicente, J., for the COSMO European Group, (2006). Drug-related mortality and its impact on adult mortality in eight European countries. Eur J Public Health 16: 198-202 [Abstract] [Full Text]  
• Gao, Y., Brimijoin, S. (2004). An Engineered Cocaine Hydrolase Blunts and Reverses Cardiovascular Responses to Cocaine in Rats. J. Pharmacol. Exp. Ther. 310: 1046-1052 [Abstract] [Full Text]  
• Sun, H., Pang, Y.-P., Lockridge, O., Brimijoin, S. (2002). Re-engineering Butyrylcholinesterase as a Cocaine Hydrolase. Mol. Pharmacol. 62: 220-224 [Abstract] [Full Text]  
• Bartzokis, G., Goldstein, I. B., Hance, D. B., Beckson, M., Shapiro, D., Lu, P. H., Edwards, N., Mintz, J., Bridge, P. (1999). The Incidence of T2-Weighted MR Imaging Signal Abnormalities in the Brain of Cocaine-Dependent Patients Is Age-Related and Region-Specific. Am. J. Neuroradiol. 20: 1628-1635 [Abstract] [Full Text]  
• Siegel, A. J., Sholar, M. B., Mendelson, J. H., Lukas, S. E., Kaufman, M. J., Renshaw, P. F., McDonald, J. C., Lewandrowski, K. B., Apple, F. S., Stec, J. J., Lipinska, I., Tofler, G. H., Ridker, P. M. (1999). Cocaine-Induced Erythrocytosis and Increase in von Willebrand Factor: Evidence for Drug-Related Blood Doping and Prothrombotic Effects. Arch Intern Med 159: 1925-1929 [Abstract] [Full Text]  
• Xie, W., Altamirano, C. V., Bartels, C. F., Speirs, R. J., Cashman, J. R., Lockridge, O. (1999). An Improved Cocaine Hydrolase: The A328Y Mutant of Human Butyrylcholinesterase is 4-fold More Efficient. Mol. Pharmacol. 55: 83-91 [Abstract] [Full Text]  
• Schulte, J. M., Nolt, B. J., Williams, R. L., Spinks, C. L., Hellsten, J. J. (1998). Violence and Threats of Violence Experienced by Public Health Field-Workers. JAMA 280: 439-442 [Abstract] [Full Text]  
• Marzuk, P. M., Tardiff, K., Leon, A. C., Hirsch, C. S., Portera, L., Iqbal, M. I., Nock, M. K., Hartwell, N. (1998). Ambient Temperature and Mortality From Unintentional Cocaine Overdose. JAMA 279: 1795-1800 [Abstract] [Full Text]  
• Dukarm, C. P., Byrd, R. S., Auinger, P., Weitzman, M. (1996). Illicit Substance Use, Gender, and the Risk of Violent Behavior Among Adolescents. Arch Pediatr Adolesc Med 150: 797-801 [Abstract]  
• Mendelson, J. H., Mello, N. K. (1996). Management of Cocaine Abuse and Dependence. NEJM 334: 965-972 [Full Text]  
• (1995). COCAINE-RELATED FATALITIES IN NEW YORK CITY. JWatch General 1995: 7-7 [Full Text]  
• Sun, H., El Yazal, J., Lockridge, O., Schopfer, L. M., Brimijoin, S., Pang, Y.-P. (2001). Predicted Michaelis-Menten Complexes of Cocaine-Butyrylcholinesterase. ENGINEERING EFFECTIVE BUTYRYLCHOLINESTERASE MUTANTS FOR COCAINE DETOXICATION. J. Biol. Chem. 276: 9330-9336 [Abstract] [Full Text]