Shane Darke1, Sharlene Kaye, Johan Duflou. 1. National Drug and Alcohol Research Centre, University of New South Wales, NSW 2052, Australia. s.darke@unsw.edu.au
Abstract
AIM: To ascertain the demographic characteristics, circumstances of death, toxicological results, and major autopsy findings of cocaine-related fatalities. DESIGN: Inspection of the coronial records of all cocaine-related deaths that occurred in New South Wales, Australia between 1 January 1993 and 31 December 2002. SETTING: New South Wales, Australia. FINDINGS: 146 cases were identified. Cocaine was implicated in the direct cause of death in 86% of cases, an antecedent cause in 8% and a significant condition contributing to death in 7%. The mean age of decedents was 34.1 years, and 84% were male. Half were employed, and 26% were in professional employment. The predominant route of administration was injection (86%), however nasal (8%), oral (3%), smoking (1%), and anal (1%) administration were all recorded. The most common location of death was a private home (53%). No intervention occurred prior to death in 82% of cases. The median blood benzoylecgonine concentration was 0.40 mg/L (range 0.00-20.00 mg/L). Cases had a mean of 3.5 drugs, with morphine (79%) the most common co-occurring drug. In 5% of cases cocaine was the sole drug detected. Cardiac pathology was noted in 57% of cases, most commonly coronary artery atherosclerosis (39%) and cardiac hypertrophy (14%). In 15% of cases moderate to severe arterial occlusion was noted. Cerebrovascular pathology was noted in 22% of cases, most commonly cerebrovascular atherosclerosis (10%). CONCLUSIONS: Cocaine-related deaths are a significant clinical problem in New South Wales.
AIM: To ascertain the demographic characteristics, circumstances of death, toxicological results, and major autopsy findings of cocaine-related fatalities. DESIGN: Inspection of the coronial records of all cocaine-related deaths that occurred in New South Wales, Australia between 1 January 1993 and 31 December 2002. SETTING: New South Wales, Australia. FINDINGS: 146 cases were identified. Cocaine was implicated in the direct cause of death in 86% of cases, an antecedent cause in 8% and a significant condition contributing to death in 7%. The mean age of decedents was 34.1 years, and 84% were male. Half were employed, and 26% were in professional employment. The predominant route of administration was injection (86%), however nasal (8%), oral (3%), smoking (1%), and anal (1%) administration were all recorded. The most common location of death was a private home (53%). No intervention occurred prior to death in 82% of cases. The median blood benzoylecgonine concentration was 0.40 mg/L (range 0.00-20.00 mg/L). Cases had a mean of 3.5 drugs, with morphine (79%) the most common co-occurring drug. In 5% of cases cocaine was the sole drug detected. Cardiac pathology was noted in 57% of cases, most commonly coronary artery atherosclerosis (39%) and cardiac hypertrophy (14%). In 15% of cases moderate to severe arterial occlusion was noted. Cerebrovascular pathology was noted in 22% of cases, most commonly cerebrovascular atherosclerosis (10%). CONCLUSIONS:Cocaine-related deaths are a significant clinical problem in New South Wales.
Authors: Rinah T Yamamoto; Christian J Teter; Tanya L Barros; Elissa McCarthy; Crystal Mileti; Trisha Juliano; Carissa L Medeiros; Alison Looby; Melissa A Maywalt; Jane F McNeil; David Olson; Gopinath Mallya; Scott E Lukas; Perry F Renshaw; Marc J Kaufman Journal: J Addict Med Date: 2007-12 Impact factor: 3.702
Authors: Kyle T Bernstein; Angela Bucciarelli; Tinka Markham Piper; Charles Gross; Ken Tardiff; Sandro Galea Journal: BMC Public Health Date: 2007-03-09 Impact factor: 3.295