Cocaine in Wayne County Medical Examiner's cases.

We determined the incidence of detection of cocaine or its metabolites in Wayne County (Michigan) Medical Examiner's cases from 1984 to 1987. Over this four-year period there was a significant (P less than 0.01) increase each year in evidence of recent cocaine use in this population, reaching 38.3% of all tested cases in 1987. Much of this increase was accounted for by homicide victims, especially those in their third or fourth decade of life, of whom 58.6 and 56.3%, respectively, tested positive in 1987. There was a large increase in recent cocaine use in teenage homicide victims in 1987, having previously changed little from 1984 to 1986. In victims of drug abuse, recent cocaine use also increased significantly (p less than 0.01) each year, reaching 47.6% in 1987, generally in combination with heroin. Although deaths attributed solely to cocaine were not as common, they also increased significantly each year from 4 in 1984 to 25 in 1987. Compared with the general population, those who use cocaine in Wayne County are more likely than those who do not to die prematurely, often as a result of violence.