Cocaine-related fatalities in New South Wales, Australia 1993-2002.
OBJECTIVE
To ascertain the demographic characteristics, circumstances of death, toxicological results, and major autopsy findings of cocaine-related fatalities.


METHODS
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.


METHODS
New South Wales, Australia.


RESULTS
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.
Darke
Shane
S
National Drug and Alcohol Research Centre, University of New South Wales, NSW 2052, Australia. s.darke@unsw.edu.au
Kaye
Sharlene
S
Duflou
Johan
J
D000293:Adolescent; D000328:Adult; D003042:Cocaine / Q000031:analogs & derivatives* / Q000097:blood; D019970:Cocaine-Related Disorders / Q000097:blood / Q000401:mortality*; D003644:Death Certificates; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology
C005618:benzoylecgonine; D003042:Cocaine