FATAL INJURIES AFTER COCAINE USE AS A LEADING CAUSE OF DEATH AMONG YOUNG-ADULTS IN NEW-YORK-CITY

Background. Cocaine intoxication can lead to fatal cardiovascular and cerebrovascular events. In addition, the neurobehavioral effects of co caine may increase the likelihood that a user will receive violent fat al injuries. Since New York City is a center for the importation and d istribution of cocaine, we sought to determine the extent of cocaine u se among city residents with fatal injuries. Methods. Among a total of 14,843 residents of New York City who received fatal injuries from 19 90 through 1992, we determined the proportion who had used cocaine sho rtly before their deaths. We also determined the population-based rate s of fatal injuries that were known to follow cocaine use and the prop ortion of all deaths of New York City residents that was represented b y 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 mea sured by the detection of the metabolite benzoylecgonine in urine or b lood, was found in 26.7 percent of all New York City residents receivi ng fatal injuries; free cocaine was detected in 18.3 percent. Approxim ately one third of deaths after cocaine use were the result of drug in toxication, but two thirds involved traumatic injuries resulting from homicides, suicides, traffic accidents, and falls. If fatal injury aft er cocaine use was considered as a separate cause of death, it would r ank among the five leading causes of death among those 15 to 44 years of age in New York City. Conclusions. Fatal injuries among cocaine use rs account for a substantial proportion of all deaths among young adul ts in New York City.