ANALYSIS OF COCAINE CHRONOTOXICOLOGY IN AN URBAN ED

To describe the chronotoxicology of cocaine and its potential impact o n emergency department (ED) staffing and services, Drug Abuse Warning Network (DAWN) data from a single urban university ED were retrospecti vely reviewed. The DAWN data reviewed spanned an Ii-year period (1/1/8 3 through 12/31/93), and 3,762 patients were enrolled. Patients were i ncluded if the ED records included documentation of recent cocaine abu se prior to presentation to the ED. Of the 3,762 study patients, 1,609 (43%) had documentation of recent cocaine use: 506 (32%) had used coc aine alone, 614 (38%) had used cocaine and ethanol in combination, and 489 (30%) had used cocaine in combination with other drugs. For all p atients using cocaine, there were two significant rhythms (P <.05) ide ntified: a circadian rhythm that peaked at 1800 and a 12-hour rhythm t hat peaked at approximately noon and midnight. A significant rhythmici ty was found among cocaine-using patients who presented during the stu dy period. increased or shift-adjusted staffing focusing specifically on psychosocial services, detoxification, and security during these pe ak hours may provide more efficient emergent care for this subpopulati on of patients. (Am J Emerg Med 1998;16:568-571. Copyright (C) 1998 by W.B. Saunders Company).