The interpretation of cocaine and benzoylecgonine concentrations in postmortem cases

This study examined cocaine and benzoylecgonine concentrations in 100 conse cutive deaths where either compound was identified in blood or urine specim ens to determine whether any relationship between these concentrations and cause of death can be found. Forty-seven of the 100 cases were deaths attri buted to cocaine, narcotic or combined cocaine and narcotic intoxication. T here were 13 cases of cocaine intoxication where no psychoactive substance other than ethanol was detected. The mean cocaine concentration in these de aths was 908 ng/ml; three cases had cocaine concentrations greater than 200 0 ng/ml, while the other ten cases had cocaine concentrations less than or equal to 700 ng/ml. The mean cocaine concentration in non-cocaine deaths wh ere no psychoactive substance other than ethanol was detected was 146 ng/ml . This difference was not statistically significant. However, the average b lood benzoylecgonine concentration in the 13 cocaine deaths was significant ly higher than in the 19 non-cocaine deaths. A review of combined cocaine a nd narcotic deaths suggest that the narcotic is the main causative agent in these deaths. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.