Skip to main content
SpringerLink
Log in

The Role of Illicit Drug Use in Sudden In-Custody Death

  • Chapter
Sudden Deaths in Custody

Part of the book series: Forensic Science and Medicine ((FSM))

Abstract

A substantial portion of all the deaths reviewed by medical examiners and coroners relates to the use of cocaine and other illicit drugs (1). Not surprisingly, because of the illegality of these substances, many of these individuals die while in the custody of law enforcement. In fact, forensic pathologists have often divided these drug-related custody deaths into four different categories: (a) death during arrest and transport or soon thereafter; (b) death within 12 hours of arrest: (c) death after 12 hours, but within a few days to weeks; and (d) death after days to weeks of incarceration (2). Death within 12 hours of arrest is commonly associated with massive drug overdose, such as can occur with smugglers who conceal drugs within body cavities, an act that is known as “body packing.” Deaths that occur days to weeks or longer after incarceration can be associated with drug withdrawal or other natural causes related to drug use (2).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Stephens BG, Jentzen JM, Karch S, Wetli CV, Mash DC. National Association of Medical Examiners position paper on the certification of cocaine-related deaths. Am J Forensic Med Pathol 2004;25:11–13.

    Article  PubMed  Google Scholar 

  2. Karch SB, Stephens BG. Drug abusers who die during arrest or in custody. J R Soc Med 1999;92(3):110–113.

    PubMed  CAS  Google Scholar 

  3. Wetli CV, Fishbain DA. Cocaine-induced psychosis and sudden death in recreational cocaine users. J Forensic Sci 1985;30(3):873–880.

    PubMed  CAS  Google Scholar 

  4. Stratton SJ, Rogers C, Brickett K, Gruzinski G. Factors associated with sudden death of individuals requiring restraint for excited delirium. Am J Emerg Med 2001;19(3):187–191.

    Article  PubMed  CAS  Google Scholar 

  5. Stratton SJ, Rogers C, Green K. Sudden death in individuals in hobble restraints during paramedic transport. Ann Emerg Med 1995;25(5):710–712.

    Article  PubMed  CAS  Google Scholar 

  6. Ross DL. Factors associated with excited delirium deaths in police custody. Mod Pathol 1998;(11):1127–1133.

    PubMed  CAS  Google Scholar 

  7. Mercy JA, Heath CW Jr, Rosenberg ML. Mortality associated with the use of upper-body control holds by police. Violence Vict 1990;5(3):215–222.

    PubMed  CAS  Google Scholar 

  8. Reay DT, Fligner CL, Stilwell AD, Arnold J. Positional asphyxia during law enforcement transport. Am J Forensic Med Pathol 1992;13(2):90–97.

    PubMed  CAS  Google Scholar 

  9. Ruttenber AJ, Lawler-Heavner J, Yin M, Wetli CV, Hearn WL, Mash DC. Fatal excited delirium following cocaine use: epidemiologic findings provide new evidence for mechanisms of cocaine toxicity. J Forensic Sci 42(1):25–31.

    Google Scholar 

  10. Kornblum RN, Reddy SK. Effects of the Taser in fatalities involving police confrontation. J Forensic Sci 1991;36(2):434–438.

    PubMed  CAS  Google Scholar 

  11. O’Halloran RL, Lewman LV. Restraint asphyxiation in excited delirium. Am J Forensic Med Pathol 1993;14(4):289–295.

    PubMed  CAS  Google Scholar 

  12. O’Halloran RL, Frank JG. Asphyxial death during prone restraint revisited: a report of 21 cases. Am J Forensic Med Pathol 2000;21(1):39–52.

    Article  PubMed  CAS  Google Scholar 

  13. Mirchandani HG, Rorke LB, Sekula-Perlman A, Hood IC. Cocaine-induced agitated delirium, forceful struggle, and minor head injury. A further definition of sudden death during restraint. Am J Forensic Med Pathol 1994;15(2):95–99.

    PubMed  CAS  Google Scholar 

  14. Pollanen MS, Chiasson DA, Cairns JT, Young JG. Unexpected death related to restraint for excited delirium: a retrospective study of deaths in police custody and in the community. CMAJ 1998;158(12):1603–1607.

    PubMed  CAS  Google Scholar 

  15. Hick JL, Smith SW, Lynch MT. Metabolic acidosis in restraint-associated cardiac arrest: a case series. Acad Emerg Med 1999;6(3):239–243.

    PubMed  CAS  Google Scholar 

  16. Park KS, Korn CS, Henderson SO. Agitated delirium and sudden death: two case reports. Prehosp Emerg Care 2001;5(2):214–216.

    Article  PubMed  CAS  Google Scholar 

  17. Andrews P. Cocaethylene toxicity. J Addict Dis 1997;16(3):75–84.

    PubMed  CAS  Google Scholar 

  18. Hearn WL, Rose S, Wagner J, Ciarleglio A, Mash DC. Cocaethylene is more potent than cocaine in mediating lethality. Pharmacol Biochem Behav 1991;39(2):531–533.

    Article  PubMed  CAS  Google Scholar 

  19. Pudiak CM, Bozarth MA. Cocaine fatalities increased by restraint stress. Life Sci 1994;55(19):PL379–382.

    Article  PubMed  CAS  Google Scholar 

  20. Blaho K, Logan B, Winbery S, Park L, Schwilke E. Blood cocaine and metabolite concentrations, clinical findings, and outcome of patients presenting to an ED. Am J Emerg Med 2000;18(5):593–598.

    Article  PubMed  CAS  Google Scholar 

  21. Wetli CV. Fatal cocaine intoxication. A review. Am J Forensic Med Pathol 1987;8(1):1–2.

    PubMed  CAS  Google Scholar 

  22. Karch SB. Interpretation of blood cocaine and metabolite concentrations. Am J Emerg Med 2000;18(5):635–636.

    Article  PubMed  CAS  Google Scholar 

  23. Davis AM, Natelson BH. Brain-heart interactions. The neurocardiology of arrhythmia and sudden cardiac death. Tex Heart Inst J 1993;20(3):158–169.

    PubMed  CAS  Google Scholar 

  24. Pavin D, Le Breton H, Daubert C. Human stress cardiomyopathy mimicking acute myocardial syndrome. Heart 1997;78(5):509–511.

    PubMed  CAS  Google Scholar 

  25. Wittstein IS, Thiemann DR, Lima JA, et al. Neurohumoral features of myocardial stunning due to sudden emotional stress. N Engl J Med 2005;352(6):539–548.

    Article  PubMed  CAS  Google Scholar 

  26. Wilkenfeld C, Cohen M, Lansman SL, et al. Heart transplantation for end-stage cardiomyopathy caused by an occult pheochromocytoma. J Heart Lung Transplant 1992;11(2 Pt 1):363–366.

    PubMed  CAS  Google Scholar 

  27. Neil-Dwyer G, Walter P, Cruickshank JM, Doshi B, O’Gorman P. Effect of propranolol and phentolamine on myocardial necrosis after subarachnoid haemorrhage. Br Med J 1978;2(6143):990–992.

    PubMed  CAS  Google Scholar 

  28. Drislane FW, Samuels MA, Kozakewich H, Schoen FJ, Strunk RC. Myocardial contraction band lesions in patients with fatal asthma: possible neurocardiologic mechanisms. Am Rev Respir Dis 1987;135(2):498–501.

    PubMed  CAS  Google Scholar 

  29. Cebelin MS, Hirsch CS. Human stress cardiomyopathy. Myocardial lesions in victims of homicidal assaults without internal injuries. Hum Pathol 1980;11(2):123–132.

    Article  PubMed  CAS  Google Scholar 

  30. Tazelaar HD, Karch SB, Stephens BG, Billingham ME. Cocaine and the heart. Hum Pathol 1987;18(2):195–199.

    Article  PubMed  CAS  Google Scholar 

  31. Mets B, Jamdar S, Landry D. The role of catecholamines in cocaine toxicity: a model for cocaine “sudden death”. Life Sci 1996;59(24):2021–2031

    Article  PubMed  CAS  Google Scholar 

  32. Vitullo JC, Karam R, Mekhail N, Wicker P, Engelmann GL, Khairallah PA. Cocaine-induced small vessel spasm in isolated rat hearts. Am J Pathol 1989;135(1):85–91.

    PubMed  CAS  Google Scholar 

  33. Lange RA, Cigarroa RG, Yancy CW Jr, et al. Cocaine-induced coronary-artery vasoconstriction. N Engl J Med 1989;321(23):1557–1562.

    Article  PubMed  CAS  Google Scholar 

  34. Flores ED, Lange RA, Cigarroa RG, Hillis LD. Effect of cocaine on coronary artery dimensions in atherosclerotic coronary artery disease: enhanced vasoconstriction at sites of significant stenoses. J Am Coll Cardiol 1990;16(1):74–79.

    Article  PubMed  CAS  Google Scholar 

  35. Benzaquen BS, Cohen V, Eisenberg MJ. Effects of cocaine on the coronary arteries. Am Heart J 2001;142(3):402–410.

    Article  PubMed  CAS  Google Scholar 

  36. Wijetunga M, Seto T, Lindsay J, Schatz I. Crystal methamphetamine-associated cardiomyopathy: tip of the iceberg? J Toxicol Clin Toxicol 2003;41(7):981–986.

    Article  PubMed  CAS  Google Scholar 

  37. Wiener RS, Lockhart JT, Schwartz RG. Dilated cardiomyopathy and cocaine abuse. Report of two cases. Am J Med 1986;81(4):699–701.

    Article  PubMed  CAS  Google Scholar 

  38. Przywara DA, Dambach GE. Direct actions of cocaine on cardiac cellular electrical activity. Circ Res 1989;65(1):185–192.

    PubMed  CAS  Google Scholar 

  39. Xu YQ, Crumb WJ Jr, Clarkson CW. Cocaethylene, a metabolite of cocaine and ethanol, is a potent blocker of cardiac sodium channels. J Pharmacol Exp Ther 1994;271(1):319–325.

    PubMed  CAS  Google Scholar 

  40. Kabas JS, Blanchard SM, Matsuyama Y, et al. Cocaine-mediated impairment of cardiac conduction in the dog: a potential mechanism for sudden death after cocaine. J Pharmacol Exp Ther 1990;252(1):185–191.

    PubMed  CAS  Google Scholar 

  41. Bauman JL, Grawe JJ, Winecoff AP, Hariman RJ. Cocaine-related sudden cardiac death: a hypothesis correlating basic science and clinical observations. J Clin Pharmacol 1994;34(9):902–911.

    PubMed  CAS  Google Scholar 

  42. Bozzuto TM. Severe metabolic acidosis secondary to exertional hyperlactemia. Am J Emerg Med 1990;8(4):369–370

    Article  Google Scholar 

  43. Sejersted OM, Medbo JI, Hermansen L. Metabolic acidosis and changes in water and electrolyte balance after maximal exercise. Ciba Found Symp 1982;87:153–167.

    PubMed  CAS  Google Scholar 

  44. Conlee RK, Kelly KP, Ojuka EO, Hammer RL. Cocaine and exercise: alpha-1 receptor blockade does not alter muscle glycogenolysis or blood lactacidosis. J Appl Physiol 2000;88(1):77–81.

    PubMed  CAS  Google Scholar 

  45. Bethke RA, Gratton M, Watson WA. Severe hyperlactemia and metabolic acidosis following cocaine use and exertion. Am J Emerg Med 8(4):369–370

    Google Scholar 

  46. Crumb WJ Jr, Clarkson CW. The pH dependence of cocaine interaction with cardiac sodium channels. J Pharmacol Exp Ther 1995;274(3):1228–1237.

    PubMed  CAS  Google Scholar 

  47. Leon-Velarde F, Huicho L, Monge C. Effects of cocaine on oxygen consumption and mitochondrial respiration in normoxic and hypoxic mice. Life Sci 1992;50(3):213–218.

    Article  PubMed  CAS  Google Scholar 

  48. Armen R, Kanel G, Reynolds T. Phencyclidine-induced malignant hyperthermia causing submassive liver necrosis. Am J Med 1984;77(1):167–172.

    Article  PubMed  CAS  Google Scholar 

  49. Rosenberg J, Pentel P, Pond S, Benowitz N, Olson K. Hyperthermia associated with drug intoxication. Crit Care Med 1986;14(11):964–969.

    Article  PubMed  CAS  Google Scholar 

  50. Liskow B. Extreme hyperthermia fro LSD. JAMA 1971;218(7):1049.

    Article  PubMed  CAS  Google Scholar 

  51. Kojima T, Une I, Yashiki M, Noda J, Sakai K, Yamamoto K. A fatal methamphetamine poisoning associated with hyperpyrexia. Forensic Sci Int 1984;24(1):87–93.

    Article  PubMed  CAS  Google Scholar 

  52. Callaway CW, Clark RF. Hyperthermia in psychostimulant overdose. Ann Emerg Med 1994;24(1):68–76.

    PubMed  CAS  Google Scholar 

  53. Rockhold RW, Carver ES, Ishizuka Y, Hoskins B, Ho IK. Dopamine receptors mediate cocaine-induced temperature responses in spontaneously hypertensive and Wistar-Kyoto rats. Pharmacol Biochem Behav 1991;40(1):157–162.

    Article  PubMed  CAS  Google Scholar 

  54. Lomax P, Daniel KA. Cocaine and body temperature in the rat: effects of ambient temperature. Pharmacology 1990;40(2):103–109.

    Article  PubMed  CAS  Google Scholar 

  55. Marzuk PM, Tardiff K, Leon AC, et al. Ambient temperature and mortality from unintentional cocaine overdose. JAMA 1998;279(22):1795–1800.

    Article  PubMed  CAS  Google Scholar 

  56. Vescovi PP, Coiro V, Volpi R, Giannini A, Passeri M. Hyperthermia in sauna is unable to increase the plasma levels of ACTH/cortisol, beta-endorphin and prolactin in cocaine addicts. J Endocrinol Invest 1992;15(9):671–675.

    PubMed  CAS  Google Scholar 

  57. Hanson GR, Jensen M, Johnson M, White HS. Distinct features of seizures induced by cocaine and amphetamine analogs. Eur J Pharmacol 1999;377(2–3):167–173.

    Article  PubMed  CAS  Google Scholar 

  58. Rowbotham MC, Lowenstein DH. Neurologic consequences of cocaine use. Annu Rev Med 1990;41:417–422.

    Article  PubMed  CAS  Google Scholar 

  59. Richards JR. Rhabdomyolysis and drugs of abuse. J Emerg Med 2000;19(1):51–56.

    Article  PubMed  CAS  Google Scholar 

  60. Ruttenber AJ, McAnally HB, Wetli CV. Cocaine-associated rhabdomyolysis and excited delirium: different stages of the same syndrome. Am J Forensic Med Patho 1999;20(2):120–127.

    Article  CAS  Google Scholar 

  61. Perper JA, Van Thiel DH. Respiratory complications of cocaine abuse. Recent Dev Alcohol 1992;10:363–377.

    PubMed  CAS  Google Scholar 

  62. Richards JR, Schneir AB. Droperidol in the emergency department: is it safe? J Emerg Med 2003;24(4):441–447.

    Article  PubMed  Google Scholar 

  63. Wilson LD, Shelat C. Electrophysiologic and hemodynamic effects of sodium bicarbonate in a canine model of severe cocaine intoxication. J Toxicol Clin Toxicol 2003;41(6):777–788.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Toxicology, Department of Emergency Medicine, University of California, San Diego, CA

    Aaron B. Schneir MD (Assistant Clinical Professor of Medicine) & Richard F. Clark MD (Professor of Clinical Medicine)

Authors
  1. Aaron B. Schneir MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Richard F. Clark MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Criminal Justice, East Carolina University, Greenville, NC

    Darrell L. Ross PhD

  2. Department of Emergency Medicine, University of California, San Diego, CA

    Theodore C. Chan MD

Rights and permissions

Reprints and permissions

Copyright information

© 2006 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Schneir, A.B., Clark, R.F. (2006). The Role of Illicit Drug Use in Sudden In-Custody Death. In: Ross, D.L., Chan, T.C. (eds) Sudden Deaths in Custody. Forensic Science and Medicine. Humana Press. https://doi.org/10.1007/978-1-59745-015-7_6

Download citation

  • DOI: https://doi.org/10.1007/978-1-59745-015-7_6

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-475-3

  • Online ISBN: 978-1-59745-015-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation