Deaths related to cocaine consumption: southern spanish experience

Introduction: In the last few years, cocaine has emerged as a major cause of morbidity and mortality in our country. The objective of this study was to get an insight into the presence of cocaine and related compounds in forensic cases received in the Department of Seville of the Spanish National Institute of Toxicology in 2005. Materials and Methods: Toxicological analyses were performed in all samples received, following our laboratory normal procedures. Ethanol was analysed by means of headspace GC-FID. Screening of drugs of abuse was performed by means of CEDIA. Extraction was accomplished by SPE (Bond-Elut, certified) and the extracts were analysed by gas chromatography with NPD and gas chromatography-mass spectrometry (GC-MS). Results: Cocaine and its metabolites were detected in 76 of the blood samples analysed and in 119 (61.57%) of the studied cases, only the metabolites were detected. Ethanol and ethylbenzoylecgonine were detected in 12 cases. Cocaine blood concentrations ranged from 0.02–7.24 mg/L. In 41 cases blood cocaine concentration was below 0.1 mg/L, in 25 was between 0.1–0.5 mg/L, in 9 cases between 0.5–1 and in 8 cases over 1 g/L. Conclusions: As it has been stated before, it seems that with the exception of massive drug exposure, cocaine-related deaths occur for the major part after prolonged drug use and it is almost impossible to correlate a specific blood concentration to toxicity. However, our results some differences between blood cocaine concentrations in people who died in road accidents and those who died in a different manner.