Cocaine - No Level Is Safe

By Margarita Nahapetyan

More than 3 per cent of "sudden deaths" in a region of south-west Spain, and probably across much of Europe, are associated with cocaine use, according to a new study released on Wednesday. The study found that cocaine use has risen sharply in recent years in Europe and that there is no such thing as "safe" recreational use of small amounts of the illegal drug.

For the study purposes, pathologists performed forensic autopsies on 668 individuals who died suddenly between November 2003 and June 2006 in Seville, Spain. During post-mortems the experts tested blood and urine samples in order to find some traces of toxic substances, and carefully studied the organs, focusing on the cardiovascular system and toxicological analysis. Information on substance abuse prior to death was also taken into consideration, as well as the circumstances of the death and death scene investigations.

As a result, cocaine was detected in 21 (3.1 per cent) of the bodies, all of which were male with the ages between 21 years and 45 years. The pathologists also found that 81 per cent of the men who died after cocaine use were smokers, and 76 per cent had been consuming alcohol. Ethanol, the intoxicating ingredient that is present in alcoholic beverages, enhances the "high" obtained from cocaine while minimizing the subsequent "low." However, both smoking and drinking are related to heart disease and the investigators said that the combination of cocaine with either or both of these habits can be considered as a deadly cocktail that contributes to the development of premature heart disease.

According to a lead researcher, Dr. Joaquin Lucena, MD, PhD, Head of the Forensic Pathology Service at the Institute of Legal Medicine in Seville, the new findings demonstrate that cocaine use causes adverse changes to the heart and arteries that later are associated with sudden death.

Dr. Lucena's study appears to be the first to investigate the prevalence of cocaine-related sudden deaths in such a detailed and methodical way. The experts highlighted the importance of this method of studying sudden deaths and called for systematic blood and urine tests in sudden death cases in order to more accurately determine the role drug abuse plays in premature deaths. Until this happens, "the prevalence of cocaine and other illicit drug use will be underestimated, and cocaine-related complications will not be recognized," they concluded.

There are about twelve million adult Europeans who use cocaine, the illegal drug, with more than 5 per cent of the population in the three European countries reporting usage at least once. The United Kingdom has the highest rate of adult individuals who have ever used cocaine, at 7.7 per cent - ahead of Spain at 7 per cent and Italy at 6.6 per cent. The number of sudden adult deaths in the United Kingdom has been put at 500 annually.

The findings were published in the European Heart Journal on January 13.