Death Caused by Cocaine

February 14, 2012 by fortox in Toxins with 0 Comments

Death Caused by Cocaine


Unlike other drugs, where death can be caused by taking too much, most cocaine deaths are accidental. This is due to its direct interaction with the heart which can cause problems associated with heart attacks, strokes, seizures and respiratory failures. This is analysed by forensic toxicologists;


“It may also cause cardiac artery spasm, resulting in an acute myocardial infarction (which can cause long-term damage to the myocardium, even if not fatal). Convulsions may lead to respiratory arrest and increased blood pressure has been linked to stroke deaths. The risk of death particularly increases if there is pre-existing cardiac disease.” (Wyatt et al 2011:473)


Cocaine can be;

  • Snorted
  • Injected
  • Smoked

“Crack” is a form of cocaine which can be smoked due to the removal of hydrochloride. When it is heated it has been described by many as making a “crackling sound”, hence the name “crack” cocaine.



Cocaine has been described as one of the most addictive drugs, if not the most addictive, by scientists. Specialists working in animal laboratories have reported that animals will work much more persistently for a cocaine bar than any other drug, even opiates.


Symptoms displayed by a cocaine user can include the following;

  • Pupil dilation
  • Elevated body temperature
  • Headaches
  • Abdominal pain
  • Nausea
  • Decreased appetite
  • Accelerated heart rate
  • Loss of sense of smell
  • Nosebleeds
  • Hoarseness
  • Anxiety and restlessness
  • Severe paranoia
  • Hallucinations
  • Swallowing problems
  • Heart attack
  • Stroke
  • Respiratory arrest


Biological samples can be taken from the body for analysis by the forensic toxicologist, these include;

  • Blood
  • Urine
  • Vitreous
  • Bile
  • Brain
  • Kidney
  • Liver
  • Skeletal muscle


Lethal levels of cocaine which can be detected in these samples by the forensic toxicologist include;


Source Lethal Level
Blood 0.1-330mg/L
Urine 0.05-402mg/L
Vitreous 0.8-13mg/L
Bile 2-468mg/L
Brain 0.04-74mg/kg
Kidney 3.8-28mg/kg
Liver 0.2-393mg/kg
Skeletal muscle 0.1-48mg/kg

(Adapted from Molina 2010:75)


Cocaine can only be detected for a few hours after use, but their metabolites can be detected for several days in urine by forensic toxicologists.  It can be tested using the following laboratory techniques;

  • Immunoassay methods (EIA, RIA, FPIA)
  • Thin layer chromatography (TLC)
  • High pressure liquid chromatography (HPLC)
  • Gas chromatography (GC)
  • Gas chromatography/mass spectrometry (GC/MS)


Alcohol intensifies the euphoric effect that is experienced after taking cocaine, which would explain why the two are taken together by many cocaine users. The intensified euphoric effect is achieved through the two toxins reacting in the liver which then produces cocaethylene as a result. However, cocaethylene poses a greater risk of sudden death, compared to the intake of cocaine alone.


Withdrawal from the drug, or “coming down” after taking it has been found to be the cause of some suicides.



Molina, D.K. (2010). Handbook of Forensic Toxicology for Medical Examiners. CRC Press : Boca Raton

Wyatt, J., Squires, T., Norfolk, G., & Payne-James, J. (2011). Oxford Handbook of Forensic Medicine. Oxford University Press : Oxford




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