Plasma cocaethylene concentrations in patients treated in the emergency room or trauma unit

Cocaethylene and cocaine concentrations were measured by high-pressure liquid chromatography in the plasma of 18 patients whose corresponding blood demonstrated ethanol and whose urine contained either benzoylecgonine and/or cocaine on screening for illicit drug use. Although sixteen patients had suffered trauma, only 15 were admitted to the trauma unit. Three patients were seen only in the emergency room. Both cocaethylene and cocaine were detected together in the plasma of 10 patients and not all in 5 patients. In two patients, cocaine was found without cocaethylene, and in one patient cocaethylene was present without cocaine. For the entire series, cocaine concentrations showed significant correlation with those of cocaethylene. Plasma cocaethylene concentrations varied and were as high as 784 nmol/L (249 micrograms/L), and those of cocaine were as high as 1,455 nmol/L (441 micrograms/L). Before this study, published measurements of cocaethylene have been limited almost exclusively to postmortem specimens.