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Ambient temperature and mortality from unintentional cocaine overdose
P M Marzuk1, K Tardiff, A C Leon
1Department of Psychiatry, Cornell University Medical College, New York, NY 10021, USA. pmmarzuk@mail.med.cornell.edu
JAMA
|June 17, 1998
Summary
Hot weather significantly increases cocaine overdose deaths by 33%. This study found that high ambient temperatures, specifically 31.1°C (88°F) and above, are linked to a rise in fatal cocaine overdoses, indicating cocaine use is more dangerous on hot days.
Area of Science:
- Environmental Health
- Toxicology
- Cardiovascular Medicine
Background:
- High ambient temperatures challenge cardiovascular function and increase heart disease mortality.
- Cocaine use is known to induce cardiovascular complications such as hypertension, tachycardia, and arrhythmias.
Purpose of the Study:
- To investigate the association between mortality from cocaine overdose and hot weather conditions.
- To determine if elevated temperatures exacerbate the risk of fatal cocaine intoxication.
Main Methods:
- Retrospective analysis of medical examiner cases in New York City from 1990-1995.
- Identified a temperature threshold of 31.1°C (88°F) for 'hot days' and compared cocaine overdose deaths on these days versus cooler days.
- Utilized contemporaneous comparison groups including opiate overdoses, other drug overdoses, homicides, and traffic fatalities.
Main Results:
- A significant increase in mean daily cocaine overdose deaths (33% higher) was observed on hot days (≥31.1°C) compared to cooler days.
- No significant increase in mortality was found for opiate overdoses, other drug overdoses, or in the proportion of cocaine-positive toxicology results for homicides and traffic fatalities on hot days.
- The findings suggest the increased cocaine overdose mortality on hot days is not due to general changes in cocaine use patterns.
Conclusions:
- High ambient temperatures are significantly associated with increased mortality from cocaine overdose.
- The heightened risk of fatal cocaine overdose during hot weather is specific to cocaine and not observed in other drug overdoses or related fatalities.
- Cocaine use poses an elevated danger during periods of high ambient temperature.