Changes in emergency consultations related to cocaine abuse during the period 2002 through to 2008

Galicia M, Nogué S, Sanjurjo Golpe E, Miró O

Objective: To analyze the epidemiologic, clinical, and toxicologic characteristics of

emergency consultations related to cocaine abuse.

Patients and methods: The 6-year study included patients seen in the emergency

department (ED) for cocaine use in the hours prior to consultation. Epidemiologic,

clinical, and toxicologic data were recorded.

Results: A total of 1755 patients were identified (292 patients per year, 70% male, mean

age 31 years). Emergency consultations for cocaine abuse accounted for 0.76% of all

medical emergencies, 15.3% of all toxic exposures, and 28.6% of all emergency

consultations for substance abuse; these figures remained relatively stable over the 6-

year study period. The drug was most commonly taken nasally (75%), for recreational

use (91%), and usually in association with other substances (72%), particularly alcohol,

cannabis, and amphetamine derivatives. The main reasons for consultation were anxiety

(27%), agitation (20%), and palpitations (12%). The triage classification was level I in

3.6% of cases, and these patients were attended immediately in the ED resuscitation

area. Hospital admission was required in 11% of cases, of which 45% were admitted to

medical-surgical specialties, 44% to psychiatry, and 11% to intensive care. There has

been no increase in the need for admission over the study period. Overall mortality was

0.17%.

Conclusions: Cocaine abuse, alone or combined with other substance abuse, generates

a large number of consultations to ED. The main symptoms are neuropsychiatric and

cardiovascular. There have been no significant changes in incidence or in the need for

admission over the past 6 years.

Galicia M, Miró O, Nogué S, Sanjurjo Golpe E