Date of Award
Master of Science (MS)
First Advisor or Mentor
Cocaine overdose deaths are on the rise in the United States. This increase may be due to the co-consumption of cocaine with other drugs. When cocaine is ingested in conjunction with alcohol, a specific metabolite called cocaethylene forms. Information regarding cocaethylene, specifically its interpretive value in post-mortem cases, has not been widely studied. Data from the Office of the Chief Medical Examiner in New York City revealed that there were 195 cases in 2017 positive for cocaethylene. These cases were most likely to involve black (42.1%) males (79.5%) in Manhattan (28.2%) aged 50 - 59 (34.4%). Most of the cases were accidental deaths (88.2%) and involved cocaine along with multiple drugs; 127 of 195 total cases had a cause of death involving cocaine and multi-drug use (65.1%). The most common drugs involved in these cases were opioids (96.9%), benzodiazepines (24.4%), and amphetamines (7.9%), and among opioids, fentanyl was the most prevalent (70.7% of opioid cases). Cocaine, benzoylecgonine, cocaethylene, and ethanol average concentrations in femoral blood cases (n=163) were 176.51 ng/mL, 806.36 ng/mL, 73.21 ng/mL, and 0.11 %, respectively. Statistical analysis showed that cocaethylene concentrations were significantly higher when cocaine and ethanol were present than not. Cocaine and cocaethylene concentrations were higher in cocaine only cases as cause of death; however, this difference was not statistically significant. Further research should be done regarding cocaethylene in order to gain a better understanding of its toxicological significance.
Alexis, Jada T., "Cocaine, Cocaethylene and Ethanol in Postmortem Blood Submitted to the New York City Office of Chief Medical Examiner" (2021). CUNY Academic Works.
Available for download on Saturday, August 26, 2023