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Drug Abusers Who Die During Arrest or in Custody

NCJ Number
238230
Journal
Journal of the Royal Society of Medicine Volume: 92 Issue: 3 Dated: March 1999 Pages: 110-113
Author(s)
Steven B. Karch M.D.; Boyd G. Stephens M.D.
Date Published
March 1999
Length
4 pages
Annotation
This study examines the causes and prevention of deaths in police custody among drug abusers who die during arrest or in custody, with a focus on California and the United Kingdom, which have similar rates of such deaths.
Abstract
Depending on when they occur, drug-related death of prisoners can be divided into four categories: death during arrest and transport; death within 12 hours of arrests; death after 12 hours but while still on remand; and death after trial. Excited delirium in chronic stimulant abusers is the principal cause of death during arrest and transport. Death from a massive drug overdose in drug smugglers and dealers is the principal cause of death during the first 12 hours. Deaths that occur after 12 hours are almost always related to drug withdrawal or natural causes. Most preventable drug deaths are due to massive ingestion of drugs, which many result from the concealment of drugs within body cavities ("bodypacking") or the swallowing of a drug inventory when arrest is imminent ("bodystuffing). If the "bodypacker" or "bodystuffer" is a cocaine user, he/she may be able to tolerate very high blood concentrations with few, if any, symptoms. Otherwise, they will exhibit a pattern of symptoms that include agitation, followed by confusion, a temperature rise, continuous seizures, and cardiac arrest. Prevention in such cases, no matter whether opioids or stimulants are involved, consists of taking the arrestee directly to a hospital for evaluation. In cases of excited delirium, patients become psychotic and can engage in several hours of violent agitation that make it difficult for police to control the subject during transport. Transport is best done in an emergency ambulance with close monitoring of pulse and oxygen levels so as to prevent death from asphyxiation. 40 references