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Peter M. Marzuk, MD; Kenneth Tardiff, MD, MPH; Dennis Smyth, MD; Marina Stajic, PhD; Andrew C. Leon, PhD

JAMA. 1992;267(19):2635-2637.

Abstract
Objective.
—To examine the association between recent cocaine use and risk taking, particularly in the form of playing Russian roulette, a paradigm for extreme risk-taking behavior.

Design.
—A case-control study.

Cases and Controls.
—The prevalence of cocaine use among all Russian roulette fatalities (N=14) was compared with a demographically similar, randomly selected sample (N=54) of all suicides by handgun during a contemporaneous 4-year period in New York City, NY.

Results.
—Recent use of cocaine, the most common drug found at autopsy, was detected in 64% of Russian roulette fatalities and in 35% of the control group (P<.05). All Russian roulette fatalities were male and usually young and unemployed. Blacks and Hispanics accounted for 80% of all cases and were overrepresented compared with their numbers in the general population.

Conclusion.
—In some populations cocaine may be associated with life-threatening risk-taking behaviors.

(JAMA. 1992;267:2635-2637)

Author Affiliations
From the Departments of Psychiatry (Drs Marzuk, Tardiff, and Leon) and Public Health (Dr Tardiff), Cornell University Medical College, New York, NY; and the Office of Chief Medical Examiner, City of New York, and Department of Forensic Medicine, New York (NY) University School of Medicine (Drs Smyth and Stajic).

Footnotes
This article is one of a number of articles on violence that will appear in upcoming issues of The Journal. The reader is referred to the June 10, 1992, issue, which will be dedicated to studies of violence.

Reprint requests to Department of Psychiatry, Cornell University Medical College, 1300 York Ave, New York, NY 10021 (Dr Marzuk).

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