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Narsipur V. Ravi, MD; Edward Hines, Jr
Veterans Administration Hospital Hines, Ill

William M. Burke, MD
Carney Hospital Boston, Mass

JAMA. 1990;263(21):2887.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The study by Marzuk et al¹ concerning the prevalence of recent cocaine use among motor vehicle fatalities in New York City is timely and highlights another major public health consequence of the current cocaine epidemic in the United States. Many of us who care for cocaine-dependent patients, based on the anecdotal evidence of their self-reports, are aware of the reckless driving and other sensationseeking behaviors that can occur after cocaine use. In addition, Robinson et al² have demonstrated a negative correlation between substance abuse and seatbelt use. It is important, however, to emphasize the authors' caution that it cannot be construed that drivers killed in motor vehicle accidents who tested positive for cocaine metabolites were impaired immediately prior to the fatal accident.

The pharmacokinetic studies that suggest cocaine is eliminated within 48 hours are outdated because they do not reflect the experience observed with . . . [Full Text PDF of this Article]

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