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Peter M. Marzuk, MD; Kenneth Tardiff, MD, MPH; Andrew Leon, PhD
Cornell University Medical College New York, NY

Marina Stajic, PhD
Office of Chief Medical Examiner New York, NY

Edward B. Morgan, MPH
Equicor-Equitable HCA Corporation New York, NY

J. John Mann, MD
University of Pittsburgh (Pa) School of Medicine

JAMA. 1990;263(21):2888.

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

In Reply. —

We are grateful for the correspondence concerning our article. Drs Ravi and Burke bring to our attention that, in a certain percentage of cocainedependent patients, benzoylecgonine can be detected for up to 120 hours. In our study, we too noted that cocaine metabolites were detected in 11 persons who survived in hospitals for greater than 48 hours. We chose our 48-hour cutoff time based on the limited literature in this area. The factors related to cocaine metabolism and elimination require further study, especially now that the pattern of compulsive use may have changed with the introduction of crack. We agree 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. It should also be noted that cocaine could influence the probability of a motor vehicle accident, either because of an acute . . . [Full Text PDF of this Article]

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