• Emanuel Rivers, Ehsan Shirazi, Taruna Aurora, Marie Mullen, Kyle Gunnerson, Brendan Sheridan, Laura Eichhorn, and Michael Tomlanovich.
• Department of Emergency Medicine and Surgery, Henry Ford Hospital, Detroit, MI 48202, USA. erivers1@hfhs.org
• Acad Emerg Med. 2004 Aug 1; 11 (8): 874-7.

ObjectivesTo determine the prevalence of cocaine use in a population of elder patients presenting to an inner-city academic emergency department (ED).MethodsThis was a prospective, blinded observational study of patients aged 60 years or older who presented to a large urban ED over a six-month period. A urine drug screen was performed on patients who had a sample obtained during treatment for routine analysis. Patients' demographic data were collected and compared.ResultsA total of 5,677 visits met the inclusion criteria. Urine samples were obtained in 911 (16%) of these visits with 852 unique individuals. There were 18 cocaine-positive results among the 911 visits, for a rate of 2.0%. The rate of positive subjects was also 2.0% (17/852). The cocaine users were younger (66.4 +/- 7.2 vs. 76.0 +/- 8.7 years), predominantly male (88.9% vs. 46.6%), and more likely to be diagnosed with drug or alcohol abuse as compared with the cocaine-negative patients. However, there were no significant differences in disposition between the cocaine-positive and cocaine-negative groups.ConclusionsElder patients may have a higher prevalence of cocaine use than previously estimated by national registries.

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