Abstract
Cocaine is frequently related to deaths as a result of overdose, cardiovascular complications, psychiatric disorders, or violent situations associated with criminalization of consumption. Differences in drug response, tolerance, and sensitization, plus postmortem redistribution hinder the elucidation of cocaine-related deaths. Acute poisoning is easily verified when the blood concentration is very high, such as, in body packers cases, but in most death cases to interpret blood levels is challenging. Brain is a very interesting specimen because it is inside an isolated compartment with low enzymatic activity, most cocaine metabolites do not cross the blood–brain barrier and take longer periods of time to occur due to putrefactive processes. Understanding the drug distribution in brain and its correlation with blood levels and other specimens helps to interpret the role of cocaine in death. This chapter shows cocaine toxicokinetic and toxicodynamic properties and postmortem distribution in brain and other specimens.
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