William M. Burke, MD; Narsipur V. Ravi, MD
To the Editor: Nademanee and colleagues (1) present an important finding in their article on myocardial ischemia during cocaine withdrawal. In discussing the possible mechanism, however, they do not consider the possibility that cocaine is a two-compartment drug that is slowly released after cessation of use so that there may be significant levels of drug present in patients for 2 or more weeks after last use. The fact that there were "negligible" levels of benzoylecgonine in the urine at the time of the first Holter does not eliminate this possibility. It has been recently shown that regular cocaine users who
Burke WM, Ravi NV. Urinary Excretion of Cocaine. Ann Intern Med. 1990;112:548–549. doi: 10.7326/0003-4819-112-7-548
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Published: Ann Intern Med. 1990;112(7):548-549.
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