• P M Marzuk, K Tardiff, D Smyth, M Stajic, and A C Leon.
• Department of Psychiatry, Cornell University Medical College, New York, NY 10021.
• JAMA. 1992 May 20; 267 (19): 263526372635-7.

ObjectiveTo examine the association between recent cocaine use and risk taking, particularly in the form of playing Russian roulette, a paradigm for extreme risk-taking behavior.DesignA case-control study. CASES AND CONTROLS: The prevalence of cocaine use among all Russian roulette fatalities (N = 14) was compared with a demographically similar, randomly selected sample (N = 54) of all suicides by handgun during a contemporaneous 4-year period in New York City, NY.ResultsRecent use of cocaine, the most common drug found at autopsy, was detected in 64% of Russian roulette fatalities and in 35% of the control group (P less than .05). All Russian roulette fatalities were male and usually young and unemployed. Blacks and Hispanics accounted for 80% of all cases and were overrepresented compared with their numbers in the general population.ConclusionIn some populations cocaine may be associated with life-threatening risk-taking behaviors.

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