Excited Delirium – Death in Police Custody

Excited DeliriumExcited delirium is a controversial proposed condition that manifests as a combination of delirium, psychomotor agitation, anxiety, hallucinations, speech disturbances, disorientation, violent and bizarre behavior, insensitivity to pain, elevated body temperature, and superhuman strength. Excited delirium is sometimes called excited delirium syndrome if it results in sudden death (usually via cardiac or respiratory arrest), an outcome that is sometimes associated with the use of physical control measures, including police restraint. All or nearly all of reported cases of excited delirium involve people who are in police custody or are fighting with the police.

It is estimated that there are between 600 and 800 in-custody deaths in the United States that correlate with excited delirium symptoms every year. Similar deaths also occur in psychiatric and geriatric care facilities. Three groups of subjects are more prone to the sudden and unexpected death associated with excited delirium: people with a mental illness, (bipolar disorder or schizophrenia), chronic illicit stimulant (cocaine, methamphetamine) abusers and ecstasy, marijuana, or alcohol abusers, or a combination of mental illness and substance abuse. Other causes of excited delirium include infection, head trauma, and adverse reactions to medication. Most subjects the police will encounter with excited delirium are males between the ages of 30 and 40. It is rarely seen in females.

The Excited Delirium Syndrome

There is no medical or psychiatric diagnosis of excited delirium. It is the subject’s behavior that indicates the syndrome. However, annually, excited delirium is increasingly determined to be the cause of in-custody deaths.

Any person experiencing delirium requires prompt medical attention as it is a result of life threatening medical conditions. Delirium is characterized by an insidious disturbance in the level of consciousness and a change in mental status. People in delirium will likely manifest acute behavior problems, including becoming oppositional, defiant, angry, paranoid and aggressive. Attempts to calm or contain them will result in further aggression and violence. Control techniques can be difficult because subjects often demonstrate unusual strength and insensitivity to pain, as well as instinctive resistance to the use of force.



About the Author
Darren is a 30 year veteran of law enforcement and criminal investigations. He currently serves as an investigator for the Crawford County Missouri coroner’s office. He holds credentials as an instructor for the Missouri Sheriff’s Training Academy, has served as president of the Missouri Medical Examiners and Coroners Association, and is certified and credentialed in numerous fields of investigation. He holds the position of lead instructor and facilitator for the Coroner Talk™ community as he speaks and writes in the area of death investigation and scene management.

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