Medical complications of cocaine: possible relationship to low plasma cholinesterase enzyme.

What predisposes some cocaine users to its complications is not known. Because cocaine is metabolized by plasma cholinesterase enzyme, we evaluated this enzyme in 14 patients with cocaine-induced complications, 11 long-term cocaine users from Bolivia, 14 persons in the United States without any documented cocaine-induced complications, and 14 subjects who have not used cocaine. The enzyme was found to be significantly lower in patients with cocaine-induced complications as compared to other groups (p < 0.05). A low level of plasma cholinesterase enzyme may predict complications from cocaine use.