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‘Excited delirium’, used by police to justify brutality, is junk science

washingtonpost.com

130 points by 1as 6 years ago · 61 comments

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ve55 6 years ago

Excited delirium is a very well-known and documented phenomenon, primarily in individuals that are on excessive doses of stimulants: https://en.wikipedia.org/wiki/Excited_delirium#Cause

However, nothing about its existence implies anything about police brutality. For some reason the article thinks it needs to deny the existence of something that obviously exists in order to argue against police brutality. This is a strange logical fallacy to commit, because you can easily argue brutality is bad regardless of what substances an individual is on.

Responding to child comments, it's possible that this condition is not unique enough to require its own name and label. But in that case, one can simply refer to the effects of doses of the given stimulants themselves, e.g. https://en.wikipedia.org/wiki/Methamphetamine#Adverse_effect....

Please note I'm not making any claim that brutality is okay or ever justified, just that there obviously does exist strong psychological and physical conditions that occur when an individual is on doses of very strong stimulants.

  • triceratops 6 years ago

    From the Wikipedia article you linked: "The condition is not recognized by the American Psychiatric Association, American Medical Association or the World Health Organization." It's under the section titled "Controversy_related_to_policing_techniques".[1]

    Just because something is well-known and documented doesn't mean it's recognized as a medical or psychological condition. Sometimes it can be that medicine hasn't caught up, and sometimes it's BS.

    1. https://en.wikipedia.org/wiki/Excited_delirium#Controversy_r...

    • Simulacra 6 years ago

      It is curious that the section you identified was added June 17th, 2020.

      • Volundr 6 years ago

        That... doesn't appear to be true. It's Wikipedia, the whole history is available. Heres the page as of early/mid April: https://en.wikipedia.org/w/index.php?title=Excited_delirium&..., which as far back as I've bothered to go, and the cited paragraph is still there.

        • drdeca 6 years ago

          in addition, here is the link for covering all changes on June 17, which shows that the section is question was not created or renamed on June 17, though it was substantially modified on that day : https://en.wikipedia.org/w/index.php?title=Excited_delirium&...

          I don't know why it being substantially modified on that day would be important. Is there some significance to that date that I'm unaware of, other than it being "1 month ago today"?

      • whymauri 6 years ago

        The world and its policies exist before they are documented on Wikipedia. What is your point?

      • newacct583 6 years ago

        That date is just when the wikipedia sentence was written, probably becuase it tracks with exactly this controversy about police violence. The facts its cites about support within the medical community certainly aren't new.

        I don't know why this seems so surprising to some here. The police use loopholes like everyone else does. If this gets them off the hook for borderline use of violence, of course they'll use it. If it's used inappropriately, they should stop.

      • novia 6 years ago

        Why? It's July.

    • ve55 6 years ago

      Yes, it is controversial for being used as a justification for police brutality and having been involved in a lot of bad incidents. But the existence of it is not controversial, as it is basically a subset of affects of substances such as methamphetamine: https://en.wikipedia.org/wiki/Methamphetamine#Adverse_effect.... Does it need its own specific name and label? perhaps not, and that is part of why some organizations have not officially recognized it

      • NotSammyHagar 6 years ago

        It's not accepted as a standard treatment, that's the key. The second key point is it's used as an excuse for violence. Same thing with pray gay away type treatments to convince men they aren't gay. Those are now illegal in many states.

        Similar things, bogus classes on checking if you are high - like your eyes move in a certain way, or when driving your tire touches the white line. Cops take these classes and use them for justification. See also, pulling drivers over if they are certain minorities (driving suspiciously).

      • cat199 6 years ago

        there is already amphetamine psychosis, etc.

        i think the issue is inventing some quasi-illness which might really be one or several other things, but conveniently describes the exact set of symptoms that can be used to justify use of force (so basically it's a way to dress up 'he was acting crazy' and sound legitimate by calling it an 'illness' when you over react)

        • ve55 6 years ago

          Yes, that would have made for a much better article+title I think. They would also make a better case by mentioning cases where the substances involved do not have such effects (for example, weed) rather than methamphetamine. But with such a poor clickbait title it's too much to expect.

        • jokowueu 6 years ago

          The thing is that there are similar substances that are not in the amphetamine class that cause similar effects . Example would be the less common experiences some people get with PCP

      • triceratops 6 years ago

        Ok...but that implies these cops may be doing coke and meth on the job, since the article says that those drugs "commonly cause" it. Surely that's an even bigger problem than "excited delirium".

        EDIT: I'm an idiot.

        • ve55 6 years ago

          I think you've misunderstood, excited delirium is claimed to be present in the individual the cop is arresting, not in the police themselves. The reason they attempt to justify greater force is in order to protect themselves from someone in such a state. I'm not agreeing with this, just stating what they would say.

          • triceratops 6 years ago

            Oops. Completely misread the article. I'll leave my comment up with a note, and wear my shame.

            • ve55 6 years ago

              It happens, appreciate the friendly response

            • Digit-Al 6 years ago

              Have an upvote for your mature response. If more people were willing to own their mistakes instead of hiding or doubling down, the world would be a better place :-)

  • jirdperson 6 years ago

    > However, nothing about its existence implies anything about police brutality.

    As I read it, the article didn't seem to be implying that the existence of "excited delirium" itself implies something about police brutality. I took their argument to be that police departments' misapplication and/or overuse of the concept had led to increased instances police brutality. Not knowing anything else about this issue, it doesn't seem implausible to me that training police officers, who generally lack medical diagnostic skills, to constantly anticipate a human threat with superhuman strength and no sense of pain might lead to an increase in the use of excessive force.

    • crooked-v 6 years ago

      One example is cited immediately in this article: https://www.floridatoday.com/in-depth/news/2019/10/24/excite...

      > But in those deaths where there was no drug use and the toxicology came back negative, the only common denominator in virtually every case was the involvement of law enforcement, such as in the case of Gregory Lloyd Edwards.

      > According to the autopsy report, Edwards died of "excited delirium and complications" due to "hyperactive and violent state with subsequent restraint."

    • ve55 6 years ago

      Even so, people give a lot of credence to the title, which is obviously very clickbaity.

      • gowld 6 years ago

        Which title? The HN/WaPo OP sas

        WaPo: "Police keep using ‘excited delirium’ to justify brutality. It’s junk science."

        HN: ‘Excited delirium’, used by police to justify brutality, is junk science

        Both of which are accurate statements of the key point: There is a body of junk science based on the concept of ‘Excited delirium’, used to justify plice brutality.

        The fact that there is something referred to as ‘Excited delirium’ that is not used for police brutality or junk science, doesn't make the title clickbait.

        Astrology is junk science, despite the fact that the constellations do exist and that a person is born under a certain configuration of stars ar the location of their birth.

  • rsynnott 6 years ago

    This is a very oddly written article.

    > Excited delirium is not recognized by some professional medical associations

    If you go to the reference for that, it mentions that it's not recognised by _any_ professional medical association.

  • SrslyJosh 6 years ago

    > Excited delirium is a very well-known and documented phenomenon, primarily in individuals that are on excessive doses of stimulants

    "Well-known and documented" by the police, I think you mean.

    Did you read what you just linked?

    From the wikipedia article:

    > Excited delirium is not recognized by some professional medical associations.

    > EXD has been accepted by the National Association of Medical Examiners and the American College of Emergency Physicians, who argue in a 2009 white paper that "excited delirium" may be described by several codes within the ICD-9.

    Imma repeat that for you:

    > may be described by several codes within the ICD-9

    In other words, "excited delirium" is not the diagnosis a physician would give.

    More from the Wikipedia article:

    > How frequently cases occur is unknown.[1] Males are affected more often than females.[9] Those who die from the condition are typically male with an average age of 36.[1] Often law enforcement has used tasers or physical measures in these cases.[1]

    This sounds like really solid medical science! It's totally not something made up to cover police brutality!

    > The first use of the term "excited delirium" (EXD) was in a 1985 Journal of Forensic Sciences article

    Oh.

    > The signs and symptoms for excited delirium may include:[12][13][14][15] > Aggressiveness and combativeness > Unexpected strength (typically while trying to resist restraint)

    Did a police officer write this?

    This is probably the most scattershot Wikipedia article I've ever read about a "medical condition", but it's also pretty damn effective in shooting down the idea that this is a real thing and not just a blanket term made up to cover the deaths of people brutalized by the police. (Assuming you don't unconditionally trust the police.)

    > The pathophysiology of excited delirium is unclear,

    Hahahahaha, of course it's unclear.

    > Key signs of excited delirium are aggression, altered mental status, and diaphoresis/hyperthermia.

    Is the primary treatment beating/tasing while shouting "stop resisting"?

    Read the Wikipedia article for yourself. It's one hell of a trip.

  • Spivak 6 years ago

    From your own link:

    > The condition is not recognized by the American Psychiatric Association, American Medical Association or the World Health Organization. Critics of excited delirium have stated that the condition is often attributed to deaths while in the custody of law enforcement and is disproportionately applied to black and Hispanic victims.

    This doesn't mean that it still isn't a thing. There are plenty of very real conditions that aren't yet officially recognized but when you have the current body of experts explicitly denying its existence your burden of proof is a lot higher.

cwkoss 6 years ago

I heard someone claim that Excited Delirium idea is being spread by Axon (Taser company) lobbyists as a way of justifying the deaths of victims of improper taser use.

https://www.npr.org/templates/story/story.php?storyId=762231...

"But according to civil-liberties groups and legal filings, Taser may have financial reasons to support — and even encourage — the use of the excited delirium diagnosis.

Take the case of Frederick Williams. On a grainy video, Williams is screaming, 'Don't kill me! I have a family to support. I've calmed down!" as several officers carry him into the Gwinnett County Detention Center in a suburb of Atlanta. One officer takes out his Taser and fires it directly onto Williams' chest.

The officer yells, "Relax! Stop resisting!" But the shock keeps jerking Williams' chest upward. As several officers hold Williams down, he is stunned six more times. A few minutes later, the officers realize Williams is not breathing. Williams died a few hours later.

Williams' family is now suing the county and Taser International. The company has made it clear in proceedings so far that it intends to argue Williams died of excited delirium — not because of the Taser or excessive force. The medical examiner could not determine the exact cause of death."

rimjongun 6 years ago

One time when I lived in Hawaii, I had snuck into an apartment’s hot tub with a girl. When leaving, I saw this massive tree of a Hawaiian man, and I’m 6’3”, so this guy was huge. This man was screaming and hitting his wife, who was trying to run away. I yelled out to distract him so she could get away. Before I could even comprehend it, he had run across the street and was right in front of me. I was a very well trained martial artist at the time and I was scared for my life, this guy was clearly high or crazy. I jumped on a ledge where he couldn’t reach me, and he ran off after the wife. I pounded on people’s doors until the cops came and saw them try to talk him down. Three cops tased him before he went down, but then he pulled them out, stood up, and punched the window out of a nearby jeep. He was eventually subdued. A cop later told me that this was fairly common in that area, because of PCP use. I’m amazed this guy came out of it alive because of how easily he shrugged off tasers.

_Nat_ 6 years ago

If you want to say someone's toe hurts because they stubbed it, you can refer to it as "stubbed toe pain". Even if "stubbed toe pain" isn't an official diagnosis in some health organizations, that doesn't mean it's junk science.

I don't get why the article's attacking the term "excited delirium" in the first place, though. I mean, do the authors think that the correctness of police-brutality hinges on whether or not there's such a thing as "excited delirium"? Do the authors think that, if there's such a thing as "excited delirium", it'd justify police-brutality?

  • in_cahoots 6 years ago

    The question isn’t whether the authors think that, it’s whether the police think that. If you thought a suspect had superhuman strength and was impervious to pain, wouldn’t you use more lethal means to control them?

    • _Nat_ 6 years ago

      Did you read the article as critiquing the belief that some suspects have superhuman strength and imperviousness to pain?

      I mean, I Google'd "drug-induced strength". Among the first few hits were [this video][1] and [this article][2], which seem like reasonable evidence of those two symptoms existing together.

      The article's logic was disjointed, but I read it as primarily focusing on terminology. If it was instead an argument against the existence of those symptoms, that'd be a tad confusing given stuff like the YouTube video.

      [1]: https://www.youtube.com/watch?v=HV6FnGeYUOE&t=24

      [2]: https://www.washingtonpost.com/news/morning-mix/wp/2015/06/1...

refurb 6 years ago

Science doesn’t have a great explanation for everything, but that doesn’t make it junk science.

Suffice to say it’s not uncommon for people to die suddenly when they encounter stressful situations, even not related to police interactions. I remember reading about a case where a person fell through the ice on a lake, the water never going over his head. He was pulled out immediately, but died of cardiac arrest. What happened? Not unusual to label it vasovagal syncope that resulted in sudden death. Is it a great explanation? No, but it’s the best we have.

Similar to excited delirium, we have folks who exhibit similar symptoms and some of them die. Do we know exactly why? Not always, but it doesn’t make “excites delirium” junk science.

Not excusing police brutality at all, but it shouldn’t be surprising some of these sudden deaths happen in police interactions too, especially when you’ve got drugs involved and/or mental illness.

  • newacct583 6 years ago

    > Science doesn’t have a great explanation for everything, but that doesn’t make it junk science.

    The issue here is that some people (the police) are applying this idea as if it was a great explanation. That's what makes it junk science.

    • refurb 6 years ago

      No doubt cops use excessive for in some cases and blame it on excited delirium.

      I guess my point is - it’s probably true in some cases.

      • newacct583 6 years ago

        Indeed. But "probably true in some cases" is sorta a giant red flag for "junk science". Real medicine uses higher standards before basing policy on a model like this.

  • crooked-v 6 years ago

    > some of these sudden deaths

    https://www.floridatoday.com/in-depth/news/2019/10/24/excite...

    > For decades, critics of using "excited delirium" as a cause of death have expressed concern that the term appears almost exclusively on medical reports for deaths in custody or that otherwise involve law enforcement.

    > About two-thirds of the cases reviewed by FLORIDA TODAY fit that bill. A majority of those cases are complicated by the presence of illegal stimulant drugs like cocaine or methamphetamine. But in those deaths where there was no drug use and the toxicology came back negative, the only common denominator in virtually every case was the involvement of law enforcement, such as in the case of Gregory Lloyd Edwards.

Simulacra 6 years ago

I wouldn't call it junk science. I am not a scientist but I do know of times I've gotten so emotional (and really, pick an emotion here) that I've lost myself. IMO there is a breakpoint for most people when we either get too depressed, or too manic, to fully appreciate and control our behavior. With the fight or flight response kicking in, I think we can find ample evidence of people under extreme stress or duress just...losing themselves and going on autopilot.

  • mikkergp 6 years ago

    The philosophy of this is interesting. As we start to understand more about genetics and psychology, we'll probably be able to more closely pinpoint why people do what they do. But that doesn't mean people shouldn't be held accountable. (Affluenza)[https://en.wikipedia.org/wiki/Affluenza] may be a real "condition"? that impacts people, but even if we eventually discover the genetic and neurological reasons behind it, it still shouldn't excuse behavior.

    I've had similar experiences where I "lose control" because I'm angry, or excited, or "emotional", but I think it's my responsibility to work to make that better. I don't know what this means in terms of consequences, but I know it shouldn't mean letting cops off the hook for brutality.

  • gowld 6 years ago

    One detail being sort of true doesn't make the overall body of work non-junk.

mzs 6 years ago

It also works in practice almost half the time in states that allow the defense to reduce a conviction from murder to manslaughter, and not only for police, cause juries are made up of humans.

AnthonyMouse 6 years ago

Might save everyone some time with a generic template:

________, used by police to justify ________, is junk science.

cool_dude85 6 years ago

Shame on the University of Miami, which has peddled this cop-acquitting bullshit for years.

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