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Colorado Becomes Second U.S. State to Ban “Excited Delirium” Following Groundbreaking PHR Research, Media Investigations

Colorado Governor Jared Polis signed a bill Thursday that prohibits state law enforcement, first responders, and coroners from using the invalid concept of “excited delirium,” making Colorado the second state after California to ban the term. 

The bill follows a landmark research report from PHR that found that “excited delirium” – often used to explain deaths in police custody – is not a valid, independent medical or psychiatric diagnosis. PHR’s report helped to expose the history, impacts, and pseudoscience of “excited delirium,” highlighting the need for clinicians and law enforcement to end the use of a baseless diagnosis rooted in racism. 

“Colorado makes history today by preventing this illegitimate science from masking additional deaths in custody,” said Joanna Naples-Mitchell, JD, PHR U.S. research advisor and co-author of PHR’s 2022 report on “excited delirium.” “Colorado legislators are showing leadership by acting to shift law enforcement, first responders, coroners, and other state officials away from reliance on such a harmful and destructive concept.” 

“We hope to see other states follow the examples of Colorado and California, which banned ‘excited delirium’ as a cause-of-death in October. In Colorado, the state should work to ensure compliance and educate the police, medical, and public safety community about this new law. This law would not exist without the leadership and activism of family members whose loved ones’ deaths were erroneously attributed to ‘excited delirium.’ Colorado should consult with them to understand how the state can improve responses to people in crisis and further accountability for deaths in custody,” said Naples-Mitchell.  

Colorado summarizes the new legislation (HB24-1103): 

“The bill prohibits training for law enforcement personnel, emergency medical service providers, or other first responders from including the term ‘excited delirium’; except in an emergency medical service provider training the term may be used in teaching the history of the term. A peace officer is prohibited from using the term ‘excited delirium’ to describe a person in an incident report. A coroner or other person authorized to determine a cause of death shall not register ‘excited delirium’ as the cause of death on a death certificate.” 

Colorado’s bill followed an extensive 9NEWS/KFF Health News investigation that exposed how “excited delirium” was cited in at least 225 deaths across the United States, including in high-profile cases in Colorado such as the 2019 killing of Elijah McClain. A previous investigation by KUNC (NPR affiliate in northern Colorado) found that medics in Colorado administered ketamine to 902 people for “excited delirium” over 2.5 years, and about 17 percent of those people experienced complications. 

For more information about “excited delirium,” explore the platform launched by Campaign Zero and PHR.

Physicians for Human Rights (PHR) is a New York-based advocacy organization that uses science and medicine to prevent mass atrocities and severe human rights violations. Learn more here.

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