Peace Officers Standards and Training Board Scraps “Excited Delirium”

Colorado's law enforcement is scrapping the controversial concept of "excited delirium" following a unanimous decision by the state Peace Officers Standards and Training board. This move comes in the aftermath of two Aurora paramedics facing felony charges for administering an overdose of ketamine to Elijah McClain, an unarmed Black man, based partly on their belief that he was experiencing "excited delirium."

Critics have long raised concerns about this diagnosis, often viewed as a law enforcement term used to describe individuals appearing hyperactive or agitated during police encounters. The term has faced accusations of racial bias, with statistics revealing a disproportionate attribution of "excited delirium" to Black and Latino victims. Advocates argue that this diagnosis is frequently employed to absolve law enforcement of responsibility in cases of in-custody deaths.

Prominent physician groups have also criticized the term, with the American Medical Association stating in 2021 that current evidence does not support the diagnosis. The National Association of Medical Examiners and the American College of Emergency Physicians have likewise distanced themselves from the term.

Elijah McClain's case, where he was forcibly restrained and administered an excessive dose of ketamine, prompted state lawmakers to pass a law restricting the use of ketamine in non-medical settings. The tragedy led to increased scrutiny of police language and training in mental health crises, with State Rep. Judy Amabile emphasizing the need for cultural change.

In addition to discarding "excited delirium," state officials voted to eliminate other terms, such as "cocaine psychosis" and "sudden in custody death," from law enforcement training manuals. The emphasis is now on training officers to understand procedures for providing first aid and transferring individuals in custody to medical care. The move aims to shift the focus from controversial diagnoses to more neutral terms, like describing individuals in "distress."

Fort Collins Police Chief Jeff Swoboda, a member of the POST board, expressed support for moving away from such diagnoses. He highlighted the importance of recognizing and addressing distress in individuals in custody, emphasizing appropriate care and assistance.

Activist Hashim Coates, who has been advocating for accountability since McClain's death, pointed out that body-worn camera footage did not show any signs of combativeness from McClain that night. Coates argues that the use of terms like "crazy strong" by officers was an attempt to protect themselves rather than an accurate representation of the situation.