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Colorado law enforcement officers still trained on controversial term 'excited delirium'

State Rep. Judy Amabile said the term is "bullsh-t." She's asking the Attorney General to drop a law enforcement training requirement surrounding it.

DENVER — A Colorado legislator has asked the Colorado Attorney General to drop a particular law enforcement training requirement following a 9NEWS Originals investigation on the use of the controversial term “excited delirium.”

State Rep. Judy Amabile (D-Boulder) said the term is “bullsh-t” and shouldn’t be used moving forward.

As of this summer, no major medical organizations recognize “excited delirium” as a medical diagnosis.  Yet an ongoing 9NEWS investigation has found Colorado continues to mandate training on recognizing “excited delirium” through POST – or Peace Officers Standards and Training – for all new law enforcement officers.

"They should get that out of the curriculum, and they should do that sooner rather than later,” Amabile said.

While the term “excited delirium” has been used by law enforcement officers and coroners’ offices for years to explain sudden, in-custody deaths, it has increasingly fallen out of favor following the high-profile, in-custody deaths of George Floyd in Minnesota and Elijah McClain in Colorado.

Our ongoing investigation has tied more than 150 deaths across the U.S. to the term since 2010. All but two happened during or shortly after law enforcement or medical restraint.

This year, both the National Association of Medical Examiners and the American College of Emergency Physicians – two of the last holdout supporters of the term – dropped their recognition of “excited delirium” as an actual medical diagnosis. In addition, in 2021, the Colorado Department of Public Health and Environment issued a report which rejected use of the term because it was “prone to implicit bias and racism.”

The term, at least among its supporters, is frequently associated with extreme agitation, superhuman strength and an imperviousness to pain. But there are plenty of skeptics who question whether it's even a real thing.

And most of those skeptics remain troubled as to how often the term has been used as an explanation as to why someone being restrained suddenly dies.

A few years ago, one of those who died was a mother of five named Jerica LaCour.

Something was deeply wrong with LaCour the night of Jan. 11, 2018.  She was found in a Colorado Springs parking lot by paramedics and police. She was alone, confused and despondent.

“Jerica! Jerica!” shouted one of the officers as his body camera was rolling.

As officers tried to figure out why she was alone, paramedics got her into a gurney.  Minutes later, the situation worsened.

LaCour started to shout. A spit mask was placed over her head. She shouted even more.

“Guess who gets ketamine!” exclaimed a paramedic.

A report written by a firefighter said the medic who shouted that felt Lacour “was in excited delirium.”

“I told the Medic [LaCour] had calmed down and did not need administer ketamine,” the firefighter said. 

The advice went ignored.

Minutes after the administration of ketamine, LaCour’s heart stopped beating.

“It’s devastating. It’s emotional. It’s painful. It hurts every day,” Jerica’s husband Anthony LaCour said.

The two share five children. 

“I have to look at them every day. I can see the different pain in their faces. Dad, what did we do? We don’t have a mom,” he said.

Even today, five years after her death, Anthony LaCour struggles to understand what “excited delirium” is.

“Do you know what it is?” 9NEWS asked.

“No, I have no idea,” he replied.

He’s hardly alone.

Dr. Jamira Jones is board certified in emergency medicine and practices in Colorado.

“What did you know about excited delirium before all of this?” we asked.

“Honestly, not much,” she said.

Following the death of Elijah McClain in 2019, Jones volunteered to sit on a panel tasked with reviewing the use of ketamine on suspected excited delirium patients in the field in Colorado. She walked away from the project with a new understanding of the use of the term “excited delirium.”

“It’s amazing how that word continues on when there’s no objective evidence behind it,” she said.

The report she and other medical professionals worked on concluded the state should reject use of the term.  

“By all indications, ExDS lacks a consensus definition, a specific diagnostic test, clearly understood pathophysiologic mechanisms, and verifiable clinical indications that can be applied to reach a reliable diagnosis,” it said.

“Even organizations that recognize the diagnosis concede that the unique indications assigned to ExDS are difficult to specify since the characteristics of the syndrome overlap with many other clinical diseases,” the report said.

Amabile said that reasoning alone should prohibit the state from mandating training on it through POST. She’s now asked Colorado Attorney General Phil Weiser, the chair of the Colorado POST Board, to drop the excited delirium training.

Through a spokesperson, the Colorado Attorney General said the office will allow the POST Board to make the final determination on the excited delirium training.

The first discussion on the topic could happen at a meeting of POST Board members on Friday in Grand Junction.

9NEWS reached out to more than two dozen Denver metro area law enforcement agencies to ask about their policies when it comes to use of the term “excited delirium.”

Only three said they don’t include the words “excited delirium” in their policies.

One of the three is the Wheat Ridge Police Department. Chief Chris Murtha said he finds use of the term problematic for a variety of reasons.

“I believe there are behaviors that mirror excited delirium,” he said. “But we’re not there yet, in my mind, and I don’t know if we will ever get there.”

“To train [law enforcement officers] on something that, in my mind, isn’t settled, is difficult,” he said.

He said he wouldn’t lose sleep if POST dropped the requirement.

“We just think there’s a better way to handle this,” he said.

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