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Warlock
May 24, 2020
746
From January 2000 to May 2014, there were no deaths.
From June 2014 to June 2020, there were 23 deaths. The
average number of deaths per month was 0.31, with an aver￾age age of 28.4 years (range 15–65 years; median 22.5 years)
and 48% were female.
From July 2020 to March 2021, there were 28 deaths. The
average number of deaths per month was 3.11, which is 9.9
times higher than the baseline of June 2014 to June 2020.
The average age was 26 years (range 16–51 years; median
24.5 years) and 41% were female.
Several temporal-geographic clusters were noted: 4 cases
in 8 months in California (2019–2020), 3 cases in 24 days in
Florida (2020), 2 cases in 35 days in Pennsylvania (2019), and
2 cases in 2 days in Massachusetts (2020).
This is extremely concerning because while intentional
nitrate/nitrite exposures reported to poison centers are
uncommon, they have skyrocketed since 2020 and have the
potential to cause death very quickly, before assistance can
be summoned. It is important for health care providers
across the country to be aware of the dramatic increase in
suicidal poisonings and deaths from these low-frequency but
very high-consequence nitrate/nitrite exposures.
 

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