Wetli first uses the term "excited delirium syndrome" in a forensic science academic journal to refer to episodes of "psychosis" followed by sudden death in cocaine users in 1985.

In a Miami newspaper in 2010, Wetli will describe the profile of individuals who receive the label of "excited delirium" post-mortem: "It only happened in chronic users of cocaine, and predominantly in males... it's as if they're impervious to pain–to pepper spray, to batons, to numchucks [sic]. You spray them with pepper spray and they just sort of look at you" (Garcia Roberts, 2010).

The cases that Wetli draws on will later prove unusable as the bodies that he bases his research on are actually people who died from asphyxiation, and not people who died from acute agitation after cocaine use.