TUCSON (KVOA) - Over the last decade, Tucson Police said five people have died while in their custody.
Earlier this week they released names, reports, pictures and bodycam footage of the incidents.
The death of Carlos Adrian Lopez in April brought everything to the forefront, including officer training.
The News 4 Tucson's Digger Deeper Team uncovered some of the training that may have saved Lopez' life had been going on for two decades.
On April 21, three officers found a naked man screaming in the garage of his grandmother's home.
The Office of Professional Standards' Administrative Investigation showed it appeared that man, Carlos Adrian Ingram Lopez was "hallucinating." For more than 20 years, officers have received extensive training to recognize "excited delirium."
Retired Tucson Police officer Mark Zojniewicz was a training instructor at the academy. He explained, "excited delirium is medically defined as a state of agitation, excitability, a crashing paranoia.."
Zojniewicz retired after 35 years in law enforcement. He is currently a reserve officer for Oro Valley Police.
He retired from Tucson Police in 2012.
"The behaviors we ask the officers to look for is communication. The person may be hallucinating, he may be delirious, he may be extremely hot," said Zojniewicz.
The majority of his career he taught use of force tactics, defensive tactics, and he even helped write the curriculum for the use of force for Arizona Post, the state agency that licenses police officers.
The officers were also taught to recognize, "He's a danger to himself and anyone else around him."
So what triggers excited delirium?
News 4 Tucson asked Dr. Francisco Moreno, professor of psychiatry at the University of Arizona's College of Medicine in Tucson and Phoenix.
"It can be triggered by stimulants, like meth, cocaine, other substances that are used medically can also be very strong stimulants," said Dr. Moreno.
The police manual goes into detail about excited delirium and how it often happens during in-custody deaths.
Dr. Moreno added, " Often we consider delirium a very serious medical presentation. That if not treated adequately can lead to very bad consequences including death."
TPD's policy also laid out the symptoms, one of which the subject saying, "I can't breathe," and what officers should do.
Zojniewicz said, "This is a time-sensitive event, this person needs to be captured, controlled and restrained, and be put on his side to be given medical attention."
"It's essential that they approach it as a medical high-risk condition," Dr. Moreno agreed.
He also has a message, not just for first responders, but for the community if they identify someone acting erratic, paranoid and out of character to seek medical help immediately.
He added, there are specially trained mental health units available to help.