Body packers: a plea for conservative treatment

Abstract

BackgroundThe incidence of smuggling and transporting of illegal drugs by internal concealment, also known as body packing, is increasing in the Western world. The objective of this study was to determine the outcome of conservative and surgical approaches in body packers.Materials and methodsClinical data on body packers admitted to our hospital from January 2004 until December 2009 were collected. The protocol for body packers required surgery when packets were present in the stomach for >48 h. Outcomes of the conservative and surgical group were assessed and analyzed. Morbidity and mortality were assessed in body packers with drug packets present in the stomach for <48 h and in those with gastric packets for >48 h.ResultsDuring the study period, more body packers were treated conservatively. Mortality was 2% in all patients and was due to intoxication. There were no significant differences of mortality, hospital admission time, and ICU admission time in the compared groups with drug packets in the stomach for less or >48 h. In 24% (4/17) of the patients with bad package material, a ruptured drug packet was found during surgery. This resulted in death in only one patient.ConclusionDrug packets in the stomach for >48 h are not an indication for surgery. We recommend that surgery should only be performed in body packers with signs of intoxication or ileus and reserve conservative treatment for all other patients.

International Smuggling of Cocaine by Body Concealment: A Case Report

“…The mortality and morbidity of these cases was once high because of the low quality of packaging and the primarily surgical treatment approach (5). Improved packaging material used by smugglers and a more conservative treatment approach have reduced the mortality and morbidity (5,9).…”

“…2017; 19(2):e38964. 3 conservative management (1,5,11). The lack of an antidote makes cocaine intoxication dangerous.…”

“…Body packer syndrome is the term used to describe individuals who present with intestinal obstruction from impacted packets or specific drug toxicity due to rupture of one or more drug-filled packet (4). Smugglers present to hospital either after detection by customs, or following the development of symptoms and signs of ingested drug toxicity or intestinal obstruction (5). Currently available data suggest that careful monitoring of the body packers for possible signs and symptoms of drug toxicity and bowel obstruction is critically important (6).…”

The Internal Machinations of Cocaine: The Evolution, Risks, and Sentencing of Body Packers

“…However, these first packets often tended to burst resulting in the loss of drugs and subsequent death of the body packer [12]." The 'lethal dose of cocaine ranges from 1 to 3 g' [12], so even one ruptured package could lead to acute cocaine toxicity and, if immediate action is not taken, death Figure 2 3-D-reconstruction of both packs in (E) with a clear depiction of the different densities" [13].As this method of drug trafficking has become more sophisticated and developed over time, new packaging has been produced. Now, "drug packets are machine produced and therefore uniform in size and weight.…”

“…Now, "drug packets are machine produced and therefore uniform in size and weight. These newer packets consist of highly compressed drugs in several layers of latex [12]." Many published articles have found that the development of this new packaging has reduced fatalities and even the chance of packaging rupture during transit.…”