| Author/s | Spears R, Thompson J |
| Year | 2012 |
| Type of publication | Conference proceeding |
| Link | https://doi.org/10.3109/15563650.2012.700015 |
| Abstract | Background: The Cardiff Poisons Unit is a ward dedicated to the treatment of adult poisoned patients. The management of individuals who swallow illicit drugs for concealment is difficult, with risk of package rupture leading to a large quantity of drugs being rapidly released into the body. Such patients are often admitted whilst in police custody and may not give a reliable history. We aim to study patients admitted to the poisons ward from 2001 to 2009 suspected of concealing drugs within the body. Method: The admissions database was searched for all patients classified as bodypackers or body stuffers. Patient notes were retrieved and details regarding treatment and outcome recorded. Results: Sixty cases (49 male and 11 female) recorded as body packers or stuffers were identified for this period. Of patients questioned regarding current drug use, 37 admitted to heroin use, 20 regularly used cannabis and 12 used cocaine; 5 did not use drugs. The majority of patients (n = 33) were suspected of swallowing packages to avoid detection by police (stuffers), 16 had inserted drugs per rectum and 6 had swallowed drugs packaged for smuggling purposes (packers). Ten patients refused imaging investigations, 20 did not receive imaging for unspecified reasons. Fifteen chest x-rays were negative for packages. Of 20 abdominal x-rays performed 4 were positive and 2 undecided. Two patients received computed tomography, one negative and the other showing multiple packets. A urine toxscreen was performed in 26 of the patients: 11 were positive for benzodiazepines; 9 for cocaine and opiates; 8 for cannabis; 3 for methadone and 1 each for amphetamine and barbiturates. Five of the patients refused treatment. A laxative was given to 31 patients. One patient underwent emergency surgery secondary to package rupture and did not survive. Three individuals were treated for opiate withdrawal whilst admitted. In 18 cases packages were retrieved, in the majority of cases (n = 9) just one package. The largest number of packages retrieved was 50 (in the patient who died). Conclusions: Other cases may have been admitted but not coded as ‘packers’ or ‘stuffers'. As 92% of cases admitted to some recreational drug use, urine screening is often not of great value in assessing package rupture. Many patients are drug users and may suffer withdrawal symptoms whilst in hospital and so may require treatment unrelated to the actual drug concealment. Lack of patient cooperation or reliable medical history adds to the difficulty of managing patients to a standard protocol. |