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September 16, 1983

The Cocaine 'Body Packer' Syndrome: Diagnosis and Treatment

Author Affiliations

From the Departments of Medicine (Clinical Pharmacology) (Dr McCarron) and Emergency Medicine (Drs McCarron and Wood), University of Southern California School of Medicine and Los Angeles County /University of Southern California Medical Center, Los Angeles. Dr Wood is now with the Department of Emergency Medicine, Wilford Hall US Air Force Medical Center, Lackland AFB, San Antonio, Tex.

JAMA. 1983;250(11):1417-1420. doi:10.1001/jama.1983.03340110031027

The current recommended treatment for cocaine "body packers" is surgical removal of the drug packages to prevent death due to cocaine poisoning. We describe 47 patients treated successfully with purgation and one patient who required surgery to remove packages obstructing the small bowel. Treatment decisions depend on the physical findings, the location of the cocaine packages in the gastrointestinal (GI) tract, and the type of package. Twelve patients (25%) had packages highly susceptible to breakage or leaching cocaine; in two cases, pieces of wrapping sloughed in the GI tract, and in another, a bag broke as it was being passed. In 36 cases (75%), the packages were more resistant to breakage or leaching cocaine, and no complications occurred. The types of packages can often be distinguished roentgenographically; however, 12 patients who passed cocaine packages had abdominal roentgenograms that did not show these foreign bodies.

(JAMA 1983;250:1417-1420)