A Five-Year Review of the Medical Outcome of Heroin Body Stuffers

Journal of Emergency Medicine

Volumn 36, Issue 3, 2009, Pages 250-256

  Jordan, Matthew T ^a   Bryant, Sean M ^b   Aks, Steven E ^b   Wahl, Michael ^b  

^a RESURRECTION MEDICAL CENTER   (United States)

^b ILLINOIS POISON CENTER   (United States)

Author keywords

body packer; body stuffer; heroin; overdose; poisoning

Indexed keywords

DIAMORPHINE; NALOXONE; OPIATE;

ARTICLE; CONTROLLED STUDY; DISEASE COURSE; DRUG INTOXICATION; DRUG OVERDOSE; DRUG TRAFFIC; HEROIN DEPENDENCE; HUMAN; MAJOR CLINICAL STUDY; OUTCOME ASSESSMENT; PRIORITY JOURNAL;

ADULT; ANTIDOTES; CHARCOAL; COMBINED MODALITY THERAPY; COMMERCE; EATING; ENDOSCOPY; FEMALE; HEROIN; HUMANS; IRRIGATION; MALE; NALOXONE; NARCOTIC ANTAGONISTS; POISONING; TIME FACTORS;

EID: 62749196581     PISSN: 07364679     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jemermed.2007.06.022     Document Type: Article

References (43)

1. The National High Intensity Drug Trafficking Area Program (2004), Office of National Drug Control Policy, Washington, DC
2. Roberts J.R., Price D., Goldfrank L., and Hartnett L. The bodystuffer syndrome: a clandestine form of drug overdose. Am J Emerg Med 4 (1986) 24-27
3. Fishbain D.A., and Wetll C.V. Cocaine intoxication, delirium and death in a body packer. Ann Emerg Med 10 (1981) 531-532
4. McCarron M.M., and Wood J.D. The cocaine 'body packer' syndrome diagnosis and treatment. JAMA 250 (1983) 1417-1420
5. June R., Aks S.E., Keys N., and Wahl M. Medical outcome of cocaine bodystuffers. J Emerg Med 18 (2000) 221-224
6. Sporer K.A., and Firestone J. Clinical course of crack cocaine body stuffers. Ann Emerg Med 29 (1997) 596-601
7. Pulse check: national trends in drug abuse (2004), Office of National Drug Control Policy, Washington, DC
8. Sporer K.A. Acute heroin overdose. Ann Intern Med 130 (1999) 584-590
9. Hamid A., Curtis R., McCoy K., et al. The heroin epidemic in New York City: current status and prognoses. J Psychoactive Drugs 29 (1997) 375-391
10. Hoffman R.S., Chiang W.K., Weisman R.S., and Goldfrank L.R. Prospective evaluation of "crack-vial" ingestions. Vet Hum Toxicol 32 (1990) 164-167
11. Riggs D., and Weibley R.E. Acute toxicity from oral ingestion of crack cocaine: a report of four cases. Pediatr Emerg Care 6 (1990) 24-26
12. Hoffman J.R., Schriger D.L., Votey S.R., and Luo J.S. The empiric use of naloxone in patients with altered mental status: a reappraisal. Ann Emerg Med 21 (1992) 20-24
13. Kleinschmidt K., Wainscott M., and Ford M. Opioids. In: Ford M., Delaney K., Ling L., and Erickson T. (Eds). Clinical toxicology (2001), W. B. Saunders, Philadelphia 627-639
14. DEA briefs & background, drugs and drug abuse, state factsheets, Illinois (2006), U.S. Drug Enforcement Administration, Washington, DC
15. Chicago, Illinois, profile of drug indictors (2005), The Office of National Drug Control Policy, Rockville, MD
16. Illinois drug threat Assessment (2002), National Drug Intelligence Center, Washington, DC
17. Hollander J.E., and Hoffman R.S. In: Goldfrank L.R., Flomenbaum N.E., Lewin N.A., Howland M.A., Hoffman R.S., and Nelson L.S. (Eds). Goldfrank's toxicologic emergencies (2002), McGraw-Hill, New York 1004-1019
18. Boerner U. The metabolism of morphine and heroin in man. Drug Metab Rev 4 (1975) 39-73
19. Oldendorf W.H., Hyman S., Braun L., and Oldendorf S.Z. Blood-brain barrier: penetration of morphine, codeine, heroin, and methadone after carotid injection. Science 178 (1972) 984-986
20. Way E.L., Kemp J.W., Young J.M., and Grassetti D.R. The pharmacologic effects of heroin in relationship to its rate of biotransformation. J Pharmacol Exp Ther 129 (1960) 144-154
21. Girardin F., Rentsch K.M., Schwab M.A., et al. Pharmacokinetics of high doses of intramuscular and oral heroin in narcotic addicts. Clin Pharmacol Ther 74 (2003) 341-352
22. Gyr E., Brenneisen R., Bourquin D., Lehmann T., Vonlanthen D., and Hug I. Pharmacodynamics and pharmacokinetics of intravenously, orally and rectally administered diacetylmorphine in opioid dependents, a two-patient pilot study within a heroin-assisted treatment program. Int J Clin Pharmacol Ther 38 (2000) 486-491
23. Inturrisi C.E., Max M.B., Foley K.M., Schultz M., Shin S.U., and Houde R.W. The pharmacokinetics of heroin in patients with chronic pain. N Engl J Med 310 (1984) 1213-1217
24. Darke S., and Ross J. Fatal heroin overdoses resulting from non-injecting routes of administration, NSW, Australia, 1992-1996. Addiction 95 (2000) 569-573
25. Rop P.P., Fornaris M., Salmon T., Burle J., and Bresson M. Concentrations of heroin, 06-monoacetylmorphine, and morphine in a lethal case following an oral heroin overdose. J Anal Toxicol 21 (1997) 232-235
26. Joynt B.P., and Mikhael N.Z. Sudden death of a heroin body packer. J Anal Toxicol 9 (1985) 238-240
27. Gill J.R., and Graham S.M. Ten years of "body packers" in New York City: 50 deaths. J Forensic Sci 47 (2002) 843-846
28. Darke S., and Zador D. Fatal heroin 'overdose': a review. Addiction 91 (1996) 1765-1772
29. Whipple J.K., Quebbeman E.J., Lewis K.S., Gottlieb M.S., and Ausman R.K. Difficulties in diagnosing narcotic overdoses in hospitalized patients. Ann Pharmacother 28 (1994) 446-450
30. Aks S.E., Vander Hoek T.L., Hryhorczuk D.O., Negrusz A., and Tebbett I. Cocaine liberation from body packets in an in vitro model. Ann Emerg Med 21 (1992) 1321-1325
31. Puschel K., Stein S., Stobbe S., and Heinemann A. Analysis of 683 drug packages seized from "body stuffers.". Forensic Sci Int 140 (2004) 109-111
32. Marc B., Gherardi R.K., Baud F.J., Garnier M., and Diamant-Berger O. Managing drug dealers who swallow the evidence. BMJ 299 (1989) 1082
33. Eng J.G., Aks S.E., Waldron R., Marcus C., and Issleib S. False-negative abdominal CT scan in a cocaine body stuffer. Am J Emerg Med 17 (1999) 702-704
34. Gherardi R.K., Baud F.J., Leporc P., Marc B., Dupeyron J.P., and Diamant-Berger O. Detection of drugs in the urine of body-packers. Lancet 1 (1988) 1076-1078
35. Nihira M., Hayashida M., Ohno Y., Inuzuka S., Yokota H., and Yamamoto Y. Urinalysis of body packers in Japan. J Anal Toxicol 22 (1998) 61-65
36. Pollack Jr. C.V., Biggers D.W., Carlton Jr. F.B., et al. Two crack cocaine body stuffers. Ann Emerg Med 21 (1992) 1370-1380
37. Tomaszewski C., Voorhees S., Wathen J., Brent J., and Kulig K. Cocaine adsorption to activated charcoal in vitro. J Emerg Med 10 (1992) 59-62
38. Utecht M.J., Stone A.F., and McCarron M.M. Heroin body packers. J Emerg Med 11 (1993) 33-40
39. Robins J.B., and Rae P.W. Recovery of ingested heroin packets. Arch Emerg Med 3 (1986) 125-127
40. Krenzelok E.P., McGuigan M., and Lheur P. Position statement: ipecac syrup. American Academy of Clinical Toxicology; European Association of Poisons Centres and Clinical Toxicologists. J Toxicol Clin Toxicol 35 (1997) 699-709
41. Fineschi V., Centini F., Monciotti F., and Turillazzi E. The cocaine "body stuffer" syndrome: a fatal case. Forensic Sci Int 126 (2002) 7-10
42. Wills B., Aks S., Mazor S., et al. Delayed passage of heroin packets by a body stuffer. J Toxicol Clin Toxicol 42 (2004) 758
43. Cumpston K.L., Laeben L., and Crandell C. Life threatening toxicity in a cocaine body "stuffer" greater than fourteen hours from ingestion. J Toxicol Clin Toxicol 43 (2005) 670