Carolinas Core Concepts Core Concepts in EM; a repository for Carolinas lecture summaries.

5Sep/11Off

Packers vs. Stuffers

Michael Beuhler, MD

  • Packers vs. Stuffers:
    • Packer: a person who premeditates a careful ingestion or rectal insertion of multiple (50-100) packets. These typically contain heroin, cocaine, amphetamines, hash, or ecstasy. The packets are well prepared, usually with multi-wax layers in and over a condom.
    • Stuffer: a person who impulsively ingests (or inserts) only a few packages.  Typically the package is not well-prepared and act was not premeditated. Marijuana, crack, heroin, cocaine, amphetamines, and prescription medications are the drugs most commonly found in a stuffer.
  • A protocol ensuring whole bowel irrigation (WBI), prolonged observation and complete removal of all drug packets results in low morbidity and mortality among drug packers. The goal of WBI is 1L/hr with Go-Lytely
  • Before discharge of an asymptomatic packer, the patient must be observed for 24 hours after the passage of 2 packet free stools and until all packets known to be passed, usually studied by a contrast CT scan.

 

Emerg Med J 2011: 28:98-101. Establishment of a definitive protocol for the diagnosis and management of body packers (drug mules). Mandava N et al.

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