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.