“Body packing” refers to the internal concealment of illicit drugs (usually in large quantities) for transportation across international borders. The drug is usually of a single type and meticulously packaged in plastic, latex, condoms or balloons. Many hours have usually elapsed before presentation to the emergency department, so most packets have already entered the small or large intestine. The vagina and rectum are not usually used for body packing, as they are more likely to be discovered on physical examination. Cocaine, heroin, amphetamine, 3-4-methylenedioxymethamphetamine (MDMA, “ecstasy”), cannabis and hashish have all been reported to have been transported by body packing. Up to 1 kg of drug, divided into 50-100 packets, may be transported by a single individual. Body packers (often referred to as ‘mules’ or ‘swallowers’) use constipating agents such as atropine-diphenoxylate to slow gastrointestinal transit such that it may take from days to weeks for all packages to pass.
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