RT Journal Article
SR Electronic
T1 Packers, pushers and stuffers—managing patients with concealed drugs in UK emergency departments: a clinical and medicolegal review
JF Emergency Medicine Journal
JO Emerg Med J
FD BMJ Publishing Group Ltd and the British Association for Accident & Emergency Medicine
SP 316
OP 320
DO 10.1136/emj.2008.057695
VO 26
IS 5
A1 R J Booker
A1 J E Smith
A1 M P Rodger
YR 2009
UL http://emj.bmj.com/content/26/5/316.abstract
AB Body packing, pushing and stuffing are methods by which illicit drugs may be carried within the human body. Patients involved in these practices may present UK emergency departments with complex medical, legal and ethical considerations. This review article examines not only the evidence behind the clinical management of these patients, but also the legal powers afforded to the authorities to authorise the use of intimate searches and diagnostic imaging for forensic purposes. Serious complications from concealed drug packets are now rare, and most asymptomatic patients may be safely discharged from hospital after assessment. Emergency surgery is indicated for body packers with cocaine poisoning and for some cases of heroin poisoning. Urgent surgery is indicated for obstruction, perforation, the passage of packet fragments and failure of conservative treatment. Guidance is given for doctors who are faced with requests from the authorities to perform intimate searches and diagnostic imaging for forensic purposes.