Heroin Body Packers

"Mules" who ingest large numbers of multiply wrapped packages of heroin for smuggling, home catharsis, and later street distribution. Abdominal x-rays confirm status and direct whole-bowel irrigation (WBI) with polyethylene glycol electrolyte (PEG) in asymptomatic patients.

Symptomatic heroin packers can be managed medically with AC, naloxone infusion, and WBI (symptomatic cocaine packers need surgery to prevent gastrointestinal ischemic necrosis and high case fatality rates (CFRs).

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