CLINICAL COURSE OF CRACK COCAINE BODY STUFFERS

Study objective: To describe the clinical course of a cohort of patien ts presenting to the emergency department with acute crack cocaine bod y-stuffer syndrome. Methods: We conducted a retrospective cohort study in the ED of a county hospital with 75,000 visits per year. Our study cohort comprised all patients who presented between January 1993 and April 1995 and who met the definition of a crack cocaine body stuffer. We defined a crack cocaine body stuffer as anyone who admitted to or was strongly suspected of ingesting crack cocaine as a means of escapi ng detection by authorities, not for recreational purposes or as a mea ns oi transporting the drug across borders. Results: We identified 98 cases; most such patients were brought to the ED by law enforcement ag ents. Most were male and younger than 30 years. Self-report by patient s indicated that the amount of crack cocaine ingested ranged from 1 to more than 15 rocks. Most commonly the drug was unwrapped (28%) or wra pped in a plastic sandwich bag (29%), Generalized seizures developed i n 4% of the patients; in all these patients seizures occurred within 2 hours of ingestion. In no patient did dysrhythmias develop. Many pati ents had minor signs of cocaine intoxication: 54% were tachycardic, 23 % were hypertensive, 22% were agitated, and 29% required sedation. Con clusion: Mild cocaine intoxication is common in crack cocaine body stu ffers, with seizures occurring within 2 hours of ingestion in a small percentage of patients.