Body packers and body stuffers: cocaine intoxications reported to French poison centers (January 1, 2020-December 31, 2024).

Introduction: Cocaine use has increased significantly over the past three decades. This study aimed to analyze cases of cocaine intoxication involving body packing and body stuffing, focusing on symptomatology, treatment, and clinical outcomes.

Methods: A retrospective analysis was performed of cases of cocaine poisoning recorded in the French national poison center database over a five-year period (2020-2024). Extracted data included demographics, amount and route of cocaine concealment, number of pellets, clinical presentation, management, outcomes, location of arrest, and packaging type. An ordinal logistic regression was conducted to identify factors associated with poisoning severity, using the Poisoning Severity Score as the dependent variable.

Results: Among 2,534 cases of cocaine intoxication, 146 involved body packers or body stuffers: 73 body packers and 73 body stuffers. The male-to-female ratio for body packers was 3.3:1, and for body stuffers, it was 72:1, with only one female. The median age of body packers was 25.5 years (range: 17-62 years) and for body stuffers, 28.2 years (range: 16-58 years). Body packers ingested between one and 190 pellets, while body stuffers ingested between one and ten pellets, each containing cocaine 1-15 g. Symptoms included gastrointestinal, cardiovascular, neurological, and respiratory effects. One death occurred among body packers, and two among body stuffers. Age was a significant predictor of severity, with older individuals at higher risk of severe outcomes.

Discussion: Cocaine intoxication in body packers and stuffers presents serious health risks. Body packers ingested larger quantities with more secure packaging, while body stuffers ingested smaller amounts but used less secure methods, often due to law enforcement urgency. Despite differences in ingestion patterns, both groups showed similar symptoms, with older body packers more likely to experience severe effects.

Conclusion: While severe complications were rare, cocaine intoxication in both body packers and stuffers can be fatal, highlighting ongoing public health risks related to cocaine trafficking and the need for timely medical intervention.