Cocaine Intoxication-Clinical Findings from 402 Acute Deaths

Abstract

The act of concealing illicit packets of drugs in body cavities for trafficking purposes is not only criminal but could prove to be a fatal venture. The most frequent cause of death among drug couriers is acute drug intoxication due to rupture of the packages inside the body. These illicit substances are often ingested with aids of balloons, condoms or plastic bags and in some cases packets are inserted into the rectum or vagina. In this report, we present a seven year study, from 402 autopsied victims spanning from 1999-2005 which included male and female cocaine couriers from Nigeria. A detailed autopsy was carried out on each body brought to the Pathology department. The different tissues and organs involved were studied and all pathological changes noted. In all the law enforcement agencies responsible for narcotics and other drugs were available before autopsy was carried out. The ratio of incidence of male to female was approximately 4:1. Results showed overwhelmed cerebral haemorrhage with massive oedema in the CNS. This trend was observed mostly among male couriers. Also the gastrointestinal tract revealed massive erosion of underlying mucosa with torrential haemorrhage. We also observed gross heart enlargement, severe pulmonary oedema and gross anthracotic patches in the lungs. Bitten tongues and multiple haemorrhages on serial cutting of the tongue were also observed. It should be noted therefore that materials used for concealment of these illicit drugs are not full proof. These can undergo damage while inside the body as we have seen, leading to acute intoxication due to mucosal absorption and death. Law enforcement agents should be suspicious of seizures and sudden deaths of would be travellers at airports. Massive campaign is needed by government to educate intending drug couriers on the dangers of this venture and the fatal consequences they might face in the process.