Thèse

Medical management of Body Packers at Cayenne Hospital in French Guiana from 2010 to 2015

Author : Clémence Bonnefoy

 

KEY WORDS : Body-Packing, French Guiana, drugs, cocaine, Cayenne hospital

 

INTRODUCTION: French Guiana is used as a drug trafficking pipeline of cocaine to Europe. The number of arrests for transporting cocaine in corpore (in body) has increased exponentially in recent years. Since 2010, the Cayenne Hospital’s Emergecny Care Unit has applied a management protocol medical care system for body-packers. Our objective here is to evaluate its implementation and adapt it with recommendations from our findings.

 

METHOD: We reviewed a first retrospective descriptive study, including 282 patients hospitalized for transporting cocaine in corpore to CHAR between January 2010 and January 2016, and a second qualitative study including interviews of patients imprisonned in RémireMontjoly prison facility in April 2016.

 

RESULT: The abdominal X-Ray confirmed the diagnosis in 97% of cases. The median age was 24 years. 2.8% of patients showed signs of severity (7 toxidromes and 2 occlusions). No surgery or deaths were reported. 28% of patients had a urine screening, of which 60.7% were found positive. The median length of stay was 1.8 days. Prolonged length of stay was significantly associated with the presence of gastrointestinal symptoms, hypoglycemia or having swallowed a minimum of 10 pellets. 8 patients participated in interviews. The average expected payment was 3800€ and the means of sentence was a minimum of 30 months in prison.

 

CONCLUSION: This increase of body-packing suspicion has required global reorganization of management. The current protocol is well applied. However the abdominal pelvic CT is now the gold standard and would reduce the number of false negatives and ensure no residual pellet.