Decontamination
Most exposures to cocaine are from snorting, intravenous injection or smoking, so gastrointestinal decontamination is not indicated.
Gastrointestinal decontamination may have a role in the management of ‘body stuffers’ and ‘body packers’1. Activated charcoal for gastrointestinal decontamination can be used for ‘body stuffers’ because there is a risk of drug leakage from ingested packages. Whole bowel irrigation can be used for ‘body packers’. Discuss these cases with a clinical toxicologist.
1 ‘Body packer’ refers to an individual who smuggles large quantities of illicit drugs in securely sealed packages. Leakage of the packaging is usually delayed, by which time it has entered the small or large intestine; presentation to the emergency department is often long after swallowing the packages. ‘Body stuffer’ refers to an individual who hurriedly ingests illicit drugs in insecure packages to avoid arrest. This packaging has a high risk of leakage and patients are likely to present earlier.Return