On-site screening and GC–MS analysis of cocaine and heroin metabolites in body-packers urine

https://doi.org/10.1016/j.jpba.2007.11.025Get rights and content

Abstract

The illicit transportation of cocaine and heroin either swallowed or inserted into the rectum and/or vagina of individuals, defined as “body-packers”, is becoming increasingly common. Assessment of smuggling by urinalysis from body-packers has been sparsely reported and on-site rapid screening methods are essentially lacking.

We screened the presence of cocaine and heroin metabolites in urine from suspected body-packers by an on-site immunochromatographic test and confirmed the obtained results by gas chromatography–mass spectrometry and X-ray examination.

Samples were collected from 64 individuals (45 men, 19 women) stopped at Fiumicino and Ciampino airports of Rome (Italy) for suspicion of internal concealment of cocaine and heroin between October 2006 and July 2007. Urine was immediately screened on-site by Cozart® rapid urine test. Irrespective of test results, individuals underwent X-ray examination and urine samples were analyzed by gas chromatography–mass spectrometry (GC–MS). In 48 out of 64 cases (24 positives and 24 negatives) screening results were confirmed by GC–MS assay and X-ray examination. In 5 cases, positive to the on-site test and GC–MS analysis, abdominal radiography was negative and individuals resulted to be drug users. In 11 cases, negative to the on-site test and radiological investigation, GC–MS analysis found benzoylecgonine in 10 cases and morphine in one case. Concentration of both substances was in all cases lower than 50 ng/ml and compatible with personal drug use.

From obtained results, on-site detection of cocaine and heroin metabolites in the urine of suspected body-packers appears to be a reliable screening test to disclose internally concealed drugs and justify subsequent radiological investigations.

Introduction

Body-packers or “mules” are people who ingest packets filled with illicit drugs (typically cocaine or heroin) in the attempt to pass undetected through airport customs. From the first report of 1973 about an individual who swallowed a condom filled with hashish in Toronto [1], the smuggling of illicit drugs either swallowed or inserted into the rectum and/or vagina is becoming increasingly common [2], [3]. The detection of this practice is of major importance, not only in the apprehension and prosecution of these smugglers, but also eventual severe health consequences [4]. The “body-packer syndrome” can show the features of acute drug intoxication, intestinal occlusion and delirium leading in some cases to sudden death [5], [6], [7].

Suspicious circumstances (e.g. travel route, person's behaviour, refusal of meals during flight, signs of intoxication, information by foreign or local police) can induce customs agents to stop suspected “body-packers” at airport after disembarking. The diagnosis of body packing can be started based on physical examination (e.g. abdominal and rectal examinations), but subsequent abdomen radiography is necessary to confirm internal concealment of drugs and induce packets passing after a purge [2], [4]. Nonetheless, some types of packaging may not be always visible on abdominal radiographs [8]. Moreover, to avoid detection pregnant women are used as body-packers, since exploration by X-rays is prohibited in these individuals, unless strong evidences of smuggling are available [9].

Detection of illicit drugs in urine from body-packers by immunological screening method, confirmed by gas chromatography–mass spectrometry (GC–MS), has been sparsely reported during the nineties and the application of on-site rapid screening methods was essentially lacking. Contradictory results led some authors to conclude for beneficial role of urinalysis and some others for its limited outcome [10], [11], [12].

We aimed to assess the reliability of an on-site immunochromatographic test for screening the presence of cocaine and heroin metabolites in urine from suspected body-packers, confirming the obtained results by gas chromatography–mass spectrometry and X-ray examination.

Section snippets

Chemicals and materials

Cozart® rapid urine multi-panel test was gently donated by Cozart Italia (Pomezia, Roma, Italy).

Cocaine-HCl, benzoylecgonine tetrahydrate (BZE), morphine-HCl, nalorphine-HCl, used as internal standard, I.S., were purchased from Salars (Como, Italy). N,O-Bis(trimethylsilyl) trifluoroacetamide (BSTFA) with 1% trimethylchlorosilane (TMCS) was obtained from Sigma–Aldrich (Milano, Italy). Bond Elut Certify solid-phase extraction (SPE) columns were from Varian (Palo Alto, CA, USA). Ultrapure water

Results and discussion

Of the 64 analyzed urine samples, on-site screening gave 29 positive results (26 for cocaine, 2 for cocaine and heroin and 1 for heroin) and 35 negative results (Table 1).

Of the 29 positive screening results, all confirmed by GC–MS for the presence of cocaine and/or heroin metabolites, 24 were from body-packers as demonstrated by X-ray examination (Table 1). Specifically, abdominal radiographs disclosed 19 cases of body packing by ingestion, 1 by ingestion and rectal insertion, 1 only by rectal

Conclusion

Detection of body packing can be a difficult task because most of the smugglers behave normally, and due to the increasing of sophistication of packaging it is not always possible to disclose internal concealment of drugs by abdominal radiographs.

In this study, we showed that there is a striking relation between the presence of drugs in urine and body packing of cocaine and heroin. The on-site Cozart® rapid urine multi-panel test used to screen the presence of cocaine and heroin metabolites in

Acknowledgments

The authors thank Dr. Federico Ferro From Cozart Italia S.r.l. for providing the on-site drug test for urine screening for cocaine and opiates.

The authors are grateful to the “Comando Gruppo Guardia Di Finanza Di Fiumicino” for their helpful cooperation during all the steps of the present investigation.

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