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What Happens When a Bag of Cocaine Bursts in Your Stomach

Transporting illegal drugs across borders is a business that can be as profitable as it can be lethal.

This article originally appeared on VICE Spain.

On March 22, a Lithuanian man landed in Barcelona and boarded metro line 9 with his luggage, but without a ticket. Witnesses describe how he started behaving weirdly, and when security guards came up to him and asked for a ticket, he fell on the ground and started shaking and foaming at the mouth. The guards couldn't have known, but that guy was a mule, a body packer: He had been carrying cocaine in his stomach in an attempt to smuggle it into Spain.


Transporting illegal drugs across borders is a business that can be as profitable as it can be lethal, and it has gained popularity in Spain since the economic crisis began. The man in question broke down because one of the bags of cocaine he carried in his stomach had ruptured. There wasn't anything the emergency services could do—15 grams of coke ended his life. When forensic doctors investigated the body, they found 34 capsules of cocaine inside him.

Such cases are pretty rare—several doctors working in emergency units in Spanish hospitals told us that a patient who's had a packet of drugs rupture inside him or her comes in about once a year. If everything goes according to plan, the bags leave the mule's body in his or her stool. They're in an ideal shape to be excavated and can stand the gastric acid that helps dissolve foods in your stomach.

"This one time, I escorted a man in his sixties to airport security. He was in his own wheelchair, so we changed him into an airport wheelchair to get him through the scanner. Once it was all over and security hadn't found anything, I took him to the gate. The guy miraculously recovered, got up, and walked ahead."

When things go wrong, however, it's hard for doctors to detect what substance the carrier has ingested, as they are either unconscious or plainly unwilling to talk about it. When the latter happens, "it's a bit like working with your eyes closed," as one doctor who wishes to remain anonymous put it. In many cases, the mules are more afraid of being caught with the drugs than they are of dying.


I got in touch with Dr. Fernando Caudevilla—a GP specialized in the physical effects of cannabis, cocaine, and synthetic drugs. Aside from his day job, he's also a medical advisor for drug users on the deep web, and he has also made a name for himself through working with Spanish drug risk reduction organization Energy Control. He explained: "Body packers can carry up to two hundred packs on each trip, with each pack containing between two and fifty grams of a substance. The packets are also often wrapped in yellowish latex tubes, between one and two inches long. When someone is caught through radiography at customs, they usually show no symptoms of having taken the drugs. In that case, they will be given laxatives to pass the pellets. A drug wrapper breaks rarely—less than one to three percent of the time."

An emergency doctor from Barcelona who also wishes to remain anonymous because she has worked with patients who were body packers, added: "If one of those wrappers breaks, the body packer is in serious trouble. A cocaine overdose can produce a psychotic episode and a nervous state that ambulance personnel will try to treat with injectable Diazepam. If the drugs have spread throughout the body, one of the common effects is vasoconstriction—increased blood pressure caused by the constriction of blood vessels. Heart attacks and vasoconstriction are the most common causes of death in those cases. If we suspect that a patient has overdosed, we perform a barium x-ray. The barium also has a laxative effect. If we discover that it's indeed a severe overdose, we immediately have the drugs surgically removed from their system."


When inserted anally, the wrappers are relatively easy to extract—if they went through the vagina, the process is way more traumatic. In this case, the packs are removed manually and without utensils, to make sure that the wrappers don't tear. In Argentina, the problem is so frequent that a hospital close to Ezeiza airport near Buenos Aires has a special unit for treating body packers.

Of course, body packers have come up with ways to get around being detected and searched at the airport. Arnau works at Barcelona airport and used to be in charge of accompanying passengers with reduced mobility. Every time a passenger in a wheelchair had to go through the body scanner, he had to make them change into an airport-owned wheelchair. If the alarm went off, the wheelchair had to be changed, and the passenger received a body search. "This one time, I escorted a man in his sixties," Arnau says. "He was only carrying a little suitcase and a jacket. He was in his own wheelchair, so we changed him into an airport wheelchair. He kept shouting 'ay ay ay ay!' throughout the experience. When he went through the scanner, the alarm went off, so he was taken into a small room nearby and searched. Again, every time they tried to touch him, he would scream. The security officer gently frisked him but didn't make him take off his shoes or jacket. It was so hard to tell if he really was in pain or not, but I felt terrible that we were putting him through this ordeal. Once it was all over, and they hadn't found anything, I took him to the gate. The man miraculously recovered, got up, and walked ahead."

On other occasions, the signs were subtler: Arnau has regularly been asked where the wheelchairs were by people happy and seemingly spry on their feet, who would minutes later appear riding in one.

When it comes to cocaine, most busts in Spain take place in ports, where drugs arrive in tons. Drug mules work individually, and the stash they carry can be easily replaced if they get caught or worse. There are statistics on drug mules in Spain, but there's a big chance they're not representative because police and anti-drug operations always focus on the big fish—a coke filled cargo ship leading to some drug kingpin is always more exciting than a poor soul, who had to resort to smuggling drugs because they found themselves in a bad financial situation. Those smuggling 15 pellets of cocaine in their intestines are the weakest links in a chain that seems impossible to break.

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