Drug mules: see how doctors catch them

It's not a task many doctors would do regularly, but for Dr Stephen Asha, staring into the belly of a drug mule is pretty run of the mill.

The emergency medic at St George Hospital sees six or seven - sometimes up to 10 - "body packers" a month, courtesy of police officers who escort suspected smugglers from nearby Sydney Airport.

Dr Asha and his colleagues use CT scans to confirm the suspects are "packing concealed objects", usually illicit drugs, in their digestive system in an attempt to sneak past immigration security.

But the drug smugglers are getting more and more devious, Dr Asha says.

"One guy wore metal rods under his clothing to try and disrupt the CT scanning equipment. He did a good job of it too," Dr Asha told Australian Doctor.

The registrar examining these scans completely missed the packages. It was only when the supervisor double checked the distorted scans that the man was confirmed as a body packer.

Another "tricky way" drug mules are trying to outwit their pursuers is to disguise their cargo as stools.

"We're not sure if it's the composition of the drugs or the packaging they use to wrap drug packages, but when they show up on the CT scans they just look like faecal matter," Dr Asha said.

Image gallery of abdominal CT scans performed on drug mules - courtesy of Dr Asha.

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In one case, this fooled the doctors at first, but the jig was up when a colleague suggested changing the viewing settings to a mode not usually used to screen the abdomen.

This revealed close to 50 packages of illicit drugs concealed in the man's digestive tract.

Dr Asha said the men, and occasional women, were not hardened criminals, but mostly migrants from developing countries who spoke little English, were down on their luck and fell in with the wrong crowd.

"By the time they have been caught by police and come to us, they are pretty happy to have the packages out of their system. All we have to do is offer them a laxative," he said.

The body packers are monitored by hospital staff until they pass the packages, at which point a second CT scan is performed to confirm their system is clear.

Police then have "the unenviable job" of searching through the stool, Dr Asha said.

No packages have ruptured among body packers who attended the hospital over the last five years, but the risk is ever-present.

"These guys are taken straight to jail after they leave us. It would be disastrous if one of those packages were to rupture when they are in an unmonitored cell," he added.

"And if they pass the product in jail, then we've introduced illicit drugs among prisoners, which I'd say isn't a great thing either."

Dr Asha and his colleagues have been debating whether they could reduce radiation exposure by performing just one initial scan, using it to count the number of concealed packages, then waiting until they have all been passed.

However, in a study, they have confirmed that the exact number of concealed packages cannot be accurately counted, suggesting a second scan remains necessary.

Emergency Medicine Journal 2014; online.