TY - JOUR
T1 - Symptomatic Exposures Among California Inmates 2011–2013
AU - Butterfield, Michael
AU - Al-Abri, Suad
AU - Huntington, Serena
AU - Carlson, Terry
AU - Geller, Richard J.
AU - Olson, Kent R.
N1 - Publisher Copyright:
© 2014, American College of Medical Toxicology.
PY - 2015/9/27
Y1 - 2015/9/27
N2 - Prisoners have a high prevalence of substance misuse and abuse, but few studies have examined symptomatic exposures among incarcerated populations. We sought to further characterize the nature of these exposures among this population using the California Poison Control System data. Keyword searches identified inmate cases in 2011–2013 for patients 20+ years old exposed to a single substance and taken to hospital from jail, prison, or police custody. Comparisons were made with non-inmate cases during the same period, using similar limitations. Body stuffers and body packers were analyzed as a subgroup. Seven hundred four inmate cases were compared to 106,260 non-inmate cases. Inmates were more likely to be younger, male, and to have engaged in drug misuse or abuse. They most commonly ingested methamphetamine, heroin, acetaminophen, and anticonvulsants. Inmates were more likely to receive activated charcoal (OR 9.87, 8.20–11.88), whole bowel irrigation (OR 44.50, 33.83–58.54), undergo endotracheal intubation (OR 4.09, 2.91–5.73), and to experience a major clinical outcome or death (OR 1.41, 1.05–1.89). When body stuffers and packers were removed, clinical findings were similar, though the odds of a major outcome or death became statistically non-significant. Body stuffers and body packers primarily used methamphetamine and heroin, and compared with other inmates had significantly higher odds of both adverse clinical effects and poor outcome. This large series provides a profile of symptomatic exposures among inmates, a little-studied population. The potential for high morbidity among body stuffers and packers suggests that a high index of suspicion of such ingestions be maintained when evaluating patients prior to incarceration.
AB - Prisoners have a high prevalence of substance misuse and abuse, but few studies have examined symptomatic exposures among incarcerated populations. We sought to further characterize the nature of these exposures among this population using the California Poison Control System data. Keyword searches identified inmate cases in 2011–2013 for patients 20+ years old exposed to a single substance and taken to hospital from jail, prison, or police custody. Comparisons were made with non-inmate cases during the same period, using similar limitations. Body stuffers and body packers were analyzed as a subgroup. Seven hundred four inmate cases were compared to 106,260 non-inmate cases. Inmates were more likely to be younger, male, and to have engaged in drug misuse or abuse. They most commonly ingested methamphetamine, heroin, acetaminophen, and anticonvulsants. Inmates were more likely to receive activated charcoal (OR 9.87, 8.20–11.88), whole bowel irrigation (OR 44.50, 33.83–58.54), undergo endotracheal intubation (OR 4.09, 2.91–5.73), and to experience a major clinical outcome or death (OR 1.41, 1.05–1.89). When body stuffers and packers were removed, clinical findings were similar, though the odds of a major outcome or death became statistically non-significant. Body stuffers and body packers primarily used methamphetamine and heroin, and compared with other inmates had significantly higher odds of both adverse clinical effects and poor outcome. This large series provides a profile of symptomatic exposures among inmates, a little-studied population. The potential for high morbidity among body stuffers and packers suggests that a high index of suspicion of such ingestions be maintained when evaluating patients prior to incarceration.
KW - Body stuffer
KW - Drug abuse
KW - Poison control
KW - Prisoner
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U2 - 10.1007/s13181-014-0456-6
DO - 10.1007/s13181-014-0456-6
M3 - Article
C2 - 25526949
AN - SCOPUS:84940450596
SN - 1556-9039
VL - 11
SP - 309
EP - 316
JO - Journal of Medical Toxicology
JF - Journal of Medical Toxicology
IS - 3
ER -