Extreme bradycardia in a case of benzodiazepine intoxication in a “body stuffer”

Abstract

Transport intoxication in the form of body stuffing, a dangerous practice involving the ingestion or insertion of psychoactive substances into the body to evade detection during drug trafficking, represents a major medical problem that requires immediate attention in the emergency department. Unlike body packing, where substances are encapsulated and swallowed for later extraction, body stuffing involves direct ingestion without wrapping, which greatly increases the risk of serious intoxication and even death. Benzodiazepines, due to their high demand on the black market, are among the most common drugs used in body stuffing. The management of this type of poisoning in the emergency department presents a significant clinical challenge due to the variability in clinical presentation, which can range from drowsiness and confusion to respiratory depression and coma.Rapid and accurate assessment is critical for effective management.The initial focus is on patient stabilization and life support as needed, which may include administration of naloxone to reverse opioid effects, mechanical ventilation for respiratory depression, and management of seizures if they occur.An appropriate approach in the emergency department is crucial to improve the prognosis and quality of life of patients affected by this type of poisoning. Timely intervention and expert management can prevent serious complications and even death. We present the case of a patient with benzodiazepine intoxication with an atypical presentation due to clonazepam transport with bradycardia and its management in an institution in Bogotá-Colombia. © 2024 The Authors