Man Goes to Doctor with Headache, Discovers It's a Drug Packet He Put Up His Nose 18 Years Ago

For one man, years of blocked noses and recurrent sinus infections turned out to be the result of a drug smuggling escapade almost two decades prior.

A medical case report published in BMJ Case Reports describes a 48-year-old man in Sydney, Australia, whose headaches and persistent sinus problems were caused by a 1.9-centimeter balloon filled with marijuana that had been lodged in his nasal cavity since he was 30.

The patient sought medical attention for headaches and was referred to the Ears, Nose and Throat (ENT) Department at Westmead Hospital in Sydney, New South Wales, after a CT scan revealed a 19×11 millimeter lesion in his right nostril. A subsequent nasendoscopy detected "a firm gray mass" in his nasal cavity.

"The foreign body was removed endoscopically under general anaesthetic," the report states. "The histopathology report noted a 'rubber capsule containing degenerate vegetable/plant matter'."

The plant matter turned out to be cannabis. On further questioning, the man admitted he had shoved the package up his nose to smuggle the drug into a correctional facility 18 years earlier.

He said the cannabis-filled rubber balloon had been given to him by his girlfriend during a prison visit. While he successfully managed to smuggle the contraband past the prison guards and into the facility, he was unable to retrieve the package and instead, pushed it further up into the nasal cavity.

The man told medics he believed he had accidentally swallowed the package and remained completely unaware of its presence until the histopathology report—in spite of the "nasal obstruction" and "recurrent sinonasal infections" he experienced in the years since.

This, the case report explains, is a particularly unusual example of a rhinolith—the medical term for a stone present in the nasal cavity. (Rhinolith literally translates to "nose stone" in ancient Greek.)

It doesn't have to be a stone. It could be a similarly small hard object like a plastic bead or a dislodged tooth but this is, according to the journal, only the second case to be reported that involves an illicit drug. The first involved codeine and opium wrapped in a nylon sheet.

The case report authors suggest this may be because most drug smuggling attempts involve swallowing the package, which "acts as a bezoar" and can be collected after it has made its way through the gastrointestinal tract and out of the body.

"Nevertheless, an index of suspicion of rhinolith should be maintained in all cases of unilateral nasal symptoms," they add.

These symptoms can include nasal obstruction, headache and facial pain as well as bleeding and/or puss-like discharge from the nasal cavity. Signs a rhinolith is present also include malodour, an unpleasant smell that should be obvious to the patient.

In this case, the drug package was removed and the man's symptoms subsided. At a three-month follow up appointment, he reported "complete resolution" of the health problems that had encouraged him to seek medical attention in the first place.

He is far from the first to get creative when it comes to smuggling illegal substances past authorities. Some more imaginative methods have involved fake carrots, fake pants and fake implants. In another incident, three women hoped nun outfits would dispel suspicion as they attempted to smuggle two kilos of cocaine to the island of San Andres.

cannabis plant
The patient's persistent sinus infections and headaches were the result of a drug package he had stuffed up his nose aged 30. Pictured: cannabis plant. Uriel Sinai/Getty

The article has been updated to correct the name of the journal to BMJ Case Reports from the British Medical Journal (BMJ).