Self-made mixture "Cobra" poisonings in Lithuanian prison

Abstract

Objective: Most substances that can cause abuse are forbidden in prison. Despite this there are many possibilities to use ordinary household items [1] that are available in prison [2] “to get high”. A mixture of tobacco, rodenticides and solvents for abuse has not been reported as a reason of severe poisoning in the available medical literature. We would like to report two cases of smoking a mixture of tobacco with solvents and rodenticides that is called “Cobra”. Mixing tobacco in different proportions with substances mentioned above seems to be quite common in Pravieniškės Correction House-Open Prison Colony. Case reports: Two patients were admitted to the Emergency Department of Hospital of the Lithuanian University of Health Sciences Kauno Klinikos. The first was a 21-year-old male who developed coma after generalized convulsions. After 12 hours of supportive care his status improved and after 20 hours he was discharged from the Emergency Department. The second patient was a 32-year-old male who presented with more severe clinical findings: coma, convulsions and respiratory failure and was admitted to the Intensive Care Unit. In this case lung ventilation was necessary for three days, and the patient stayed in hospital for five days. Both patients were transported back to Prison Colony after treatment. The toxic agent was reported by the staff of Prison Colony and by the patients themselves. Toxicologic investigations were not performed. Conclusion: Abuse of different chemical substances by prisoners is quite common, sometimes by self-made narcotics. Severe intoxications by the mixture of tobacco, rodenticides and solvents can cause convulsions, respiratory depression and unconsciousness.