Acute intestinal obstruction due to sponge bezoar in a patient with a history of eating disorders: a case report.

Drug trafficking is a multifaceted global issue that presents significant challenges to law enforcement agencies, policymakers, and societies worldwide []. Defined as the illegal trade of narcotics, it involves intricate networks spanning production, transportation, and distribution []. It mirrors high and growing global prevalence of drug use, with the United Nations Office on Drugs and Crime (UNODC) World Drug Report 2025 estimating that 316 million people worldwide had used drugs in the past year, representing approximately 6% of the global population aged 15–64 years [,]. UNODC systematically monitors and researches illicit drug markets to understand their dynamics []. For example, it has been determined that a substantial portion of the world’s heroin, approximately 350–580 tons, originates from Afghan opium []. Major trafficking routes, such as the Balkan – traversing Iran, Turkey, Greece, and Bulgaria – and northern routes – typically passing through Central Asian countries such as Tajikistan and Kyrgyzstan, which serve as transit points on the route to Russia- serve as key conduits for heroin, linking Afghanistan to markets in the Russian Federation and Western Europe []. By contrast, cocaine predominantly circulates in North America and western and central Europe, regions which together accounted for over 40% of global seizures in 2020, reflecting their role as the principal consumer markets. Cocaine production reached almost 2,000 tons in 2020 and has continued to rise steadily over the past decades []. The trafficking of cocaine often involves transportation from Colombia to Mexico or Central America by sea, followed by overland routes to the United States and Canada. In Southeast Asia, countries commonly implement stringent penalties for drug-related offenses due to the prevalence of the ‘golden triangle’ of drug production, historically a global center of opium production. These penalties include lengthy prison sentences and, in some cases, the death penalty []. Increasingly this region is witnessing extensive trafficking of synthetic drugs. In 2024, authorities in East and Southeast Asia seized a record 236 tons of methamphetamine, representing a 24% rise from the 190 tons confiscated the year before []. These findings are consistent with the World Drug Report 2025, which identified amphetamine-type stimulants (ATS) as the dominant category among synthetic drug seizures globally []. An international operation coordinated by the International Criminal Police Organization (INTERPOL) targeting drug trafficking in Southeast Asia resulted in unprecedented seizures of synthetic drugs, with an estimated total value of approximately USD 1.05 billion, highlighting the scale and complexity of regional illicit drug networks []. Clearly, widespread drug trafficking of a range of substances is a global issue. It has complex societal determinants and impacts, and frequently intersects with other illicit activities, such as sex work. The exploitation of vulnerable individuals, often coerced into sex work due to drug addiction or financial desperation, underscores the interplay between these phenomena []. This article specifically examines these phenomena in Bangladesh. Bangladesh is situated between the Golden Triangle and the Golden Crescent and has emerged as a critical transit point for international drug smugglers. Despite not sharing direct borders with Laos or Thailand, its proximity to Myanmar renders it vulnerable to trafficking routes emanating from the Golden Triangle []. Yaba (a mixture of methamphetamine and caffeine) and Phensedyl (a pharmaceutical cough syrup combining codeine and chlorpheniramine) continue to flood the market in Bangladesh, exacerbated by Myanmar’s failure to curb yaba production and India’s increased Phensedyl smuggling, reflected in a rising number of seizures by the authorities. Drug networks are known to distribute yaba from Myanmar into Bangladesh through India’s Mizoram, Meghalaya, and Assam. They enter Bangladesh via Zakiganj in Sylhet. Despite increased vigilance in Cox’s Bazar, this route offers less risk to traffickers. Another route via Teknaf-Kuakata was also utilized previously []. More recently, drugs like crystal meth pose emerging threats []. The scale of trafficking in Bangladesh is reflected in the most recent national data published by the Department of Narcotics Control (DNC), Bangladesh (2023–2024). This reported 20,704 cases involving 21,924 accused individuals, along with the seizure of, for example 3.7 million yaba tablets, 25.5 kg of heroin, 8.5 kilograms of cocaine, and 8,146 kilograms of cannabis []. The societal impact of such proliferation of drugs on the Bangladeshi population is considerable. For example, it has been estimated that around 8–8.5 million people in Bangladesh are drug users, primarily young people []. The trade is fueled by international drug rings using the country as a transit hub and poses significant challenges to local authorit