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More than half of The Mule is spent watching actor Angus Sampson (as Ray Jenkins) portray a very believable character managing tremendous pain. Sampon sweats profusely, rolls around on his bed, shrieks and groans in agonizing pain. It’s painful even for the viewer, like watching a pregnant woman endure a 10-day labor. Couple Ray’s internal pain with the fact that he’s being kicked in the stomach and slapped around by tough-guy cops who think he’s garbage, and it starts to make you wonder if getting arrested for drug smuggling would be the better option.

Clearly Ray is in extreme pain because there are 20 condoms full of heroin sitting in his belly. In order to prevent him from excreting it during normal bodily functions, he swallowed codeine that has blocked him up, forcing the packets to remain in his system. That’s a far cry from a balanced, nutritious diet. But what would really be going on internally that would cause so much pain? What effects would harboring this load of drugs in the GI system have on the body?

Dr. Victor Weinstein, an emergency room physician, gave his take on what would be happening inside Ray:

“It is possible to take constipating medicine (like codeine) in order to prevent defecating for 10 days, but it would be extremely painful, would limit what he can eat or drink, and may have other serious health consequences. Codeine slows down the innervation of the GI tract. By taking codeine, you decelerate the GI tract by slowing down peristalsis (the rhythmic movement of the GI tract), which results in nothing moving down. While these “things” are sitting in the gut, they produce gases, the gases can’t pass through, and it results in bloating. It also can lead to obstipation and obstruction which would be very painful and debilitating. ”

That’s why Ray is continuously writhing in pain, ultra-sensitive to the cops’ physical abuse, unable to sleep, and unable to eat. His stomach is so jam-packed with gas that has nowhere to go, it causes massive pressure buildup with no means of release.

The physical presence of the drug balloons in the body also would pose a danger.

“The packets themselves could increase the likelihood of obstruction because you have these pellets (balloons, basically) and they are more likely to cause obstruction. The combination of codeine and the heroin pellets creates a synergistic effect, because codeine slows down peristalsis and the multiple condoms (balloons) - which you’re hoping are inert and not going to be broken down by the enzymes in the GI tract - exacerbate the blockage.”

If that had happened, The Mule would have been a much shorter movie. Rupture of even one of the condoms would cause the contents to spill out into the system, likely resulting in a massive drug overdose and death for the carrier.