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What’s being used to spike your drink? Alleged spiked drink cases in inner city London

¹ Guys and St Thomas’ Poisons Unit, Guys and St Thomas’ NHS Foundation Trust, London, UK
² Medical Toxicology Laboratory, Guys and St Thomas’ NHS Foundation Trust, London, UK
³ Emergency Department, Guys and St Thomas’ NHS Foundation Trust, London, UK

Correspondence to:
Dr P Dargan, Medical Toxicology Unit, Avonley Rd, New Cross, London SE14 5ER, UK; Paul.Dargan{at}gstt.nhs.uk

Objectives: To determine the incidence and character of drink spiking in an urban population of patients within the UK presenting to an emergency department concerned they had consumed a deliberately contaminated drink.

Study design: Prospective case series determining the presence and quantity of sedative and illicit drugs, and ethanol in biological samples (blood and urine) obtained from consenting patients >18 years of age presenting to a large inner city London emergency department alleging they had consumed a spiked drink within the previous 12 h.

Results: Biological samples were obtained from 67 (blood) and 75 (urine) of 78 study participants. 82% of participants were female, mean age 24 years. Mean time from alleged exposure to biological sampling was 5.9 h (range 1–12 h). Ethanol was detected in 89.7% of participants. Mean serum ethanol concentration was 1.65 g/l (range 0.04–3.1 g/l); 60% of participants had a serum ethanol concentration associated with significant intoxication (>1.5 g/l). Illicit drugs were detected in 12 (15%) participants; 7 denied intentional exposure (3 methylenedioxymethamphetamine, 3 cannabis, 1 -hydroxybutyrate). Medicinal drugs were detected in 13 participants; only 1 exposure was unexplained (benzodiazepine). Overall illicit or medicinal drugs of unexplained origin were detected in 8 (10%) participants. Unexplained sedative drug exposure was detected in only 2 (3%) participants.

Conclusions: Use of sedative drugs to spike drinks may not be as common as reported in the mainstream media. A large number of study participants had serum ethanol concentrations associated with significant intoxication; the source (personal over-consumption or deliberate drink spiking) is unclear.

Abbreviations: DFSA, drug facilitated sexual assault; ED, emergency department; GHB, -hydroxybutyrate; MDMA, methylenedioxymethamphetamine

Keywords: spiked drink; illicit drugs; ethanol; poisoning; unlawful