Unsolicited contamination of drinks in bars and clubs: Toxicological analysis of alleged cases

• Published in: Clinical toxicology (Philadelphia, Pa.) Pa.), 2005-10, Vol.43 (6), p.663-664
• Main Authors: Greene, S L, Shiew, C M, Earl, B, Dargan, P I, Jones, AL
• Format: Article
• Language: English
• ISSN: 1556-3650

There is increasing awareness and media coverage surrounding the potential for 'spiked drinks' (unsolicited addition of a drug to a drink consumed in a bar or club) and drug-facilitated sexual assault. The perceived increasing incidence and spectrum of implicated drugs highlights the need for a deeper understanding of the issue. This study aims to quantify the incidence and pattern of possible intoxicants in suspected cases presenting to a large urban Emergency Department (ED) in the United Kingdom (UK). To our knowledge, no similar study has been undertaken in the UK. Patients presenting to the ED of one hospital concerned their drink may have been 'spiked' in the previous 12 hours were offered toxicological analysis of blood and urine. Time and place of possible exposure and clinical details/drug history were recorded. Patients who admitted using a recreational drug were excluded. A single blood and urine sample was analysed for drugs of abuse and ethanol (immunoassay and gas chromotography-mass spectroscopy). The study was approved by the Hospital Ethics Committee (IRB). Initial results in this ongoing study from the first 36 patients indicate that ethanol was the predominant intoxicant detected. Only one sample was collected from 3 patients (2 urine+ 1 serum sample missing). Ethanol was detected in 30/34 urine samples (88.2%) and 29/35 serum samples (82.8%), serum range 15-280 mg/dL, mean 163 mg/dL. Ethanol was the only substance detected (excluding metoclopramide given by ED) in 30/36 patients (83.3%). Of the remaining 6 patients, 4 (11.1%) were positive for MDMA, 1 (2.7%) cannabinoids and 1 (2.7%) for opioids and benzodiazepines. All 6 patients denied using drugs. Ethanol is the predominant substance involved and the sole substance found in 83% of patients presenting to the ED worried their drink may have been spiked. A substantial number of patients had high serum ethanol concentrations which could account for symptoms leading to the erroneous belief that their drink was spiked. There were a small number with positive results, indicating a low but significant incidence of possible spiked drinks in this ED population.