Clinical urinalysis of drugs and alcohol in instances of suspected surreptitious administration (“spiked drinks”)

Abstract

Many suspected victims of surreptitious drug and/or alcohol administration may present to hospitals or healthcare centres and never come to the attention of forensic or law enforcement professionals. Therefore, it is necessary to include clinical toxicological findings in order to assess the growing perception that instances have become more widespread within society. Between July 2002 and June 2004, 180 requests were received for toxicological analysis of individuals presenting to their GP or hospital following self-reported or suspected surreptitious drug administration (e.g. "spiked drink"). There was a rise of 77% in the number of requests from 2002-2003 to 2003-2004 which peaked in December of each year (most likely due to the increased socialization of people during the festive season). Between 2002 and 2004, 34% of patients were male and 66% were female with an overall average age of 25 (range 11-73). Following urinary analysis using immunoassay and gas chromatography (mass spectrometry, flame-ionisation detection and nitrogen-phosphorus detection), 59% of cases were negative for drugs and alcohol in 2002-2003 and 51% in 2003-2004. Drugs or alcohol were detected in 32% of cases in 2002-2003 and in 45% in 2003-2004. Out of the 169 cases analysed, ethanol (alcohol) was the most commonly detected compound (24% of cases), followed by amphetamines (amphetamine, MDMA, MDA, MDEA--11% of cases), cannabinoids (9% of cases), benzodiazepines (temazepam, nordiazepam, oxazepam--9% of cases), cocaine (4% of cases), opiates (dihydrocodeine, codeine--2% of cases), chlorpheniramine (0.6% of cases), ephedrine 0.6% of cases), fluoxetine (0.6% of cases), tramadol (0.6% of cases) and zopiclone (0.6% of cases). No gamma-hydroxybutyrate (GHB), gamma-butyrolactone (GBL) or flunitrazepam was detected in the cases analysed.