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

Drink and injection spiking: how to approach an increase in presentations?

In 2021, there was a significant increase in the number of reported drink spiking incidents across the UK. The new phenomenon of spiking via injection also emerged, which gained significant media attention. Campaigns encouraged potential spiking victims to attend an ED for testing. However, there is limited published research on drink spiking and no published studies on injection spiking. One UK guideline for the management of spiking exists, advising testing 'if clinically indicated' and is likely underused. Therefore, patients are often managed without drug testing, psychological support or a clear onward referral pathway. This practice review will explore the background of spiking, discuss drug testing options and highlight the psychological sequelae of spiking. An example guideline for the management of spiking incidents is attached.

Toxicological Assessment of the Role of Alcohol and Drugs in Drug-Facilitated Sexual Assault Cases in New Zealand

This report details the toxicology profile of victims of drug-facilitated sexual assault (DFSA) in New Zealand from 2015 to 2018. This study represents all of the toxicology results for DFSA cases in New Zealand during this time period, of which there were 161 cases. Blood and urine samples were screened for legal and illicit drugs in addition to testing for alcohol and correlating alcohol concentration with sampling delay. Our results indicate that increased delay in sampling time resulted in a corresponding decrease in alcohol concentration. In victims who had declared alcohol use but of which none was detected, the average sampling time was 14 hours for blood and 17 hours for urine, which is in excess of the average sampling delay for even the lowest alcohol-positive samples. The most frequently detected alcohol concentration was in the range of 51-80 mg/100 mL for blood and 121-200 mg/100 mL for urine with an average sampling time of 8.5 and 6.5 hours, respectively. We also examined acetone concentrations in alcohol-positive samples, and our results indicate that 82% of blood alcohol-positive samples contained acetone at concentrations between 5 and 10 mg/L and 68% of alcohol-positive urine samples contained acetone at a concentration >20 mg/L. It may be that the nature of sexual assault affects an individual's metabolism of alcohol and results in increased acetone production. Cannabis was the most commonly detected illicit drug, followed by methamphetamine. In relation to medicinal drugs, there was a high usage of antidepressants and antipsychotics, suggesting the victims may have been people of vulnerable personality. Based on case information, it does not appear there are many cases where stupefaction by unknown administration of a drug has occurred, instead loss of consent through voluntary alcohol and drug consumption is more common and poses a greater risk than surreptitious drug administration.

Detection of iso-α-acids to confirm beer consumption in postmortem specimens

Iso-α-acids (IAAs) can be used as markers for the consumption of beer. Postmortem specimens from a range of coronial cases were analyzed for IAAs in order to determine the prevalence of beer consumption and any correlation to blood alcohol concentrations (BAC). A total of 130 cases were included in this study including those where beer was mentioned in the case circumstances, cases where beer was not mentioned specifically but alcohol was detected, and cases where neither beer was mentioned nor a positive BAC was present. Available blood, serum, vitreous humour and urine specimens were analyzed. Of the 50 cases where beer was mentioned, 86% had one or more IAAs detected. In cases that only had a positive BAC (n = 60), 57% of these cases also showed the presence of these beer markers. IAAs were detected in specimens obtained from traumatized, burnt, and decomposed cases with a mention of beer consumption or where BAC was positive in blood. No IAAs were detected in cases where BAC was negative. There was little or no correlation between blood IAA concentrations and BAC. This study demonstrates the possible detection of IAAs as a marker for beer consumption.

Date rape among Cypriot female college students: an explorative study

This study examined the prevalence and reporting of date rape among female college students (aged 18-24) in Cyprus and assessed the students' attitudes and awareness regarding date rape. In addition, the study examined how date rape is perceived among representatives of related private and governmental organizations in Cyprus. This is part of a larger multi-country study. This paper will focus only on the results pertaining to Cyprus. The study was coordinated by the Mediterranean Institute of Gender Studies. This study used quantitative and qualitative methods. In total, 476 female college students responded to an anonymous questionnaire, two focus group discussions were carried out, and five key-informant interviews with relevant institutional representatives were conducted. The results of the study indicated that unwanted sexual experiences and sexual violence, including date rape, do exist among young Cypriot women. Specifically, 1.3% of the research participants reported experiencing an attempted rape by their date, and 1.9 % of the study participants reported being raped on a date. Often this was caused by their boyfriend, friend or sexual partner (54.2%). The results of the qualitative study showed that young female Cypriots agreed that many women give in to psychological pressure because they feel guilty about letting the other person down or because they 'didn't satisfy him' or fear they might lose him. Despite the explorative nature of the study, it is significant as research on date rape in Cyprus is almost non-existent. The authors anticipate that the results of the study will be useful to other researchers and policy-makers involved in this area of research.

Teenage toxins: recreational poisoning in the adolescent

Adolescents are experimenting with recreational drugs on a regular basis, particularly at social gatherings such as parties, raves and mass events. A combination of reduced fluid intake, physical activity and drug-induced hyperthermia leads to complications such as heat stroke, delirium and potentially death. The clinician needs to be aware of the variety of pharmacologically active substances available in the recreational marketplace in order to diagnose and manage these patients. Recreational misadventure, because of incorrect dosage or mixing multiple substances, is a common reason for teenagers presenting to hospital with toxidromes. Death from club drug overdose is more likely to be associated with suicidal intent, related risky behaviour and trauma, as well as the inherent toxicity of the drug itself. Although many teenagers are concerned about 'drink spiking' with club drugs, the most common agent causing drink spiking incidents is ethanol.