PDF(Pubmed)
Abstract：
OBJECTIVE: People regularly contact emergency medicine services concerned that they have been exposed to drink spiking, i.e., exposure to drugs without their knowledge or permission. We identified drugs in blood and urine samples from patients suspecting exposure to drink spiking, with special consideration for drugs not reported taken by the patient (unreported drugs).
METHODS: From September 2018 to May 2019, we collected blood and urine samples from patients 16 years or older presenting at an emergency clinic in Oslo, Norway, within 48 hours of suspected exposure to drink spiking. We also collected information on ethanol ingestion and drugs taken. Blood samples were analyzed for 20 classical recreational drugs using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) and an automated enzymatic method for ethanol. Urine samples were analyzed using immunoassay methods and a specific gas chromatography mass spectrometry (GCMS) method for gammahydroxybutyrate (GHB).
RESULTS: From 100 included patients (median age 24 years, 62 females), we collected 100 blood samples and 72 urine samples. Median time since exposure was 5 hours. Unreported drugs were found in 15 patients. Unreported drugs in the blood samples were clonazepam in 3, methylenedioxymethamphetamine (MDMA) in 3, amphetamine in 2, tetrahydrocannabinol (THC) in 2, tramadol in 1, cocaine in 1, and methamphetamine in 1. Unreported drugs in the urine samples were cocaine in 5, amphetamine in 4, ecstasy in 3, and cannabis in 2. Ethanol was found in 69 patients, all reporting ethanol ingestion. Median blood ethanol concentration was higher in patients with no unreported drugs detected, 1.00‰ (interquartile range (IQR) 0-1.52) vs. 0‰ (IQR 0-0.46) (p<0.001). GHB was not detected.
CONCLUSIONS: Unreported drugs, possibly used for drink spiking, were found in 15% of patients. Blood ethanol concentration was higher when no unreported drugs were found. GHB was not detected in any patient.
METHODS: From September 2018 to May 2019, we collected blood and urine samples from patients 16 years or older presenting at an emergency clinic in Oslo, Norway, within 48 hours of suspected exposure to drink spiking. We also collected information on ethanol ingestion and drugs taken. Blood samples were analyzed for 20 classical recreational drugs using ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) and an automated enzymatic method for ethanol. Urine samples were analyzed using immunoassay methods and a specific gas chromatography mass spectrometry (GCMS) method for gammahydroxybutyrate (GHB).
RESULTS: From 100 included patients (median age 24 years, 62 females), we collected 100 blood samples and 72 urine samples. Median time since exposure was 5 hours. Unreported drugs were found in 15 patients. Unreported drugs in the blood samples were clonazepam in 3, methylenedioxymethamphetamine (MDMA) in 3, amphetamine in 2, tetrahydrocannabinol (THC) in 2, tramadol in 1, cocaine in 1, and methamphetamine in 1. Unreported drugs in the urine samples were cocaine in 5, amphetamine in 4, ecstasy in 3, and cannabis in 2. Ethanol was found in 69 patients, all reporting ethanol ingestion. Median blood ethanol concentration was higher in patients with no unreported drugs detected, 1.00‰ (interquartile range (IQR) 0-1.52) vs. 0‰ (IQR 0-0.46) (p<0.001). GHB was not detected.
CONCLUSIONS: Unreported drugs, possibly used for drink spiking, were found in 15% of patients. Blood ethanol concentration was higher when no unreported drugs were found. GHB was not detected in any patient.
摘要：
目标：人们经常联系急诊医疗服务机构，担心他们已经暴露于饮料中，即，在没有他们的知识或许可的情况下接触毒品。我们从怀疑接触饮料的患者的血液和尿液样本中鉴定出药物，特别考虑患者未报告服用的药物（未报告的药物）。
方法：从2018年9月至2019年5月，我们收集了在奥斯陆急诊诊所就诊的16岁或以上患者的血液和尿液样本。挪威,在怀疑接触酒精的48小时内。我们还收集了有关乙醇摄入和服用药物的信息。使用超高效液相色谱-串联质谱（UHPLC-MS/MS）和乙醇的自动酶法分析了血液样品中的20种经典娱乐性药物。使用免疫测定方法和γ-羟基丁酸酯（GHB）的特定气相色谱质谱（GCMS）方法分析尿样。
结果：来自100名纳入的患者（中位年龄24岁，62名女性），我们采集了100份血样和72份尿样.自暴露以来的中位时间为5小时。在15名患者中发现了未报告的药物。血液样本中未报告的药物为3种氯硝西泮，3种亚甲二氧基甲基苯丙胺（MDMA），2种苯丙胺，2种四氢大麻酚（THC），1种曲马多，1种可卡因和1种甲基苯丙胺。尿液样本中未报告的药物为可卡因5，苯丙胺4，摇头丸3和大麻2。在69名患者中发现了乙醇，所有报告乙醇摄入。未检测到未报告药物的患者的血液乙醇浓度中位数较高，1.00‰(四分位数间距(IQR)0-1.52)与0‰(IQR0-0.46)(p<0.001)。未检测到GHB。
结论：未报告的药物，可能用于饮料加标，在15%的患者中发现。当没有发现未报告的药物时，血液乙醇浓度较高。在任何患者中均未检测到GHB。
方法：从2018年9月至2019年5月，我们收集了在奥斯陆急诊诊所就诊的16岁或以上患者的血液和尿液样本。挪威,在怀疑接触酒精的48小时内。我们还收集了有关乙醇摄入和服用药物的信息。使用超高效液相色谱-串联质谱（UHPLC-MS/MS）和乙醇的自动酶法分析了血液样品中的20种经典娱乐性药物。使用免疫测定方法和γ-羟基丁酸酯（GHB）的特定气相色谱质谱（GCMS）方法分析尿样。
结果：来自100名纳入的患者（中位年龄24岁，62名女性），我们采集了100份血样和72份尿样.自暴露以来的中位时间为5小时。在15名患者中发现了未报告的药物。血液样本中未报告的药物为3种氯硝西泮，3种亚甲二氧基甲基苯丙胺（MDMA），2种苯丙胺，2种四氢大麻酚（THC），1种曲马多，1种可卡因和1种甲基苯丙胺。尿液样本中未报告的药物为可卡因5，苯丙胺4，摇头丸3和大麻2。在69名患者中发现了乙醇，所有报告乙醇摄入。未检测到未报告药物的患者的血液乙醇浓度中位数较高，1.00‰(四分位数间距(IQR)0-1.52)与0‰(IQR0-0.46)(p<0.001)。未检测到GHB。
结论：未报告的药物，可能用于饮料加标，在15%的患者中发现。当没有发现未报告的药物时，血液乙醇浓度较高。在任何患者中均未检测到GHB。
