Given the unknowns involved, I’m wondering how hospitals handle people who’ve had their drinks spiked. Let’s say a woman walks in and says she was at a party, left her drink out of their sight and started feeling really weird after a while. What does a hospital do at that point?
I remember watching some British cop drama show some years ago where a guy was in a gay bar and got offered a drink by another guy. In the next scene, his vision was turning wobbly. He told the other guy he was feeling weird and the second guy put an envelope in his pocket (presumably containing more of the drug) and told him they could do more at his place. The character (wisely) GTFO at that point.
How would a hospital deal with that, especially if the guy wanted to know just what he ingested?
My guess is that they’d work on the assumption that it wasn’t a deadly poison but just something meant to slightly incapacitate/drug the person (I mean, otherwise what’s the point) and then just deal with the symptoms as they pop up. IOW, stick them with an IV and let them sleep it off.
Assuming your drink was spiked at a bar, I think it’s really just a handful of things if the person is trying to get you wonky enough to have sex with you and not kill you or just get you high on a random drug because they think it’s funny.
They can check your urine and blood for a lot of common things. If you’ve been given an opioid, they can offer you Narcan. If you have some way of taking the drink, or a sample of the drink with you, and your wits about you to do it, do so. In most states that I know of, you can’t carry a drink out of a bar (I knew this in general, but once when all I had was Coke I walked out with it, and the doorman chased me down, and I found out you can’t do that either). You can go to the bathroom, pour out most of a drink, stuff paper towel in the cup, and put it in your purse or pocket.
Would spilling some of the drink on yourself help? Would it still need to be “wet” by the time it got to the lab or could a lab stand a likely chance of finding a detectable amount of a drug in dried up stain/residue, assuming that you got the clothes to the lab before washing them?
If I thought my drink was spiked the first thing I would do is call the cops. Once at the ER a drug screen for common drugs used in date rape would be performed.
Depends on the person’s condition. People sometimes report with nothing but alcohol in their blood, or some medications they took earlier in the day, or no foreign substances at all. Blood analysis may take a while and a saline drip and monitoring the patient may be all they can do without knowing exactly what they’ve ingested.
Whether it was urine, blood or drink which was analyzed, would they be likely to later tell the person just what the substance likely was? I can see someone having had their drink spiked wanting to know just what was put into their body, especially since some common drink spiking substances (like ecstasy) may be neurotoxic even at common doses or mixed with substances which are just a bad idea (cocaine, meth, bath salts).
There are very few credible reports of date rape by stimulant drug, including MDMA; it’s a lot easier to get the victim unconscious or sedated (with alcohol, or GHB, or a benzodiazepine) than to somehow drug her into liking you while awake. Most (all?) of the drugs you list also have a very bitter taste that would be hard to mask. I’m assuming “bath salts” to mean “random stuff that’s sort of like a cathinone” here.
As an aside, early reports of MDMA’s neurotoxicity were exaggerated. Later animal research shows that the effect, if it exists, is pretty small (link), and research on human subjects is complicated by their abuse of other drugs. I’m not a doctor, but I don’t think they’d treat suspected ingestion of MDMA except symptomatically, or maybe with gastric lavage and charcoal or whatever if they think it’s recent enough to help.
Not necessarily. I can order our standard tox screen. What drugs are screened for will vary between institutions depending on which commercial test is used. For instance my tox screen does not detect GHB.
If someone comes in and reports they think they were drugged I can ask if they want the police called. If they have any suspicion that they were sexually assaulted I can offer a forensic sexual assault exam. I can offer a tox screen and an alcohol level. But mostly I’m going to observe them until I’m sure they’re sober enough to be safely discharged.
Where I work we would run a urine tox screen, which doesn’t cover as much CSI stuff as you think, and give supportive care which is dealing with symptoms as they present. The cops might be interested in the drink if you brought it, but it would be worthless to us.
Any idea where the bitter taste comes from? It seems to be common among the riskier substances like most of the NBOMEs.
In some gay subcultures, could stimulants not be way of hitting on someone that is blunt and jerkish/clueless but still not that out of the ordinary?
As for MDMA, the article you link to mentions reduced serotonin and something need not kill cells to be toxic, even damaging parts of them (like the releasing vesicles) would be reasonably considered toxic, no?
Also, wouldn’t the doparminergic effect be liable to result in neurotoxicity for dopamine cells? The study you link to mentions anxiety-like behavioral aftereffects which is consistent with some of the problems of taking too much dopamine or norepinephrine (the latter would also apply to MDMA because it’s metabolized from dopamine, is it not?).
Drugs (and other biologically important chemicals) are often alkaloids, and alkaloids are alkaline, and my high school chemistry teacher told me that alkaline stuff usually tastes bitter. I’m afraid you’ll need an actual biochemist for a better explanation.
I’m not gay, but I can’t say I’ve ever heard of that. As a partially related aside, I read a paper once about a public health effort to treat an STD outbreak (I think syphilis?) by giving infected men antibiotics both for themselves and for their partners, the theory being that the partners are more likely to get treated if he hands them the drugs than if they have to go see a doctor themselves. Apparently, one of the leading questions from the patients was “Can I grind up the pill and slip it in his drink?”…
This is getting even farther outside my area, but as far as I understand, the release of neurotransmitters from synaptic vesicles is just part of normal cognition. Most (all?) psychotropic drugs will make that happen more or less, but no one counts that as damage. The authors outline the markers of neurotoxicity that they considered around the top of page 414. I’m grossly unqualified to comment, but I couldn’t find anyone disagreeing with their choice in the literature.
MDMA does seem to cause longer-term (weeks) depletion of serotonin in the brain, and longer-term change in behavior. That might be bad, but it’s not brain damage, any more than it would be brain damage for a person to experience major depression after a traumatic event.