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As a result
of both increased public perceptions, and the number of enquiries that we are
now receiving, we are now able to offer an analytical service to help support
those suspecting that they have been a victim of a “Spiked Drink” or “Drug
Facilitated Sexual Assault” (DFSA).
These are
both very serious issues that need appropriate support and management. To aid
this process, we are able to offer a combination of approaches to cover the most
common illicit and sedative drugs that are
suspected to be used in these cases.
The analytical techniques used (a combination of
immunoassay, chromatography and mass spectrometry) will be supported by an
interpretive service to aid in the realisation of the advantages of this service
but to also explain some of the limitations associated with trying to look for
very low concentrations of drugs several days or even hours post incident.
Invariably, a sample collection delay of 48 hours is too
great to provide evidence of drug exposure.
The breadth of this service will be reflected in the
associated costs, but these should be seen in the light of the support that
clinicians could derive from the extensive investigation of these cases.
We
would reiterate that in order to properly investigate and interpret such cases,
both blood and urine should be collected within 24 hours of the incident. Also,
as much information as possible pertaining to the timing of the incident and
sample collection should be stated on the request form – in addition to
relevant drug history of the patient. These requests are performed for clinical
purposes only and in the event of any potential criminal proceedings, the
patient is advised to contact the Police to arrange analysis.
Proposed Drug Panel
Below is a list of drugs proposed by a DFSA Working Group
as a potential list of drugs/compounds which should be included in all DFSA
cases requiring toxicological analysis of biological fluid. Although the Working
Group was primarily set-up for police work and criminal cases, there is an
obvious need for some form of standardisation within clinical toxicology.
The drug/compounds proposed have been chosen due to their
potential effects and their previous detection in DFSA cases. In addition, it is
recommended that the list be regularly updated in order to maintain the
relevance of the drugs included.
“Essential” Drugs
Amphetamines
Barbiturates
“Low dose” Benzodiazepines (e.g. flunitrazepam (rohypnol),
midazolam, lormetazepam)
Other Benzodiazepines (e.g. diazepam, temazepam)
Cannabinoids
Chloral Hydrate
Cocaine
Ethanol
GHB (liquid ecstasy)
Ketamine
Methadone
Opiates/opioids
Sedative antidepressants (e.g. dothiepin, amitriptyline)
Sedative antihistamines (e.g. diphenhydramine,
chlorpheniramine)
Zolpidem
Zopiclone
“Other” Drugs
(if “Essential Drug Screening” is
negative and/or if techniques are available)
Phenothiazines (e.g. thioridazine, chlorpromazine)
Volatile substances of abuse (e.g. chloroform)
Zaleplon
Sample Requirements
>5 mL Blood (lithium heparin and/or
fluoride/oxalate tube)
Detection Windows
If clinicians
need any advice regarding this service, please contact
the Laboratory as usual.
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