疑似被药物污染的饮品暴露受害者的血液和尿液样本中的药物：来自挪威奥斯陆的一项前瞻性观察研究。
Drugs in blood and urine samples from victims of suspected exposure to drink spiking: A prospective observational study from Oslo, Norway.
机构信息
Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
Oslo Accident and Emergency Outpatient Clinic, City of Oslo Health Agency, Oslo, Norway.
出版信息
PLoS One. 2024 Jul 10;19(7):e0306191. doi: 10.1371/journal.pone.0306191. eCollection 2024.
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.
CONCLUSION
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.
目的
人们经常联系急诊医学服务部门，担心自己接触到了被人下药的饮料，即未经自己知情或同意而摄入药物。我们从怀疑接触到被人下药的饮料的患者的血液和尿液样本中鉴定出药物，特别考虑到患者未报告的药物（未报告的药物）。
方法
从 2018 年 9 月至 2019 年 5 月，我们从挪威奥斯陆一家急诊诊所的 16 岁及以上的患者中收集了 48 小时内怀疑接触到被人下药的饮料的血液和尿液样本。我们还收集了关于乙醇摄入和服用药物的信息。使用超高效液相色谱-串联质谱法（UHPLC-MS/MS）和乙醇自动酶法分析血液样本中的 20 种经典娱乐性药物。使用免疫测定法和特定的气相色谱-质谱法（GCMS）分析尿液样本中的γ-羟基丁酸（GHB）。
结果
在 100 名纳入的患者（中位年龄 24 岁，62 名女性）中，我们收集了 100 份血液样本和 72 份尿液样本。暴露后的中位时间为 5 小时。在 15 名患者中发现了未报告的药物。血液样本中的未报告药物为 3 例氯硝西泮、3 例亚甲二氧基甲基苯丙胺（MDMA）、2 例安非他命、2 例四氢大麻酚（THC）、1 例曲马多、1 例可卡因和 1 例甲基苯丙胺。尿液样本中的未报告药物为 5 例可卡因、4 例安非他命、3 例摇头丸和 2 例大麻。在 69 名报告乙醇摄入的患者中发现了乙醇，中位数血乙醇浓度在未检测到未报告药物的患者中较高，为 1.00‰（四分位距（IQR）0-1.52）与 0‰（IQR 0-0.46）（p<0.001）。未检测到 GHB。
结论
在 15%的患者中发现了可能用于被人下药的饮料的未报告药物。当未发现未报告的药物时，血乙醇浓度较高。在任何患者中均未检测到 GHB。
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