Drink Spiking Cases Are Underreported, Boston Hospital Officials Say

BOSTON, MA — Nearly a year after Boston police issued a warning about what seemed to be an uptick in drink spiking at local bars, Boston doctors say that it is difficult to confirm whether these increases are still occurring or ever did occur.

But in interviews with Patch, multiple local experts emphasized that cases of drink spiking are likely considerably underreported.

"If people are coming to the hospital concerned for their drink spiked, our plan is primarily to ensure they are medically safe," Dr. Peter R. Chai of Brigham and Women’s Hospital's Division of Medical Toxicology told Patch via email. "Testing for specific drugs like Rohypnol or flunitrazepam —the 'date rape drugs' — is specialized and requires samples, usually urine, be sent out to a specialty lab. We don’t do this much because these results take days to come back and are difficult to interpret."

Chai added that "if the test is negative, it doesn’t mean [the person] wasn't exposed since these drugs rapidly break down in the body," and "If the test is positive, it isn’t clear if that is the inciting factor that resulted in their clinical presentation."

"We can check a urine drug screen but these are known to be somewhat unreliable and reflect what the person has used over the past several days or even weeks and not a reflection of what is in their system now or just prior," said Dr. Alice K. Bukhman, a physician at Brigham and Women's Faulkner Hospital's Department of Emergency Medicine, in an email to Patch.

Another caveat to proper drink-spiking incidence reporting is that people who get drugged might not seek medical help at all.

"People may feel like they had their drink spiked, but assuming they were safe and got home, they sleep it off and don’t come to see us in the hospital," Chai said.

'Impossible To Tell'

In a notice shared last month, the Boston Police Department reminded community members of scentless, colorless, and tasteless drugs like Rohypnol, also known as roofies, being placed in the drinks of unsuspecting victims.

Other drugs commonly used in a similar fashion are gamma-hydroxybutyric acid or ketamine, the department reported.

"These drugs and substances can cause disorientation, confusion, temporary paralysis, or unconsciousness, along with a host of other symptoms, leaving the potential victim vulnerable to the intentions of the suspect," according to the department.

Multiple experts emphasized to Patch that it can be difficult or even impossible to tell whether a person has been drugged or is experiencing alcohol intoxication. This is especially true since the effects of drugs vary by the type of drug used, and the effects vary from person to person.

"Usually [people who have been drugged] just feel more intoxicated than they would otherwise expect based on what they drank," Bukhman said. "Roofies are known to cause amnesia, which is similar to blacking out from alcohol."

'More Inebriated Than They Intended'

Both alcohol intoxication and drugging can cause increased risks of injuring yourself by falling or otherwise being in an unsafe situation, and other potential respiratory problems such as aspirating, Executive Medical Director of Emergency Medicine at Brigham and Women’s Hospital Dr. Paul Chen told Patch via email.

But mixing agents, like alcohol and benzodiazepines, is always more dangerous in terms of causing increased respiratory depression, Bukhman said. In addition, when a person is unknowingly drugged, they can quickly become more inebriated than they intended, and the resulting confusion increases the risk of danger.

Bukhman said that a patient who presents at the hospital intoxicated by any substance is given supportive care as needed and then discharged when they have sobered up.

'The Big Caveat'

"The big caveat here is that spiking cases raise a concern for sexual assault," Bukhman said. "If the patient reports a sexual assault — or any concern that they were assaulted — we would offer them treatment for any possible STIs as well as evidence collection and psychosocial support. If we are collecting evidence in the case of a reported sexual assault, we can get forensic testing for substances."

Chai added that a specific drug-testing protocol — a Massachusetts Sexual Assault Nurse Examiner Program Comprehensive Toxicology Screening — is best in cases when people are concerned they were sexually assaulted while drugged or they want to pursue legal action. This is because testing is carefully regulated by the state with a clear chain of custody that allows results to be admissible in court.

Testing guidelines state that the drug that might have facilitated a sexual assault must have been ingested within 96 hours of a visit to the emergency department. Blood samples are only collected for assaults within 24 hours, while urine samples are collected for up to 96 hours after an assault.

Local Officials Seeking Change

Bristol and Norfolk state Sen. Paul Feeney, who has been working with survivors, local and state law enforcement, and venue owners and security, filed a bill this year that would require Massachusetts hospitals to test for date rape drugs if a person believes they’ve been drugged, Boston 25 reported.

Feeney told Boston 25 that he is discussing with other officials the possibility of state money being used to purchase drink-spiking testing strips, which he hopes could be stocked at venues.

The outlet also found that the Boston Police Department has implemented a change in its internal reporting system to include a marking option for contaminated drinks, which District 1 Boston City Councilor Gabriela Coletta told Boston 25 she hopes is "a step toward better identifying where this is happening and the frequency."

Coletta added that the department has also committed to assigning a detective to a case even when they don't believe a sexual assault occurred.

Steps To Take

There are steps you can take to protect yourself against sexual assault. In its notice last month, the police department suggested that those gathered in social settings create a "buddy system" to prevent getting separated and be sure drinks are served directly by a bartender or server.

The department also suggested that people:

• Don’t allow those you don’t know or trust to order drinks and deliver them to you.
• Watch your drink at all times. Never leave your drink unattended.
• Take your drink with you to the restroom if need be.
• Keep your hand covered over your drink when you’re not looking at it. Many creative inventions exist that can help you cover your drink.
• Test your drink with test strips or nail polish that light up a certain color if they detect drugs.
• Get help immediately if you begin to feel dizzy, nauseated, light-headed or strange in any way.

"Please be aware of any uncharacteristic behavior from your acquaintances and be wary of strangers attempting to lure individuals away from their friends," the department said. "Also, should you observe any individual who appears to be in distress, wandering alone late at night, or dressed unsuitably for the weather, be sure to contact the police immediately."

To speak with someone who is trained to help in cases of sexual assault, call the National Sexual Assault Hotline at 800-656-4673 or chat online at online.rainn.org.