• Tess Blandamer, Jo Daniels, James Dear, Fraser Birse, Edward Carlton, Kate Burgess, and Tom Roberts.
• Emergency Department, Southmead Hospital, North Bristol NHS Trust, Bristol, UK tess.blandamer62@outlook.com.
• Emerg Med J. 2023 Apr 1; 40 (4): 308312308-312.

AbstractIn 2021, there was a significant increase in the number of reported drink spiking incidents across the UK. The new phenomenon of spiking via injection also emerged, which gained significant media attention. Campaigns encouraged potential spiking victims to attend an ED for testing. However, there is limited published research on drink spiking and no published studies on injection spiking. One UK guideline for the management of spiking exists, advising testing 'if clinically indicated' and is likely underused. Therefore, patients are often managed without drug testing, psychological support or a clear onward referral pathway. This practice review will explore the background of spiking, discuss drug testing options and highlight the psychological sequelae of spiking. An example guideline for the management of spiking incidents is attached.© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.

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