Needle Spiking
Needle Spiking which is “Criminal, injection of substances without the recipients consent” to induce a vulnerable state has been a theme. Substances can be date rape drugs, ketamine, or other illegal or prescription drugs. Through discussion with our secondary care colleagues we have so far established:
Blood tests
At presentation all patients should be advised to have a blood test: for “Virology sample for storage”, and then subsequent HIV/ Hep B, Hep C at 12 then 24wks.
Drug testing
- There is currently no role for a toxicology screen in patients who can be managed in the community. It will only be considered in hospital for those who are significantly unwell (requiring immediate medical intervention- the medically unstable patient)
- The police may arrange a forensic toxicology screen but this is only likely when an offence is being investigated- please advise the patient to call 101.
HIV Post Exposure prophylaxis
Is not usually recommended, unless the needle has been confirmed to have been recently been used on a person with confirmed HIV infection. If this is the case, the person should be advised to attend ED.
Hep B
An immediate vaccine (within 48hrs) is recommended for either unvaccinated, partially vaccinated, or fully vaccinated (if last dose >1yr ago). Currently this should be given in ED, unless we can confirm that a GP is willing/ able to administer this promptly. Hep B immunoglobulin (HBIG) is recommended only if the person is a known “non-responder” to Hep B Vaccine (administered in ED).
Further work is ongoing with system colleagues in ED/ General practice to develop a system wide pathway. We will keep you posted with any updates. However, given the need for immediate blood samples for storage and Hep B vaccination or HBIG, ED seems the most suitable course of action in most cases, at this time.
More information can be found on the following links
https://www.clinicaltoolkit.co.uk/wp-content/uploads/2023/07/NBT-spiking-guideline.pdf