How to be properly poisoned
This is a victim's guide to being poisoned, not a guide describing different categories of common or less common poison. Nor indeed is it a guide to how to poison people. Plenty of those have been written already, for some of the world's less salubrious intelligence services.
There are a lot of different substances that can poison a person. One could write several volumes about different poisons and their effects. This is not useful to a person who fears that they are at risk of poisoning; or that they have been poisoned and are wondering what to do. The good news (if one can call it that) is that almost all poisonings are now intentional. The old category of "food poisoning", that is to say a toxin reaching one's restaurant meal by reason of negligently poor health standards, is increasingly rare because food hygiene standards in the modern world are more universally understood and complied with than in the past. Even countries that have supermarkets without fridges (there still are some) generally now know not to leave degradable products on the shelves for too long.
The only other sort of reasonably plausible accidental poisoning is when an animal has become trapped in a water tank of a building, died, and its carcass has rotted. This is also increasingly rare, because building hygiene standards have improved so much. The two occasions where this author suspects they were poisoned by death of an animal in the water tank were both in the former Soviet Union, in which badly built Soviet apartment blocks had not been updated to add the shutters above the water tanks necessary to avoid animals from getting stuck inside. The good news about this sort of poisoning is that it isn't generally very serious. You will have stomach upsets possibly involving vomiting and diarrhoea; and then you will stop drinking the polluted water and these symptoms will soon cease.
As for all other poisonings, they are intentional: someone is trying to harm you and, most importantly, it is not a casual intention (as might be someone getting angry with you while drunk in a bar and trying to attack you). Poisoning is pre-planned, which means that somebody has gone out of their way to plan to hurt you. It is a mistake however to infer automatically that it is you specifically that they are trying to hurt. A lot of poisonings involve the wrong person getting poisoned; that is generally because the people doing the poisoning may be people like staff in bars and restaurants being paid to do something they don't care about (or even don't want to happen, so they deliberately get it wrong); whereas the person planning and paying for the poisoning (it is very expensive to order a person's poisoning, as it requires lots of different people and moving parts) may in all likelihood be several stages away from the action. So poisoning often goes awry, and has some unintended outcome.
On the other hand, if you are being pursued by an assassin - a specialist in poisoning people who has been directly paid to poison you - then it will be very difficult to avoid being poisoned unless you are tipped off in advance that this may happen. That is why it is imperative upon governments, when they are aware of a risk of attack to a person, that they inform them. Only if they inform the person at risk, can risks of poisoning be mitigated. If you've no reason to suspect that somebody may be out to poison you, it is extremely difficult to take measures to avoid it. You can't spend your entire life taking anti-poisoning measures; it's paranoid - unless the Russian government wants to kill you (and we will come to that).
From the consumer's perspective, there are three sorts of poison and five ways of administering it. There are poisons that kill you quickly (e.g. potassium cyanide, a white crystalline substance that dissolves in water); poisons that kill you slowly (e.g. polonium, often described as the most deadly poison but it does not kill you quickly); and poisons that incapacitate you and/or make you feel sick. The purpose of the third category may either be to steal something from you or to plant something upon you; or to give you a warning of some sort. The five methods of administration are orally (the vast majority of poisons are ingested); inhalation (very rare because gases inevitably poison lots of people, not just the intended person); touch to the skin (also rare because very few substances actually are toxic in this way; nerve agents are one such category); by injection - this is rare outside post-Soviet Union hospitals, that have a reputation for not wasting money on elderly people by giving them lethal injections soon after they enter the ward and this author has had an elderly person in such a hospital beg him not to leave for precisely this reason; and - often forgotten - placing the toxin in the water tank of the building where the victim is residing.
Let us start with poisons that we specifically eat rather than drink. These are very rare, provided one takes some elementary precautions when eating out in restaurants. One is only to go to good restaurants. In good restaurants no chef, no matter how well bribed he is, will permit a deadly toxin from circulating in his kitchen. There is of course an exception to this which is special Russian restaurants with special sorts of staff. There are such places, and they're not just in Russia. Don't go to such restaurants! They're usually obvious - they're horrendously expensive, the food is revolting (because the chefs are not focused quite so much on customer satisfaction in the regular sense of the word) and the staff predominantly speak Russian. Another way of avoiding this sort of intoxication entirely is not to make restaurant reservations (and not to tell members of intelligence services with reputations for assassinating people - Russia stands out as to the top poisoner-in-chief - where you are going to dine). If you otherwise buy your food in supermarkets or green markets, poisoning is impossible because nobody knows exactly what you're going to buy.
Before this author continues with defamatory comments about the Russian intelligence services' propensity for poisoning people (they also like poisoned gas - so a hose from the exhaust pipe to the inside of the car is a Russian favourite), it must be emphasised that Russian assassinations, while usually involving poison, are extremely rare. They must be authorised by the President of the Russian Federation, and he does not authorise assassinations lightly, particularly ones outside Russia. The Russian intelligence services virtually never poison persons who is neither Russian nor from what the Russians call their "near-abroad". You can't buy a GRU poisoning on the market, as a private citizen. (The GRU are Russia's elite intelligence operatives that undertake the most sensitive of missions.) The Russian intelligence services have many faults; but assassinating people with poisons without the written authorisation of the Russian President is not one of them. Anyone who did it would know what awaited them upon their return. Nor will the President of Russia authorise foreigners' assassinations save where they have somehow previously adhered (strong) allegiance to Russia; because he understands the "tit-for-tat" logic of doing this. If Russia assassinates foreigners just because it doesn't like them, then other countries may start doing the same thing to Russian officials and diplomats for equally empty reasons.
So although the Russian government is one of the world's principal poisoners, and with any poisoning one must consider whether the Russian government had a hand in it, they do follow rules of their own kind no matter how much they dislike you. They are not likely to poison you unless they consider you to be from one of their satellite states. Russians mostly, but not always, use deadly poisons; they tend to like to use poisons that make it clear that it was Russia that did it (a sort of grim publicity and warning to others), typically by reason of the fact that the only place in the world that makes that sort of poison is a Russian government military facility. The Novichok poisonings in Salisbury, England in 2018 were an example of this; so was the Polonium poisoning of Alexander Litvenenko in London in 2006. In both cases the intended victims were former or current Russian intelligence members; they were targeted, in the eyes of the Kremlin, because they had betrayed their country. The fact that twelve years expired between those two events in England, a country notorious for being packed with Russian dissidents, shows just how infrequent and specifically targeted Russian poisoning may be. Your average Joe is simply not at risk of being poisoned by the Russian intelligence services. There are all sorts of stories of Russian agents working abroad who carry phials of poison; but they do not use them without the written permission of the President.
Let us now go back to our person who is dining or otherwise relaxing in public. The vast majority of poisonings are things placed in one's drink. This requires either a complicit barman, or an attacker who just waits until the victim goes to the bathroom. A totally paranoid person buys only bottled beer or water and takes the bottle with them when they use the lavatory. This is too paranoid even for this author's fantasies. It is rare for barmen (or women) to poison a drink that they are serving (except in certain sorts of East Asian bar, that we will mention below). They are not, after all, professional assassins, and they do not want to become so. Moreover the toxin might get mixed up behind the bar with some other sorts of items; so a fellow barman might inadvertently poison the wrong person which would be very bad because poisons for the most part are easily detectable and traceable. This leads to a very obvious point which is often forgotten, particularly when we imagine some fantastical world in which Russian agents are all walking round with phials of poison. The more deadly a poison, the more potentially dangerous it is to the person administering it. Therefore a deadly poison requires a committed person with substantial expertise to carry and administer it; otherwise they may end up dead themselves. You don't smear Novichok on a door handle without knowing exactly what you're doing. This excludes totally the idea that barmen might administer deadly poisons; because barmen are not skilled killers.
If a deadly poison is placed in someone's drink, then it is placed there while that person is in the bathroom or otherwise not paying attention to their drink. This, we may say, is an iron rule of poisoning.
Almost as strong a rule is that an incapacitating poison is very likely to have been administered in the same way - that is to say, when the victim is not paying attention to their drink. In all the poisonings but one that this author has been the victim of, an incapacitating poison was placed in his drink when he wasn't looking - he was distracted by some pretty girl or he was in the bathroom. The more incapacitating the poison, the more likely it is that a specialist has administered it. This author has known of a bar in a city in Europe in which MDMA had been placed in certain cocktails, as a matter of routine. MDMA does not significantly incapacitate; it just makes people feel silly. In those cases the local people generally know which drinks will contain the recreational narcotic; and the presumption is that the consumer wants to be poisoned (if you see what I mean). So there the barman doesn't need to be a specialist at all; he is giving something to his customers that he assumes that they want. It can be quite a shock, however, to find that your drink is laced with MDMA. In the highly unlikely event that this happens without your anticipating it, just buy a bottle of beer, drink that, and stay calm for 30 minutes.
Now we come to the hard fact that if you are poisoned in public, then it is highly likely that the poisoning agent is flunitrazepam, also known as Rohypnol. Flunitrazepam is a strong benzodiazepine prescribed very rarely now and only for conditions such as severe insomnia or in the course of pre-anaesthetic treatments. It is a liquid, colourless, odourless and tasteless and that causes loss of motor functions, amnesia, and unconsciousness. Hence it has been called the "date rape drug", although there are no reliable figures for how often it is used with this purpose in mind. It is easily made in pharmaceutical factories, and typically produced in 1mg capsules the shells of which are soluble in the mouth and stomach. Unless one is the director of a pharmaceutical factory prepared to engage in gross and verifiable misconduct, it is not possible to create a bottle of flunitrazepam. Instead if you are being poisoned with flunitrazepam, someone is probably dropping one of these capsules - which can be obtained in a sophisticated pharmacy with the right sort of prescription - in your drink, possibly squeezing the capsule open with their fingers as they do it. (Otherwise you might find a partly dissolved capsule in your drink, which should put you off consuming any more of it.) Flunitrazepam is also available in pharmacies as a conventional tablet, which it is less likely will be used to poison a person because grinding up a tablet and putting it in a drink is rather more obvious a transgression than using an odourless colourless flavourless liquid.
The quantity of flunitrazepam needed to have any specific effect upon a victim varies wildly with the victim's body weight, alertness or fatigue, quantity of alcohol consumed (it is generally believed that alcohol amplifies flunitrazepam's effects, although that is not the case with all people) and a variety of other subjective factors. Therefore getting the dosage right may not be straightforward, depending upon the poisoner's purposes. The cases where it is used for date rape are often with a woman (typically a lower body weight) who has also been drinking alcohol. A big enough dose will knock anybody unconscious - and indeed kill them; flunitrazepam is also used in suicides. But the key quality of flunitrazepam from the perspective of the victim trying to avoid being poisoned is its relatively slow onset and half-life. It does not hit you immediately; the onset is gradual. Within about 20-30 minutes of ingestion of a substantial quantity of flunitrazepam, the victim will incur the symptoms of high benzodiazepine intake. This is an experience that everybody should have at least once, because it is highly distinctive. One feels slightly happy, at peace, anxieties fade, one's heartbeat goes down, motor skills are lost, and with sufficient quantity one gradually drifts off to sleep. Flunitrazepam has substantially the same effects as say alprazolam (xanax) or diazepam (valium), but it is much stronger.
In an ideal world, the best way to fight flunitrazepam poisoning is to sip your drink very slowly and see whether you have any gradual onset benzodiazepine symptoms. However life is seldom so straightforward; and of all the poisons you are not expecting (until you'd read this article), flunitrazepam is the most likely poison that will be administered to you. There are bars, particularly associated with amorous women and particularly in the Far East (Bangkok is one city where there are such bars), in which the barmen are "in on it". They spike the drinks, you become drowsy and the women rob you, either in the bar or having taken you to some stupid place you should not have gone to. Benzodiazepines can make you suggestible but so can alcohol. Other motives of flunitrazepam poisoning, aside from theft, can include rape ( this is risky for the perpetrator, as the loss of memory may not be at all complete; but in many countries there is no legal system to provide redress) or persuading you to talk (one's increased suggestibility makes it more likely you will answer questions). Flunitrazepam is rarely used as an assassin's drug, because exceptional cases notwithstanding, the quantity of the poison required to kill is relatively high and relatively difficult to administer; and the significant period of onset, in which the victim will collapse at some point, makes it all the more likely that an antidote (of which there are several) will be administered before the death that is intended.
If you feel benzodiazepine symptoms coming over you within 15-20 minutes after taking a drink, the first thing to do is to stop drinking until you have worked out what is wrong with you. The next point is very important: once you have the concern, do not delay because the transition from losing motor skills to amnesia and even falling unconscious comes over the victim relatively quickly. There are basically three courses of action open to you when you realise you are fading:
Find a reliable person of authority (usually a Police Officer but it may be another responsible-looking person in the bar, in particular anyone who appears to have had military training, lawyers are also good for this); inform them explicitly that you believe you have been poisoned. Don't start getting into the "what by" conversation - that's for an emergency blood test once that person gets you to hospital. Just explain that you've been taking that drink and now you feel very sick and it's not alcohol-related sickness; and you release yourself into their care, anticipating that whatever they do with you will be a better outcome than what the poisoner has planned for you.
If you are carrying a powerful stimulant, such as amphetamine or cocaine, then take a big line of it. Don't wait for the bar staff to make you a strong cup of coffee - they may be in on the trick, in which case that cup of coffee will take a long time to come. An immediately available stimulant will serve as a rough and ready antidote - but not forever. You then get out of the hostile environment, and try to get in a taxi or other place of safety in case you collapse. Assuming that the stimulant you use for this purpose is illegal where you are, you can't take it walking down the street or in the back of a bus - unless it is a really desperate situation in which you are being followed and you absolutely must keep awake. In such circumstances, being arrested for taking recreational narcotics in public is probably a relatively good outcome because the Police will take you somewhere safe (if not pleasant) and you can explain what happened whereupon they will obtain medical attention for you. That is more important than any penalty you may pay for possession of recreational narcotics, which is not treated as a very serious matter in most countries in Europe (except Belarus, in which case it may be better to be robbed than serve an eight-year mandatory prison sentence).
Absent either of these possibilities, you run. By this I mean go jogging. It does not matter whether you have ever jogged anywhere in your life. You are in danger, your adrenalin will kick in, and you will jog. You do this preferably in a place with other people around. If the poisoner (or poisoners) run down the street after you, then that will alert other people that you are in jeopardy. If you collapse in the street in front of other people while jogging, that will alert them to call the emergency services - hopefully to the exclusion of persons jogging after you. And if you manage to jog all the way home, then go to bed. In this way, the adrenalin produced by the flight instinct and jogging will serve as an informal antidote to the flunitrazepam intoxication. This may wear off, if the flunitrazepam dose was large enough; but provided you remember to keep jogging in a place where people are around you will probably find yourself collapsing in a less dangerous environment than the one in which you were poisoned.
Flunitrazepam has a long half-life, of 18 hours or so. If you fall unconscious, you may be asleep for several hours. Again it all depends on the dose and upon your personal constitution. If you're built like an ox and you're fit as a fiddle, then by the time you've finished a half-hour jog the narcotic may have passed through your system. Go to hospital if you feel the need to, but expect a lot of questions. The most important thing is to go to bed and to sleep in a safe environment. Eventually you will wake up and you will be fine.
Finally, we must make a few comments about poisoning in the water supply. It is more common than you think; all the poisoner needs to know, if they are tolerably skilled, is your address. Then they can establish where the water supply is (there are a limited number of places where water tanks are situated, and limited entrance points for the water) and insert the poison in the right part of the system. The purpose of this kind of poisoning may be a warning; but it is more likely to be a method of disabling you during a recovery period. For these purposes an emetic and/or diarrhetic may be used, making you unable to do anything except sitting on a toilet until the effects pass.
This author has had that experience, and it was a mess: everything you drink comes straight out. It can last for several hours or even a day. It is nothing like the dead bird in the water tank, which this author has also experienced. The dead bird makes you feel a bit ill, as though you have 'flu, and you may have some diarrhoea. The emetic / diarrhetic poisoning combination is vastly more acute and makes one literally unable to move or do anything for an extended period. Unfortunately there is very little you can do to protect yourself against this, save for residing in premises with sealed water tanks. Open water tanks are more common a feature of the developing world, although the experience this author had of poisoning via a water tank was in a European country.
The good news about poisoning via a water tank is that the intention is probably not mortal. That is because the poisoning may well take effect upon several people other than the intended victim (people in the same residence or in the same apartment building sharing a water tank); and it is practically impossible to predict how many people one's water tank poisoning will effect. Assassins generally want to minimise their collateral damage, and hence water tank poisoning is not a preferred method. Moreover there are so many other, easier ways of assassinating somebody, that this method is highly unlikely to be used for any purpose in practice except for incapacitation.
Poisoning is rare; but it's more common than you think. Russian intelligence agencies aside, it's most likely an effort to rob you - whether of your wallet, your keys, or something else you have about your person. Rape as a motive is rare in the west, because the perpetrator knows that they will be caught. It is more plausible as a motive in more lawless countries. Stay alert, without trying to be paranoid after having read this. And, as one of the cardinal rules of self-defence, stay away from places with bad people in them.