Drug-Facilitated Sexual Assaults

Medical and criminal justice personnel may be confronted with subjects who may have been sexually assaulted while under the influence of a substance that affected their ability to resist or, in some cases, even to recall the assault. Drug-facilitated sexual assault (DFSA) implies the use of a mind altering chemical being used in the course of a sexual assault. Drugs incapacitate victims physically as well as mentally, rendering them powerless to resist an attack or unable to provide conscious, valid consent. The most common class of drugs used in DFSA are central nervous system depressants, primarily hypnotic sedatives. Most women are sexually assaulted during voluntarily intoxication. About half of all of sexual assaults occur under the influence of alcohol or drugs and most often these intoxicants are used voluntarily by the victim and assailant Social lubricants like alcohol and drugs like LSD, MDMA, GHB, marijuana, uppers, and downers are all popular and freely used in nightclubs, bars, and disco-dance/rave parties. Commonly used licit substances include anxiolytic, sedative, hypnotic drugs including benzodiazepines, barbiturates, chloral hydrate, codeine, propoxyphene, antihistamines, muscle relaxants, and others. Flunitrazepam (Rohypnol), diazepam, triazolam, tetrazepam, clonazepam, lorazepam, zolpidem, zopiclone, eszopiclone, zaleplon, and ketamine are the most commonly implicated prescription medications in DFSA. Commonly used illicit drugs are familiar recreational drugs (cannabinoid, cocaine, opioids, and amphetamines including MDMA and LSD) and “knockout” drugs (GHB, ketamine, rohypnol, scopolamine, and datura). DFSA calls for a high index of suspicion since poor recall, lesser degrees of physical injury, and delays in providing body fluids can complicate identification, investigation, and prosecution. A forensic evaluation of suspected DFSA calls for obtaining thorough and systematic history, physical and mental status examination, and evidence collection. In delayed presentation, tests for metabolites with long half-lives, as well as scalp hair and sweat may be needed. From a legal standpoint, DFSA laws can take commonplace behavior between individuals and reframe the acts as heinous crimes. False reporting can occur with individuals who are confused, delirious, hallucinating, or delusional or from misidentification. Expert may testify that symptoms described by alleged rape victim are consistent with the administration of a drug to facilitate the attack. Professional involvement in suspected DFSA cases requires careful review of a database: crime reports, victim/suspect accounts, emergency room records, and results of sexual assault examination findings; knowledge and familiarity of the various drugs that can be used in DFSA and their psychological and medical presentation; the ability to review and interpret toxicological findings; cognizance of issues such as sexual deviance, false victimization and false memories, suggestibility, and eye witness identification