Transcript Drug Facilitated Sexual Assault

DRUG FACILITATED
SEXUAL ASSAULT
(Content areas reflective of current
practice 7/16/09 – revise as appropriate
to reflect current standards of care.)
Drug Facilitated Sexual Assault
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“Sexual assault facilitated by the offender’s
use of an “anesthesia-type” drug which, when
administered to the victim, (stealthily or not)
rendered the victim “physically incapacitated
or helpless” and thus incapable of giving or
not giving consent.”
American Prosecutor’s Research
Institute - 1999
What is Drug Facilitated
Rape?
Classic ‘slipping a mickey’
 Recreational drug use by victim
 Victim mixing Rx or OTC meds with
ETOH or Recreational drugs
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MOST Common “Date Rape”
Drugs
GHB
 Ketamine
 Ecstasy
 Alcohol
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Challenges Surrounding
Reporting
Is it even reported ?
 Time elapsed since drugging
 Convincing law enforcement
 Is the victim being truthful?
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Challenges With Evidence
Collection
Proper specimens
 Enough specimens
 Preservation of specimens
 Testing facilities
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Signs of Date Rape Drugging
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Victim REPORTS:
Recalls having a drink but doesn’t remember
what happened afterward
Feeling very drunk after one or two drinks
Suddenly feeling very nauseated after one or
two drinks or no ETOH
Wake up feeling like someone had sex with
them, but doesn’t remember who, where or
when.
Scenario
Female aged 15-25, at a bar, club or private
party
 Given a beverage she didn’t see poured, or
left her drink unattended
 Sudden onset nausea; goes to the bathroom
 Male waiting outside bathroom, expresses
concern, offers to accompany female outside
for air or a ride home.
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Scenario (cont.)
Female wakes up 1 – 12 hours later
in her car
in her home
next to a stranger in unfamiliar
surroundings
in an isolated location
 Complains of confusion, HA, genital soreness
 Clothing messed up, some articles missing
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Scenario (cont.)
Victim has no memory or only flashes
 May recall being awake but unable to
move extremities
 Perpetrator may tell her that she
consented
 Victim often too confused or
embarrassed to tell anyone or report to
police because she can’t remember
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Ethanol (ETOH)
What makes ethanol a good DFSA drug?
 Easy to obtain
 Most commonly associated with rape
 Victims commonly consume voluntarily
 May cause decreases inhibitions, impaired
perceptions, loss of consciousness, amnesia
 Prosecution doubtful
 CNS depressant, enhancing effect of other
drugs
 Associated with risk behaviors
Pharmacology of Ethanol
Pharmacokinetics
 Rapidly absorbed into bloodstream
 Distribution to entire body including CNS
 Rapidly eliminated
Detection periods:
 Blood 5 – 15 hrs.
 Urine 5- 24 hrs.
Gammahydroxybuterol GHB
Liquid E
Grievous Bodily Harm
Soap
Georgia Home Boy
Easy Lay
Scoop
Salty Water
Blue Verve
Goop
G
Gamma - oh
GHB
Naturally occurring metabolite of GABA
 Strong CNS depressant
 Abuse / Misuse
bodybuilders
recreational
DFSA
 Detectable less than 8 hrs. in blood; less than
12 hrs. in urine
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GHB
Made in clandestine labs
 Ingredients include industrial degreaser
and lye
 End product a tasteless – colorless liquid
 Street Cost: $10 per dose
 Greatly enhanced with ETOH
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What Makes GHB A Good
DFSA Drug?
Easy to obtain
 Fast acting sedative properties
 Mimics ethanol
 Amnesiac
 Rapidly eliminated
 Majority of labs do not have assays
 Naturally occurring
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Ketamine
Special K
Vitamin K
Jet
Super Acid
Bump
Kit Kat
Cat Valium
Ketamine
Since 1972, anesthetic induction agent
 Vets - Watch robberies
 Structurally similar to PCP
 Increasingly popular hallucinogen
 Described as superior to PCP and LSD
 $40 - $50 / ½ gram
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Ketamine
“K Hole” Businessman’s LSD
mind body separation
near death experience
extremely short half life
go into “K Hole” then get back to
work
 Able to follow instructions and obey
commands
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What Makes Ketamine A Good
DFSA Drug?
Dissociative, analgesic and mild
sedative effects
 Popular drug of abuse
 Readily available
 Often victim voluntarily ingests
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Ecstacy
X
XTC
Candy
Love Drug
Light Show
Hug Drug
Smurfs
Love Drug
Ecstacy
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Chemical Name MDMA
methelenedioxymethamphetamine
Central nervous system stimulant
Increases BP and HR
Often highly elevated core body temps of
over 105
Rapid dehydration – H2O intoxication
Street Cost: $8 - $20 per pill
Holiday stamps on tablets
What Makes Ecstasy A Good
DFSA Drug?
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The “love drug” or “hug drug”
The “perfect high”
Becoming very popular “club drug”
Often voluntarily ingested
Intense thirst and need to suck, grind teeth
and clench jaws
Increased perception of sensory stimuli:
lights brighter with trails
skin surfaces more sensitive
Recommendations for Victims
of DFSA
Collect first urine in a clean container
 Ask trusted people for help
 Call police
 Get to a SANE team
 Be truthful about any ethanol or
recreational drugs on board
 Save the glass, can or bottle
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Recommendations for Medical
Professionals
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Get 100 cc of urine if reported within first 96
hrs.
Get blood if within 24 hrs.
10cc in grey top tube
Big red tube
Hair samples in research – longer window
Immediately refrigerate up to 7 d and frozen if
over 7 days (make LE aware!)
Follow local procedure for analyzing specimens
Discuss local protocol / forms / lab venues
Conclusions
DFSA cases are increasing, esp. on campus
 Many different drugs, not just ones in media
 Many challenges to be overcome:
education of kids, esp. teen girls
education of medical personnel
education of law enforcement/judicial
thorough investigation a MUST
teamwork is vital SART approach
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