DRUG FACILITATED DRUG FACILITATED SEXUAL ASSAULTSEXUAL ASSAULT

(Content areas reflective of current (Content areas reflective of current practice 7/16/09 – revise as practice 7/16/09 – revise as

appropriate to reflect current appropriate to reflect current standards of care.)standards of care.)

Drug Facilitated Sexual Drug Facilitated Sexual AssaultAssault

““Sexual assault facilitated by the Sexual assault facilitated by the offender’s use of an “anesthesia-type” offender’s use of an “anesthesia-type” drug which, when administered to the drug which, when administered to the victim, (stealthily or not) rendered the victim, (stealthily or not) rendered the victim “physically incapacitated or victim “physically incapacitated or helpless” and thus incapable of giving or helpless” and thus incapable of giving or not giving consent.”not giving consent.”

American Prosecutor’s American Prosecutor’s Research Research Institute - 1999Institute - 1999

What is Drug Facilitated What is Drug Facilitated Rape?Rape?

Classic ‘slipping a mickey’Classic ‘slipping a mickey’ Recreational drug use by victimRecreational drug use by victim Victim mixing Rx or OTC meds with Victim mixing Rx or OTC meds with

ETOH or Recreational drugsETOH or Recreational drugs

MOST Common “Date MOST Common “Date Rape” DrugsRape” Drugs

GHB GHB KetamineKetamine EcstasyEcstasy AlcoholAlcohol

Challenges Surrounding Challenges Surrounding ReportingReporting

Is it even reported ?Is it even reported ? Time elapsed since druggingTime elapsed since drugging Convincing law enforcementConvincing law enforcement Is the victim being truthful?Is the victim being truthful?

Challenges With Evidence Challenges With Evidence CollectionCollection

Proper specimensProper specimens Enough specimensEnough specimens Preservation of specimensPreservation of specimens Testing facilitiesTesting facilities

Signs of Date Rape Signs of Date Rape DruggingDrugging

Victim REPORTS:Victim REPORTS: Recalls having a drink but doesn’t Recalls having a drink but doesn’t

remember what happened afterwardremember what happened afterward Feeling very drunk after one or two Feeling very drunk after one or two

drinksdrinks Suddenly feeling very nauseated after Suddenly feeling very nauseated after

one or two drinks or no ETOHone or two drinks or no ETOH Wake up feeling like someone had sex Wake up feeling like someone had sex

with them, but doesn’t remember who, with them, but doesn’t remember who, where or when.where or when.

ScenarioScenario

Female aged 15-25, at a bar, club or Female aged 15-25, at a bar, club or private partyprivate party

Given a beverage she didn’t see Given a beverage she didn’t see poured, or left her drink unattendedpoured, or left her drink unattended

Sudden onset nausea; goes to the Sudden onset nausea; goes to the bathroombathroom

Male waiting outside bathroom, Male waiting outside bathroom, expresses concern, offers to accompany expresses concern, offers to accompany female outside for air or a ride home.female outside for air or a ride home.

Scenario (cont.)Scenario (cont.)

Female wakes up 1 – 12 hours laterFemale wakes up 1 – 12 hours later

in her carin her car

in her homein her home

next to a stranger in unfamiliar next to a stranger in unfamiliar surroundingssurroundings

in an isolated locationin an isolated location Complains of confusion, HA, genital Complains of confusion, HA, genital

sorenesssoreness Clothing messed up, some articles missingClothing messed up, some articles missing

Scenario (cont.)Scenario (cont.)

Victim has no memory or only flashesVictim has no memory or only flashes May recall being awake but unable to May recall being awake but unable to

move extremitiesmove extremities Perpetrator may tell her that she Perpetrator may tell her that she

consentedconsented Victim often too confused or Victim often too confused or

embarrassed to tell anyone or report embarrassed to tell anyone or report to police because she can’t rememberto police because she can’t remember

Ethanol (ETOH)Ethanol (ETOH)

What makes ethanol a good DFSA drug?What makes ethanol a good DFSA drug? Easy to obtainEasy to obtain Most commonly associated with rapeMost commonly associated with rape Victims commonly consume voluntarilyVictims commonly consume voluntarily May cause decreases inhibitions, impaired May cause decreases inhibitions, impaired

perceptions, loss of consciousness, amnesiaperceptions, loss of consciousness, amnesia Prosecution doubtfulProsecution doubtful CNS depressant, enhancing effect of other CNS depressant, enhancing effect of other

drugsdrugs Associated with risk behaviorsAssociated with risk behaviors

Pharmacology of EthanolPharmacology of Ethanol

PharmacokineticsPharmacokinetics Rapidly absorbed into bloodstreamRapidly absorbed into bloodstream Distribution to entire body including Distribution to entire body including

CNSCNS Rapidly eliminatedRapidly eliminated

Detection periods:Detection periods: Blood 5 – 15 hrs.Blood 5 – 15 hrs. Urine 5- 24 hrs.Urine 5- 24 hrs.

Gammahydroxybuterol Gammahydroxybuterol GHBGHB

Liquid ELiquid EGrievous Bodily HarmGrievous Bodily Harm

SoapSoapGeorgia Home BoyGeorgia Home Boy

Easy LayEasy LayScoopScoop

Salty WaterSalty WaterBlue VerveBlue Verve

GoopGoopGG

Gamma - ohGamma - oh

GHBGHB

Naturally occurring metabolite of GABANaturally occurring metabolite of GABA Strong CNS depressantStrong CNS depressant Abuse / MisuseAbuse / Misuse

bodybuildersbodybuilders

recreationalrecreational

DFSADFSA Detectable less than 8 hrs. in blood; less Detectable less than 8 hrs. in blood; less

than 12 hrs. in urinethan 12 hrs. in urine

GHBGHB

Made in clandestine labsMade in clandestine labs Ingredients include industrial Ingredients include industrial

degreaser and lyedegreaser and lye End product a tasteless – colorless End product a tasteless – colorless

liquidliquid Street Cost: $10 per doseStreet Cost: $10 per dose Greatly enhanced with ETOHGreatly enhanced with ETOH

What Makes GHB A Good What Makes GHB A Good DFSA Drug?DFSA Drug?

Easy to obtainEasy to obtain Fast acting sedative propertiesFast acting sedative properties Mimics ethanolMimics ethanol AmnesiacAmnesiac Rapidly eliminatedRapidly eliminated Majority of labs do not have assaysMajority of labs do not have assays Naturally occurringNaturally occurring

KetamineKetamine

Special KSpecial K

Vitamin KVitamin K

JetJet

Super AcidSuper Acid

BumpBump

Kit KatKit Kat

Cat ValiumCat Valium

KetamineKetamine

Since 1972, anesthetic induction Since 1972, anesthetic induction agentagent

Vets - Watch robberiesVets - Watch robberies Structurally similar to PCPStructurally similar to PCP Increasingly popular hallucinogenIncreasingly popular hallucinogen Described as superior to PCP and Described as superior to PCP and

LSDLSD $40 - $50 / ½ gram$40 - $50 / ½ gram

KetamineKetamine

““K Hole” Businessman’s LSDK Hole” Businessman’s LSDmind body separationmind body separationnear death experiencenear death experienceextremely short half lifeextremely short half lifego into “K Hole” then get back go into “K Hole” then get back

to to workwork Able to follow instructions and Able to follow instructions and

obey commandsobey commands

What Makes Ketamine A What Makes Ketamine A Good DFSA Drug?Good DFSA Drug?

Dissociative, analgesic and mild Dissociative, analgesic and mild sedative effectssedative effects

Popular drug of abusePopular drug of abuse Readily availableReadily available Often victim voluntarily ingestsOften victim voluntarily ingests

EcstacyEcstacy

X X

XTC XTC

CandyCandy

Love DrugLove Drug

Light ShowLight Show

Hug DrugHug Drug

SmurfsSmurfs

Love DrugLove Drug

EcstacyEcstacy

Chemical Name MDMAChemical Name MDMAmethelenedioxymethamphetaminemethelenedioxymethamphetamine

Central nervous system stimulantCentral nervous system stimulant Increases BP and HRIncreases BP and HR Often highly elevated core body temps Often highly elevated core body temps

of over 105of over 105 Rapid dehydration – H2O Rapid dehydration – H2O intoxicationintoxication Street Cost: $8 - $20 per pillStreet Cost: $8 - $20 per pill Holiday stamps on tabletsHoliday stamps on tablets

What Makes Ecstasy A What Makes Ecstasy A Good DFSA Drug?Good DFSA Drug?

The “love drug” or “hug drug”The “love drug” or “hug drug” The “perfect high”The “perfect high” Becoming very popular “club drug”Becoming very popular “club drug” Often voluntarily ingestedOften voluntarily ingested Intense thirst and need to suck, grind Intense thirst and need to suck, grind

teeth and clench jawsteeth and clench jaws Increased perception of sensory stimuli:Increased perception of sensory stimuli:

lights brighter with trailslights brighter with trailsskin surfaces more sensitiveskin surfaces more sensitive

Recommendations for Recommendations for Victims of DFSAVictims of DFSA

Collect first urine in a clean containerCollect first urine in a clean container Ask trusted people for helpAsk trusted people for help Call policeCall police Get to a SANE teamGet to a SANE team Be truthful about any ethanol or Be truthful about any ethanol or

recreational drugs on boardrecreational drugs on board Save the glass, can or bottleSave the glass, can or bottle

Recommendations for Recommendations for Medical ProfessionalsMedical Professionals

Get 100 cc of urine if reported within first 96 Get 100 cc of urine if reported within first 96 hrs.hrs.

Get blood if within 24 hrs.Get blood if within 24 hrs. 10cc in grey top tube10cc in grey top tube Big red tubeBig red tube

Hair samples in research – longer windowHair samples in research – longer window Immediately refrigerate up to 7 d and frozen Immediately refrigerate up to 7 d and frozen

if over 7 days (make LE aware!)if over 7 days (make LE aware!) Follow local procedure for analyzing Follow local procedure for analyzing

specimensspecimens Discuss local protocol / forms / lab venuesDiscuss local protocol / forms / lab venues

ConclusionsConclusions

DFSA cases are increasing, esp. on campusDFSA cases are increasing, esp. on campus Many different drugs, not just ones in Many different drugs, not just ones in

mediamedia Many challenges to be overcome:Many challenges to be overcome:

education of kids, esp. teen girlseducation of kids, esp. teen girls

education of medical personneleducation of medical personnel

education of law enforcement/judicialeducation of law enforcement/judicial

thorough investigation a MUSTthorough investigation a MUST

teamwork is vital SART approachteamwork is vital SART approach