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DRUG FACILITATED SEXUAL ASSAULT (Content areas reflective of current practice 7/16/09 – revise as appropriate to reflect current standards of care.)

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Presentation on theme: "DRUG FACILITATED SEXUAL ASSAULT (Content areas reflective of current practice 7/16/09 – revise as appropriate to reflect current standards of care.)"— Presentation transcript:

1 DRUG FACILITATED SEXUAL ASSAULT (Content areas reflective of current practice 7/16/09 – revise as appropriate to reflect current standards of care.)

2 Drug Facilitated Sexual Assault “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.” “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

3 What is Drug Facilitated Rape? Classic ‘slipping a mickey’ Classic ‘slipping a mickey’ Recreational drug use by victim Recreational drug use by victim Victim mixing Rx or OTC meds with ETOH or Recreational drugs Victim mixing Rx or OTC meds with ETOH or Recreational drugs

4 MOST Common “Date Rape” Drugs GHB GHB Ketamine Ketamine Ecstasy Ecstasy Alcohol Alcohol

5 Challenges Surrounding Reporting Is it even reported ? Is it even reported ? Time elapsed since drugging Time elapsed since drugging Convincing law enforcement Convincing law enforcement Is the victim being truthful? Is the victim being truthful?

6 Challenges With Evidence Collection Proper specimens Proper specimens Enough specimens Enough specimens Preservation of specimens Preservation of specimens Testing facilities Testing facilities

7 Signs of Date Rape Drugging Victim REPORTS: Victim REPORTS: Recalls having a drink but doesn’t remember what happened afterward Recalls having a drink but doesn’t remember what happened afterward Feeling very drunk after one or two drinks Feeling very drunk after one or two drinks Suddenly feeling very nauseated after one or two drinks or no ETOH 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. Wake up feeling like someone had sex with them, but doesn’t remember who, where or when.

8 Scenario Female aged 15-25, at a bar, club or private party Female aged 15-25, at a bar, club or private party Given a beverage she didn’t see poured, or left her drink unattended Given a beverage she didn’t see poured, or left her drink unattended Sudden onset nausea; goes to the bathroom Sudden onset nausea; goes to the bathroom Male waiting outside bathroom, expresses concern, offers to accompany female outside for air or a ride home. Male waiting outside bathroom, expresses concern, offers to accompany female outside for air or a ride home.

9 Scenario (cont.) Female wakes up 1 – 12 hours later 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 Complains of confusion, HA, genital soreness Clothing messed up, some articles missing Clothing messed up, some articles missing

10 Scenario (cont.) Victim has no memory or only flashes Victim has no memory or only flashes May recall being awake but unable to move extremities May recall being awake but unable to move extremities Perpetrator may tell her that she consented 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 Victim often too confused or embarrassed to tell anyone or report to police because she can’t remember

11 Ethanol (ETOH) What makes ethanol a good DFSA drug? Easy to obtain Easy to obtain Most commonly associated with rape Most commonly associated with rape Victims commonly consume voluntarily Victims commonly consume voluntarily May cause decreases inhibitions, impaired perceptions, loss of consciousness, amnesia May cause decreases inhibitions, impaired perceptions, loss of consciousness, amnesia Prosecution doubtful Prosecution doubtful CNS depressant, enhancing effect of other drugs CNS depressant, enhancing effect of other drugs Associated with risk behaviors Associated with risk behaviors

12 Pharmacology of Ethanol Pharmacokinetics Rapidly absorbed into bloodstream Rapidly absorbed into bloodstream Distribution to entire body including CNS Distribution to entire body including CNS Rapidly eliminated Rapidly eliminated Detection periods: Blood 5 – 15 hrs. Blood 5 – 15 hrs. Urine hrs. Urine hrs.

13 Gammahydroxybuterol GHB Liquid E Grievous Bodily Harm Soap Georgia Home Boy Easy Lay Scoop Salty Water Blue Verve GoopG Gamma - oh

14 GHB Naturally occurring metabolite of GABA Naturally occurring metabolite of GABA Strong CNS depressant Strong CNS depressant Abuse / Misuse Abuse / Misuse bodybuilders bodybuilders recreational recreational DFSA DFSA Detectable less than 8 hrs. in blood; less than 12 hrs. in urine Detectable less than 8 hrs. in blood; less than 12 hrs. in urine

15 GHB Made in clandestine labs Made in clandestine labs Ingredients include industrial degreaser and lye Ingredients include industrial degreaser and lye End product a tasteless – colorless liquid End product a tasteless – colorless liquid Street Cost: $10 per dose Street Cost: $10 per dose Greatly enhanced with ETOH Greatly enhanced with ETOH

16 What Makes GHB A Good DFSA Drug? Easy to obtain Easy to obtain Fast acting sedative properties Fast acting sedative properties Mimics ethanol Mimics ethanol Amnesiac Amnesiac Rapidly eliminated Rapidly eliminated Majority of labs do not have assays Majority of labs do not have assays Naturally occurring Naturally occurring

17 Ketamine Special K Vitamin K Jet Super Acid Bump Kit Kat Cat Valium

18 Ketamine Since 1972, anesthetic induction agent Since 1972, anesthetic induction agent Vets - Watch robberies Vets - Watch robberies Structurally similar to PCP Structurally similar to PCP Increasingly popular hallucinogen Increasingly popular hallucinogen Described as superior to PCP and LSD Described as superior to PCP and LSD $40 - $50 / ½ gram $40 - $50 / ½ gram

19 Ketamine “K Hole” Businessman’s LSD “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 Able to follow instructions and obey commands

20 What Makes Ketamine A Good DFSA Drug? Dissociative, analgesic and mild sedative effects Dissociative, analgesic and mild sedative effects Popular drug of abuse Popular drug of abuse Readily available Readily available Often victim voluntarily ingests Often victim voluntarily ingests

21 Ecstacy XXTCCandy Love Drug Light Show Hug Drug Smurfs Love Drug

22 Ecstacy Chemical Name MDMA Chemical Name MDMAmethelenedioxymethamphetamine Central nervous system stimulant Central nervous system stimulant Increases BP and HR Increases BP and HR Often highly elevated core body temps of over 105 Often highly elevated core body temps of over 105 Rapid dehydration – H2O intoxication Rapid dehydration – H2O intoxication Street Cost: $8 - $20 per pill Street Cost: $8 - $20 per pill Holiday stamps on tablets Holiday stamps on tablets

23 What Makes Ecstasy A 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 ingested Often voluntarily ingested Intense thirst and need to suck, grind teeth and clench jaws Intense thirst and need to suck, grind teeth and clench jaws Increased perception of sensory stimuli: Increased perception of sensory stimuli: lights brighter with trails skin surfaces more sensitive

24 Recommendations for Victims of DFSA Collect first urine in a clean container Collect first urine in a clean container Ask trusted people for help Ask trusted people for help Call police Call police Get to a SANE team Get to a SANE team Be truthful about any ethanol or recreational drugs on board Be truthful about any ethanol or recreational drugs on board Save the glass, can or bottle Save the glass, can or bottle

25 Recommendations for Medical Professionals Get 100 cc of urine if reported within first 96 hrs. Get 100 cc of urine if reported within first 96 hrs. Get blood if within 24 hrs. Get blood if within 24 hrs. 10cc in grey top tube 10cc in grey top tube Big red tube Big red tube Hair samples in research – longer window Hair samples in research – longer window Immediately refrigerate up to 7 d and frozen if over 7 days (make LE aware!) Immediately refrigerate up to 7 d and frozen if over 7 days (make LE aware!) Follow local procedure for analyzing specimens Follow local procedure for analyzing specimens Discuss local protocol / forms / lab venues Discuss local protocol / forms / lab venues

26 Conclusions DFSA cases are increasing, esp. on campus DFSA cases are increasing, esp. on campus Many different drugs, not just ones in media Many different drugs, not just ones in media Many challenges to be overcome: Many challenges to be overcome: education of kids, esp. teen girls education of kids, esp. teen girls education of medical personnel education of medical personnel education of law enforcement/judicial education of law enforcement/judicial thorough investigation a MUST thorough investigation a MUST teamwork is vital SART approach teamwork is vital SART approach


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