Drug-Facilitated Sexual Assault ('Date Rape')

Richard H. Schwartz, MD, Regina Milteer, MD, Department of Pediatrics, Inova Fairfax Hospital for Children, Falls Church, Va; and Marc A. LeBeau, MS, Chemistry Unit, FBI Laboratory, Federal Bureau of Investigation, Washington, DC

South Med J. 2000;93(6) 

In This Article

Abstract and Introduction

In the past few years, drug-facilitated sexual assaults have received widespread media coverage. In addition to alcohol, the most frequently used date-rape drug, flunitrazepam (Rohypnol), a fast-acting benzodiazepine, and gamma-hydroxybutyrate (GHB) and its congeners are among the most popular drugs used for this purpose. The latter drug is easily procured at some gymnasiums, popular bars, discos, and rave clubs, as well as over the Internet. Perpetrators choose these drugs because they act rapidly, produce disinhibition and relaxation of voluntary muscles, and cause the victim to have lasting anterograde amnesia for events that occur under the influence of the drug. Alcoholic beverages potentiate the drug effects. We review several date-rape drugs, provide information on laboratory testing for them, and offer guidelines for preventing drug-facilitated sexual assault.

A notable increase has occurred in the past few years in the frequency of reports of drug-facilitated sexual assaults of older adolescents and young adults at bars, nightclubs, rave clubs (high-tech, loud, fast beat music in large warehouses), and social parties. At least 20 drugs have been used for drug-facilitated sexual assault (Table). Of 1,179 specimens collected from victims of alleged assault nationwide, 38% were positive for alcohol, 18% for tetrahydrocannabinol (THC), 8% for benzodiazepines, and 4% for gamma-hydroxybutyrate (GHB).[1] Sedative adulterants included flunitrazepam (Rohypnol, also known as the "date-rape drug"), alprazolam, and triazolam. A banned "dietary supplement" used as a euphoriant and purported aid to bodybuilding, GHB was found more often than flunitrazepam. Also found were gamma-butyrolactone (GBL) and 1,4 butanediol (BD), which are precursors of GHB. Perpetrators choose the new generation of drugs because they act rapidly -- often within 20 minutes -- and frequently cause disinhibition, passivity, loss of will to resist, relaxation of muscles, and lasting anterograde amnesia. Alcoholic beverages potentiate the effects of these potent sedative adulterants.

Because of the amnesic effects of some of the more newsworthy date-rape drugs and the nature of the crime of rape, the victim may not report the crime for days, weeks, or even longer. The general medicine physician may be the first person receiving the report. In many of the reported cases, a young woman reports that she visited a bar or party and was offered a mixed drink containing alcohol or a soft drink such as fruit punch. Distracted for a moment, she paid no attention to her drink. The woman recalls that she became strangely lightheaded and that memory for further events was lost. Awakening in strange surroundings with disheveled clothing, the victim realized that she had been sexually violated.

On restoration of consciousness and orientation, the victim may have multiple symptoms, including drowsiness, confusion, dizziness, impaired memory and judgment, reduced inhibition, impaired motor skills, "rubbery legs," weakness, and unsteadiness. If some memory of the event remains, the victim may describe a strange sensation of being paralyzed, powerless, and unable to resist and a disassociation of mind and body. Vital signs, particularly pulse rates and blood pressure, if obtained within 6 to 8 hours after the incident, are often depressed.

We describe three of the most commonly used date-rape drugs, guidelines for preventing drug-facilitated sexual assault, and information on tests used to detect drug metabolites.

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