Background This study examined whether a brief video intervention (Prevention of Postrape Stress; PPRS) delivered in the emergency department to recent sexual assault (SA) victims reduced alcohol and marijuana use at three points over the course of a six-month follow-up compared to treatment as usual (TAU) and an active control condition (Pleasant Imagery and Relaxation Information; PIRI). Prior assault history, minority status, and pre-SA substance use also were examined as moderators of intervention efficacy. Methods Women age 15 and older (N = 154) who participated in a post-SA medical forensic exam were randomly assigned to watch the PPRS video (n=54), the PIRI video (n=48), or receive TAU (n=52) and completed at least one follow-up assessment targeted at 1.5 (T1), 3 (T2), or 6 (T3) months following the exam. Results Regression analyses revealed that, relative to TAU, PPRS was associated with less frequent alcohol use at 6 months post-SA among women reporting pre-SA binge drinking and minority women. Relative to TAU, PPRS also was associated with fewer days of marijuana use at T1 among those who did not report pre-SA marijuana use and prior SA. Findings for pre-SA marijuana use were maintained at T3; however, findings for prior SA shifted such that PPRS was associated with fewer days of marijuana use at T3 for women with a prior SA. Conclusions PPRS may be effective at reducing substance use for some recent SA victims, including those with a prior SA history, a prior substance use history, and minority women.

In recent years, drugs including flunitrazepam, gamma-hydroxybutyrate, ketamine, and ethanol, have become popularly associated with drug-facilitated sexual assault. Other drugs are also candidates as factors in "drug facilitated sexual assault" (DFSA). The true extent of DFSA is not known, and is difficult to estimate. We recruited sexual assault complainants at four clinics in different parts of the U.S. to anonymously provide urine and hair specimens, and to answer questions about suspected drugging, drug use, and the sexual assault incident. Urine and hair specimens were tested for 45 drugs, including ethanol, and those pharmacologically capable of inducing sedation, amnesia, or impairment of judgment. Analytical test results were used to estimate the proportion of subjects, and the proportion of all complainants to the clinic in the same time period, who were victims of DFSA. Overall, cases of 43% of 144 subjects, and 7% of 859 complainants, were characterized as DFSA. Subjects underreported their use of drugs. The role of toxicological results and history in characterizing DFSA cases is discussed.

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