Uncovering forensic evidence of drug-facilitated sexual assault: Toxicological findings from Eastern Denmark from 2015–2022

Skov, Kathrine; Johansen, Sys Stybe; Linnet, Kristian; Klose Nielsen, Marie Katrine

doi:10.1016/j.legalmed.2023.102325

Cited by 5 publications

(6 citation statements)

References 43 publications

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“…We found unreported drugs in only 15% of the patients suspecting exposure to drink spiking. This is in accordance with the estimate of 2–22% in a recent review [ 8 ]. However, cases of drink spiking may have gone undetected, as drugs we did not screen for may be used to spike drinks.…”

Section: Discussionsupporting

confidence: 94%

“…Clonazepam was detected in three cases, the only benzodiazepine found among the unreported drugs in our study. This is surprisingly few considering how frequently benzodiazepines are detected in drug-facilitated sexual assault [ 8 ], though in line with the few reports from other emergency department settings [ 4 , 5 , 7 ]. Benzodiazepines are CNS depressants controlled under drug or medicine legislation and can induce confusion, impaired thinking, memory loss, drowsiness, sleepiness, fatigue, impaired coordination, and dizziness [ 26 ].…”

Section: Discussionmentioning

confidence: 74%

“…However, cases of drink spiking may have gone undetected, as drugs we did not screen for may be used to spike drinks. We did not analyze for antihistamines, antidepressants, or ketamine, drugs not uncommonly detected in victims of drug facilitated sexual assault [ 8 , 10 ]. Nor did we analyze for any of the numerous novel psychoactive substances that have appeared during the last two decades, also having a potential to be used for drink spiking [ 22 – 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Most studies on drink spiking have concentrated on drug facilitated sexual assault [ 8 – 11 ]. In systematic reviews of toxicological analyses from victims of drug facilitated sexual assault, the incidence of detection of different substances varies widely: ethanol was found in 10–66% of patients, cannabis in 1–58%, benzodiazepines in 3–83%, cocaine in 1–37%, amphetamines in 1–20%, methylenedioxymethamphetamine (MDMA) in 1–11%, ketamine in 0–18%, and gammahydroxybutyrate (GHB) in 0–6% [ 8 – 11 ]. Several other drugs were also found.…”

Section: Introductionmentioning

confidence: 99%

“…In most studies, context information was sparse, and whether substances were taken voluntarily or not was difficult to discern. In a recent review, 2–22% of cases were estimated to result from covert drug administration [ 8 ]. In studies of other drug-facilitated crime, analyses have shown different mixtures of benzodiazepines, and also scopolamine, used to incapacitate and then rob the victims [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Drugs in blood and urine samples from victims of suspected exposure to drink spiking: A prospective observational study from Oslo, Norway

Dalaker,

Furuhaugen,

Brekke

et al. 2024

PLoS ONE

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Objective People regularly contact emergency medicine services concerned that they have been exposed to drink spiking, i.e., exposure to drugs without their knowledge or permission. We identified drugs in blood and urine samples from patients suspecting exposure to drink spiking, with special consideration for drugs not reported taken by the patient (unreported drugs). Methods From September 2018 to May 2019, we collected blood and urine samples from patients 16 years or older presenting at an emergency clinic in Oslo, Norway, within 48 hours of suspected exposure to drink spiking. We also collected information on ethanol ingestion and drugs taken. Blood samples were analyzed for 20 classical recreational drugs using ultra-high performance liquid chromatography–tandem mass spectrometry (UHPLC-MS/MS) and an automated enzymatic method for ethanol. Urine samples were analyzed using immunoassay methods and a specific gas chromatography mass spectrometry (GCMS) method for gammahydroxybutyrate (GHB). Results From 100 included patients (median age 24 years, 62 females), we collected 100 blood samples and 72 urine samples. Median time since exposure was 5 hours. Unreported drugs were found in 15 patients. Unreported drugs in the blood samples were clonazepam in 3, methylenedioxymethamphetamine (MDMA) in 3, amphetamine in 2, tetrahydrocannabinol (THC) in 2, tramadol in 1, cocaine in 1, and methamphetamine in 1. Unreported drugs in the urine samples were cocaine in 5, amphetamine in 4, ecstasy in 3, and cannabis in 2. Ethanol was found in 69 patients, all reporting ethanol ingestion. Median blood ethanol concentration was higher in patients with no unreported drugs detected, 1.00‰ (interquartile range (IQR) 0–1.52) vs. 0‰ (IQR 0–0.46) (p<0.001). GHB was not detected. Conclusion Unreported drugs, possibly used for drink spiking, were found in 15% of patients. Blood ethanol concentration was higher when no unreported drugs were found. GHB was not detected in any patient.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Drugs in blood and urine samples from victims of suspected exposure to drink spiking: A prospective observational study from Oslo, Norway

Dalaker,

Furuhaugen,

Brekke

et al. 2024

PLoS ONE

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Automated enzymatic hydrolysis of urine samples for improved systematic toxicological analysis of drug‐facilitated sexual assault cases

Skov,

Johansen,

Linnet

et al. 2024

Drug Testing and Analysis

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Drug‐facilitated sexual assault (DFSA) is characterized by victim incapacitation due to intoxicating substances. Detection of single drug exposure from DFSA requires a systematic toxicological analysis strategy including sensitive methods covering a broad spectrum of substances. The aim of this study was to develop and validate an UHPLC–MS/MS screening method for analysis of samples from DFSA cases and incorporate an automated enzymatic pre‐treatment of urine samples into a robotic sample preparation for an efficient laboratory workflow. The screening method included 144 drugs of abuse, pharmaceuticals, and metabolites relevant to DFSA. The use of a recombinant enzyme showed an efficient glucuronide hydrolysis with an average parent drug recovery of 97%. Investigation of matrix effect showed no pronounced ion enhancement or suppression for most analytes (96%), and extraction recovery was above 80% for 97% of analytes. Process efficiency ranged from 50% to 138% for most analytes. The LODs ranged from 0.0001 mg/L to 2 mg/L depending on analyte, and most analytes met the SOFT recommended minimum performance limits. The validated method was applied to authentic suspected DFSA cases (n = 38). Results showed that drugs of abuse, benzodiazepines, and antidepressants were most commonly found in suspected DFSA cases. Incorporation of an automated enzymatic hydrolysis step during sample preparation enables a fast and simple workflow for simultaneous analysis of blood and urine samples for an improved systematic toxicological analysis strategy for DFSA cases.

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NPS–EQA PART II: Four years’ experience in external quality assessment program in Italy for classical and new psychoactive substances analysis in hair

Rotolo,

Graziano,

Varì

et al. 2024

Journal of Pharmaceutical and Biomedical Analysis

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Uncovering forensic evidence of drug-facilitated sexual assault: Toxicological findings from Eastern Denmark from 2015–2022

Cited by 5 publications

References 43 publications

Drugs in blood and urine samples from victims of suspected exposure to drink spiking: A prospective observational study from Oslo, Norway

Drugs in blood and urine samples from victims of suspected exposure to drink spiking: A prospective observational study from Oslo, Norway

Automated enzymatic hydrolysis of urine samples for improved systematic toxicological analysis of drug‐facilitated sexual assault cases

NPS–EQA PART II: Four years’ experience in external quality assessment program in Italy for classical and new psychoactive substances analysis in hair

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