A global epidemiological perspective on the toxicology of drug-facilitated sexual assault: A systematic review
Section snippets
Background
Drug-facilitated sexual assault (DFSA) is a term used to describe incidents of sexual assault in which the victim is incapacitated and/or unable to provide consent to the sexual act as a result of drug or alcohol consumption. Gee and colleagues (2006) identify two primary typologies of DFSA: (i) “proactive DFSA”, in which the victim is either covertly or with force administered “an incapacitating or disinhibiting substance by an assailant for the purpose of sexual assault”; and (ii)
Methodology
A systematic review of the literature was undertaken in order to understand global trends in the rate and toxicology of reported DFSA in individuals at or above the age to consent to sexual activity (i.e., 16 years of age). While studies included in this systematic review were not randomized control trials per se, a similar methodology to a Cochrane Collaboration systematic review15 was used to ensure that a high level of scrutiny was applied to the quality of included studies. Due to the
Global trends in the toxicology of DFSA
The search strategy initially identified 394 published studies, all of which were reviewed by the lead author. Due to the broad search terms utilized (to ensure adequate sensitivity), the majority of publications was not relevant to DFSA and were thus were immediately excluded from the study (see Fig. 1). There were three studies identified that seemingly met the inclusion criteria, but upon further investigation, it appeared that they were sequential publications of an ongoing study. In
Alcohol intoxication poses the greatest risk for DFSA
Contrary to popular media reports and public perception, this review of the relevant available literature globally, indicates that alcohol is the most commonly detected substance in suspected DFSA cases aged 16 and above. However, the literature also indicates that alcohol, on its own, is rarely a single causative or contributing factor to DFSA. Polydrug use was also commonly reported in cases of suspected DFSA, and it was often unclear the extent to which the victims had voluntarily ingested
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*Denotes studies included in the systematic review.