A global epidemiological perspective on the toxicology of drug-facilitated sexual assault: A systematic review

https://doi.org/10.1016/j.jflm.2017.02.005Get rights and content

Highlights

  • Alcohol is the most commonly detected substance in drug facilitated sexual assault globally.

  • Detection of more than one substance is common in drug facilitated sexual assault.

  • Covert drink-spiking appears to be an un-common occurrence in drug facilitated sexual assault.

Abstract

Purpose

A systematic review was undertaken to determine the current global prevalence of drug-facilitated sexual assault (DFSA) reported in adults in order to identify trends in the toxicology findings in DFSA around the world over the past 20 years.

Methods

Databases PubMed, PsycINFO and Scopus were systematically searched using the terms: “drug-facilitated sexual assault”, “chemical submission”, “date rape”, “rape drugs” and “drink-spiking” to identify relevant studies for inclusion in the review. This study focused on adult victims of suspected DFSA aged 16 years and above in which toxicology results were reported.

Results

The majority of studies included were published in the United States, followed by the United Kingdom, with only a single study dedicated to this area in both Australia and Europe. Epidemiology, prevalence rates, and toxicology for DFSA appear broadly commensurate across different continents, although there are some differences in how “drug-facilitated sexual assault” is defined, as well as differences in the sensitivity of toxicological analyses. Nonetheless, alcohol is the most commonly detected substance and co-occurrence with other drugs is common. Aside from alcohol there was no other specific drug category associated with DFSA. Cannabinoids and benzodiazepines were frequently detected, but a lack of contextual information made it difficult to establish the extent that these substances contributed to suspected cases of DFSA.

Conclusions

This comprehensive review suggests that alcohol intoxication combined with voluntary drug consumption presents the greatest risk factor for DFSA, despite populist perceptions that covert drink-spiking is a common occurrence. There is a need to develop policies that encourage early responders to suspected DFSA (e.g., law enforcement agencies, medical staff, support agencies, etc), to collect detailed information about the individual's licit and illicit drug consumption history, in order to assist in providing appropriate and more thorough contextual information.

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

References1 (26)

  • M. Lee

    The genesis of fear of crime

    Theor Criminol

    (2001)
  • L. Slaughter

    Involvement of drugs in sexual assault

    J Reprod. Med

    (2000)
  • Cited by (104)

    View all citing articles on Scopus
    1

    *Denotes studies included in the systematic review.

    View full text