Web Box 16.2 Of Special Interest: "Date Rape" Drugs

Men have long used alcohol to reduce women’s sexual inhibitions, thereby making them more willing sexual partners. If the alcohol consumption has been sufficient to render the woman incapacitated, she is vulnerable to sexual assault, including rape. Most drug-related sexual assaults are of this kind. However, in recent years, an insidious phenomenon has emerged in which a sedating drug is put clandestinely in a woman’s drink so that she isn’t even aware that anything is amiss until she wakes up hours later in the man’s bed. Drugs are sometimes used in this way on a date, hence the term “date rape” drugs. However, government authorities have documented numerous instances in which a woman or man was sexually assaulted by a total stranger after being given one of these substances. For this reason, researchers in this area prefer to use the term “drug-facilitated sexual assault” (DFSA).

Some authors have found it useful to distinguish between assaults in which victim voluntarily self-administered the substance and assaults in which the substance was surreptitiously administered to the victim, typically by spiking the victim’s beverage. These two types of DFSA have been termed “opportunistic DFSA” and “predatory DFSA” (Grela et al., 2018). As mentioned above, alcohol is the most common drug associated with opportunistic DFSA, although other substances such as cannabis, benzodiazepines, barbiturates, opioids, ketamine, cocaine, and amphetamine have also been identified in this context (Anderson et al., 2017; Grela et al., 2018). The association of stimulants like cocaine and amphetamine with DFSA may seem paradoxical; however, these drugs can reduce social inhibitions, thereby leading the user to engage in risky behaviors that culminate in an assault.

Perpetrators of predatory DFSA typically employ substances that have sedating effects on the victim. These include not only some of the drugs listed above (i.e., cannabis, benzodiazepines, barbiturates, opioids, and ketamine), but also GHB. A recent sensational case in the United Kingdom (UK) involved a serial rapist named Reynhard Sinaga, a postgraduate student living in Manchester, England. Sinaga was apprehended in 2017 and later convicted of 136 counts of sexual assault on men (although authorities believe that many more men were victimized) (BBC News, 2020). Sinaga’s victims were drugged before being assaulted, most likely with GHB. However, this has not been proved since no forensic examinations were performed around the times of the actual crimes. Nevertheless, the serious nature of this case has led the UK government to call for a reassessment of the legal scheduling of GHB and its precursor substance GBL (Wise, 2020).

As discussed in the text, GHB is a CNS depressant that can induce unconsciousness in sufficiently high doses. It is colorless and odorless, which facilitates its surreptitious use by the perpetrator (although the sodium salt of GHB has a distinctive salty flavor that could be detected unless the victim’s beverage is already strongly flavored by fruit juice, for example). Its depressant effects add to those produced by alcohol, thereby increasing the likelihood that the victim will lapse into an unconscious state. Among the benzodiazepines associated with predatory DFSA, the most notorious is flunitrazepam (trade name Rohypnol). Rohypnol is a powerful sleep-inducing agent that is used medicinally in numerous countries but is not currently approved for sale in the United States. Nevertheless, it is available illicitly under street names like “roofies,” “rophies,” or “roche” (the drug is manufactured by the Hoffmann-La Roche pharmaceutical company). Despite the historical association of flunitrazepam with date rape, recent toxicological studies of DFSA in the United States have mainly found other members of the benzodiazepine family rather than flunitrazepam (Fiorentin and Logan, 2019). Overall, these studies found cannabinoids, alcohol, amphetamine or methamphetamine, and various benzodiazepines to be the substances most likely to be detected in the urine and/or blood of sexual assault victims. GHB was detected in urine samples in only 8.4% of sexual assault cases, compared to 38.0% for cannabinoids and 37.7% for alcohol (Fiorentin and Logan, 2019). Because this survey did not differentiate between opportunistic and predatory DFSA, however, it is possible that GHB was used more frequently than either cannabinoids or alcohol for the latter type of assault.

It is impossible to know how frequently drugs are used to perpetrate a sexual assault, partly because many assaulted victims do not come forward for personal reasons, and partly because some of these compounds (e.g., GHB) are metabolized and cleared from the body relatively quickly. The private sector has taken several steps to improve the detectability of potential date rape drugs. For example, Hoffmann-La Roche replaced its old Rohypnol formulation, which was colorless when dissolved in an alcoholic beverage, with a new tablet that turns blue when dissolved. This has likely contributed to the substitution of other benzodiazepines on the part of DFSA perpetrators. Another commercial approach to preventing DFSA is the marketing of inexpensive devices to test one’s drink for the presence of certain illicit drugs. For example, a firm called Drink Safe Technologies offers coasters and test strips designed to detect both GHB and ketamine, which has also been used as a date rape drug. As shown in Figure 1, each Drink Safe coaster contains two pairs of test circles located at the bottom corners. If the coaster is being distributed by a bar or club, it may also include some type of advertisement or logo that has been selected by the proprietor of the establishment. The individual is instructed to place a drop of their drink on both of the circles in a pair of test circles and wait for about 1 minute. A positive test is indicated by either circle turning a darker blue color, which is interpreted as a drug-contaminated drink.

It is important to note that the use of the Drink Safe coaster is not recommended for highly acidic beverages such as drinks containing large amounts of fruit juice. There are other limitations as well. The color change could be masked by the drink itself (e.g., red wine), or the bar or club could be so dark that confirming a modest color change would be difficult. These limitations have been noted not only by the manufacturer but also by researchers who performed controlled, independently conducted tests of the Drink Safe coaster (Meyers and Almirall, 2004; Quest and Horsley, 2007). Therefore, even though test coasters may help prevent some sexual assaults, people should remain alert for potential adulteration of their drinks even when such coasters are available and seem to indicate that everything is normal.

References

Anderson, L. J., Flynn, A., and Pilgrim, J. L. (2017). A global epidemiological perspective on the toxicology of drug-facilitated sexual assault: A systematic review. J. Forensic Legal Med., 47, 46–54.

BBC News (2020). Reynhard Sinaga: “Evil sexual predator” jailed for life for 136 rapes. Available at https://www.bbc.com/news/uk-50987823. Accessed 6/29/21.

Fiorentin, T. R., and Logan, B. K. (2019). Toxicological findings in 1000 cases of suspected drug facilitated sexual assault in the United States. J. Forensic Legal Med., 61, 56–64.

Grela, A., Gautam, L., and Cole, M.D. (2018). A multifactorial critical appraisal of substances found in drug-facilitated sexual assault cases. Forensic Sci. Int., 292, 50–60.

Meyers, J. E., and Almirall, J. R. (2004). A study of the effectiveness of commercially available drink test coasters for the detection of “date rape” drugs in beverages. J. Anal. Toxicol., 28, 685–688.

Quest, D. W., and Horsley, J. (2007). Field-test of a date-rape drug detection device. J. Anal. Toxicol., 31, 354–357.

Wise. J. (2020). Government orders urgent review of date rape drugs. BMJ, 368:m51. doi: 10.1136/bmj.m51.