Drug Facilitated Sexual Violence

Albino GomesForensic Nurse Examiner

DRUG FACILITATED SEXUAL VIOLENCE

Albino Gomes

DRUG FACILITATED SEXUAL ASSAULT

Sexual assault facilitated by the offender’s use of an anesthesia type drug which when administered to the victim rendered the victim physically incapacitated or helpless and thus incapable of giving or not giving consent

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DRUG FACILITATED SEXUAL VIOLENCE

Most common symptom in alleged drug facilitated sexual assault is

anterograde amnesia

The victim remembers events up to but not after the drink

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DRUG FACILITATED SEXUAL VIOLENCE

THE CHALLENGES TO INVESTIGATING DRUG-FACILITATED SEXUAL

ASSAULT The victim’s lack of resistance

Inconsistent or untrue statements

Delayed reporting

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DRUG FACILITATED SEXUAL VIOLENCE

COMMON DRUGS

DRUGS IN ABUSE

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DRUG FACILITATED SEXUAL VIOLENCE

Ethanol

Marijuana

GHB (liquid ecstasy)

Flunitrazepam

(rohypnol)

Ecstasy

Ketamine

Hypnotics

Cocaine

Amphetamines

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COMMON DRUGS

DRUGS IN ABUSE

DRUG FACILITATED SEXUAL VIOLENCE

ROHYPNOL (Flunitrazepam)

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DRUG FACILITATED SEXUAL VIOLENCE

When mixed with alcohol can

incapacitate a victim

Increased use in U.S.

Abuse started in Europe in 1970’s, in

U.S. the 1990’s

Rapidly dissolved in liquid

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ROHYPNOL (Flunitrazepam)

DRUG FACILITATED SEXUAL VIOLENCE

USE AND EFFECTS

Ingested with alcohol and other drugs, especially heroin, causes muscle and mental relaxation and amnesia

Drugs effects begin within 30 minutes and persist for 8 hours or more

Can be detected in blood for 24 hours and in urine for 48 hours

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ROHYPNOL - (Flunitrazepam)

DRUG FACILITATED SEXUAL VIOLENCE

Seizures, hypotension, memory impairment, dizziness and confusion, amnesia

Can cause excitability and aggressive behavior

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ROHYPNOL - (Flunitrazepam)

DRUG FACILITATED SEXUAL VIOLENCE

ADVERSE EFFECTS

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GHB(Gama - hydroxybutyerate)

DRUG FACILITATED SEXUAL VIOLENCE

- Liquid ecstasy -

Used since 1990 in Europe for euphoria, sedative, and anabolic effects

Found in liquid or white powder-tasteless and odorless

Frequently combined with alcohol in doses of 75-100mg/kg

Causes loss of inhibition within 10-15 minutes

Effects last 3 hours, with alcohol 20-30 hours

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GHB (Gama - hydroxybutyerate)

DRUG FACILITATED SEXUAL VIOLENCE

USE AND EFFECTS

GHB can cause drowsiness, hypothermia, dizziness, seizures especially with methamphetamine, severe respiratory depression and coma

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GHB (Gama - hydroxybutyerate)

DRUG FACILITATED SEXUAL VIOLENCE

ADVERSE EFFECTS

Powerful anesthetic Similar to PCP and LSD Common at teenage rave parties Separates perception from sensation Can be snorted, ingested, or laced with

marijuana Onset of effects within 4 to 20 minutes Effects last from 30 minutes to 2 hours

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KETAMINE

DRUG FACILITATED SEXUAL VIOLENCE

USE AND EFFECTS

At high doses ketamine causes delirium, amnesia, impaired motor function, hypertension, depression, and respiratory failure.

Emergency room reports have risen 300 times in the last six years (England).

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KETAMINE

DRUG FACILITATED SEXUAL VIOLENCE

ADVERSE EFFECTS

Analog of amphetamine

Developed and synthesized by Merck in 1912 as an appetite suppressant

Became popular in 1970’s as adjunct to psychotherapy

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MDMA(Ecstasy)

DRUG FACILITATED SEXUAL VIOLENCE

Tablets, capsule, white powder

Tablets are most common, can be any color with any logo on them

Can contain many other substances due to illegal manufacture-caffeine, ephedrine, cocaine, ketamine, dextromethorphan

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MDMA (Ecstasy)DRUG FACILITATED SEXUAL VIOLENCE

USE AND EFFECTS

Psychologically addictive-abusers feel irritable, sick and crave more.

Hyperthermia common

Neurotoxic to the serotoninergic system-occurs with the first dose, most likely from metabolites

Also causes kidney failure and liver damage

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MDMA (Ecstasy)DRUG FACILITATED SEXUAL VIOLENCE

ADVERSE EFFECTS

Victims without a feeling of revolt

Victims confused and disoriented

Victim with amnesia

Uninformed about victim offender

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HISTORY OF DRUGS

DRUGS IN ABUSE

DRUG FACILITATED SEXUAL VIOLENCE

She tells you she took the drug

The victim reports symptoms of amnesia

She recalls feeling “strange” or “very drunk”

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RECOGNIZE THE INDICATORS OF A DRUG-FACILITATED

SEXUAL ASSAULT

DRUGS IN ABUSE

DRUG FACILITATED SEXUAL VIOLENCE

Physical trauma (vaginal, anal), unexplained

Waking up in an unknown location

Evidences of semen in the body or clothing

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RECOGNIZE THE INDICATORS OF A DRUG-FACILITATED

SEXUAL ASSAULT

DRUGS IN ABUSE

DRUG FACILITATED SEXUAL VIOLENCE

3212 cases of sexual abuse

1252 cases – there were no drugs (39%)

1121 casos – one drug (35%)

839 casos – several drugs (26%)

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STUDY IN EUROPE IN 2 YEARS

DRUGS IN ABUSE

DRUG FACILITATED SEXUAL VIOLENCE

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DRUG FACILITATED SEXUAL VIOLENCE

PROTECTING YOURSELF Do not leave beverages unattended At a bar or club, accept drinks only

from a bartender, waiter or waitress Be alert of the behavior of friends Follow your instincts Have a buddy system Party in groups

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DRUG FACILITATED SEXUAL VIOLENCE

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PROTECTING YOURSELF

DRUG FACILITATED SEXUAL VIOLENCE

The victim

The suspect

The witness

The crime scene

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EVIDENCE COLLECTION

DRUG FACILITATED SEXUAL VIOLENCE

Informed consent

Inform all medications taken will be found

Describe: probable time of exposure, time of collection of blood and urine

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TOXICOLOGY

DRUG FACILITATED SEXUAL VIOLENCE

If the patient believes that something was put in her drink or does not remember everything that happened

› Urine specimen (100 ml)› 2 gray topped tubes of serum

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“DATE RAPE” DRUGS

DRUG FACILITATED SEXUAL VIOLENCE

Urine

Drug abuse and medication

Blood

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DRUG FACILITATED SEXUAL VIOLENCE

BARRIERS TO PROSECUTION Victim may not remember what

happened

Victim may be groggy for a long period after waking up

Drugs eliminate from the bodyvery quickly (As quickly as 4 hours)

Juries may have trouble knowing just how helpless the victim was without evidenceAlbino Gomes

DRUG FACILITATED SEXUAL VIOLENCE

Victim’s drug/alcohol use may make the victim seem to lack credibility to the system and/or to juries

Juries may blame the victim

Prosecutor may not be able to prove details of the case necessary for a conviction

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BARRIERS TO PROSECUTION

DRUG FACILITATED SEXUAL VIOLENCE

Albino Gomes

DRUG FACILITATED SEXUAL VIOLENCE

FORENSIC NURSING

Grazie !!!