The Weapons Of Drug-Facilitated Sexual Assault
By Trinka Porrata
A key element for improving law enforcement and prosecutorial response to DFSA cases requires more detailed training about drug symptom recognition and better use of drug identification resources, such as local police officers or medical personnel with specialized drug knowledge. Whether it is a college panel hearing a case about allegations of DFSA at a fraternity or a criminal court case, accurate knowledge about the effects of drugs needs to take center stage to overcome the myths and achieve justice. Trust me, adequate drug knowledge is precious and sadly too rare a commodity.
The lower reporting rate of DFSA is undoubtedly driven by the fact that drugging victims are typically confused, uncertain and afraid of trying to report with such limited and chaotic information. A 2011 survey by the Substance Abuse and Mental Health Services Administration (SAMHSA), utilizing emergency room statistics from 2009, found that drugging by others indeed does happen. Their first-of-a-kind national report identified that 14,720 people ended up in emergency rooms unwittingly, but intentionally, drugged by someone else. It noted that 73 percent were over 21, 63% percent of those drugged were female, and thus the remaining 37 percent were male, a statistic that surprised some researchers. Men may be drugged for sexual assault, robbery or credit card fraud, pranks, or to prevent them from being able to protect a female companion (SAMHSA, November 3, 2011).
A Basic Example
If a person walking down the street is hit from behind with a baseball bat and wakes up alone in an alley with indicators of sexual assault, it is at least comprehensible to that person and others why that the person may have little, if any, information about the suspect and about what happened after being rendered unconscious. Any injury to the victim’s head provides visible evidence consistent with the reported assault.
But, what if that same person is eating in a restaurant, having a drink with dinner, goes to the bathroom at some point, and then wakes up at home with no idea how they got there? The victim can’t recall speaking with anyone other than the waitress, and doesn’t remember leaving the location. The victim may simply wake up with a vague feeling that sexual activity has taken place, especially if a condom was used, leaving no body fluid which would make it more obvious. The victim may have extremely few details and uncertainty about whether or not a sexual assault occurred, who the perpetrator might be, or how many assailants may have been involved.
This is just one DFSA scenario demonstrating how extremely difficult it is for victims to come forward. It’s even more difficult to come forward with vague, confusing accusations against a sports star, media personality, politician, etc. Who would believe it? A properly trained first responder or investigator certainly should. It isn’t about immediately assuming something to be “true” just because it is reported. It IS about understanding that this confused, crazy sounding story indeed could be true and thus needs to be INVESTIGATED. The facts and a thorough investigation then can lead to the truth.
What is DFSA?
The traditional view of DFSA is the offender’s use of “anesthesia-type” (i.e., central nervous system depressant, sedative) drugs, whether given surreptitiously or not, that renders the victim physically helpless or otherwise mentally incapacitated. The victim is thus unable to give or withhold consent to sexual activity. Unfortunately, there is no clear legal standard for incapacitation.
The drug may be slipped into a drink or food, without the victim’s knowledge. Or it may be presented to the victim as a sports drink, an elixir for increased energy or a vitamin tonic; the victim then “willingly” drinks the substance, but without accurate knowledge of its contents or effects. This is accomplished by deceit and thus does not negate the act of drugging nor does it make any resulting sexual activity consensual.
Voluntary intoxication (alcohol and/or drugs) on the part of the victim may not be a wise choice but incapacitation does not equate to carte blanche consent to have sex. There is also the possibility of “accidental” intoxication. The victim may take a dietary supplement, vitamin tonic or energy mix and then consume alcohol without realizing how the two might interact. Or the victim may take a prescribed medication as directed but consume alcohol within the effective range of the drug, resulting in impairment. For my training purposes, DFSA refers to covert drugging, as well as voluntary or accidental intoxication. If the person in impaired and unable to give or withhold consent, then it is not consensual, regardless of the cause of the impairment.
The current view of DFSA includes hallucinogenic drugs. While most drugs in the traditional view are central nervous system depressants, hallucinogens don’t generally produce the “down” side (intoxication, sleep or unconsciousness), but their effects interfere with a person’s ability to self-protect, to physically resist, to accurately remember, to give or withhold consent.
Establishing the victim’s condition, the level of impairment and source of such impairment, is difficult but essential. Establishing that the suspect knew or should have known about the victim’s impairment, especially if the suspect did not necessarily cause that impairment, is a key challenge for the investigator. State laws vary greatly as to how impairment and consent issues are handled. But, for the investigator’s analysis of the case and investigative strategies to move forward, these are important factors regardless of the charging considerations.
The myth of “unconsciousness” clearly complicates the job for investigators and prosecutors but should not be used as a reason not to proceed. This is where drug knowledge and details gleaned from witness descriptions of a victim’s appearance and behavior and timing of events, victim statements about timing, recall of activities, sensations, and physical evidence such as videos and photos can make the difference. Depending on the drug utilized, the quantity of the drug consumed, and the amount of alcohol or other drugs consumed, victims may or may not be unconscious at some point. They may be unconscious all, part, or none of the time. There may be a period of time where the victim is cognizant but feels paralyzed and unable to physically respond. A key factor in most DFSA drugs is amnesia.
Conscious or not, the victim may have periods of amnesia. This may entail a prolonged, total loss of awareness or may involve bits and pieces of memory interspersed through the lost time. Thus it is critically important to understand the difference between “passing out” and “blacking out.” The victim will not be capable of telling the difference and may report “passing out,” or “going back to sleep” yet witnesses, surveillance tapes, cell phone pictures or videos may show the victim apparently functioning during that time period.
Details such as a slow or accelerated breathing rate, snoring, blank stare, dilated or pinpointed pupils, slurred speech, unstable or otherwise impaired physical condition, lack of action by the victim (suspect doing all the movement and/or positioning the victim) are clues in analyzing videos. The victim may even appear to knowingly participate in the events. Clearly this “participation” will be challenged as proof the victim is lying or that the sexual contact was consensual. Attention to the details often found in videos and witness statements is the key.
REMEMBER: That’s how drugs work. That’s why they do it.
The difference between passing out (unconscious) versus blacking out (time lost, time unaccounted for) is important when writing reports and determining charges as state laws vary on the required elements for sexual assault of an unconscious or impaired person. Whenever possible, agency forms that include documentation for “how long was the victim unconscious” should be changed to reflect “how much time was unaccounted for” or “time lost.”
It is important to remember victims cannot consent if they are substantially impaired and the suspect knew or reasonably should have known at the time of the sexual contact. How this translates into charging issues will depend on your state’s laws, but this is a basic underpinning of an investigation.
An early question to consider is whether or not there is a reason to question the victim’s capacity to consent. If so, was it from an accident (car crash, a fall or some other physical injury), a severe cognitive disability, the victim’s age, or a possible drugging? What would establish that the victim was unable to give or withhold consent? What would establish that the suspect knew or should have known about the victim’s impairment? Collecting detailed information and evidence as quickly as possible is crucial. Collecting the appropriate toxicology samples and identifying the appropriate laboratory to test the samples is equally crucial.
The Range Of Drugs Involved
The media has publicized “roofies” (flunitrazepam, trade name Rohypnol), ketamine and GHB as the three “date rape drugs.” In reality more than 50 drugs have been identified in DFSA cases. In fact, the term “date rape drug” is inaccurate and should be avoided because the majority of sexual assaults, including DFSA, do not involve “dates” or any expectation of intimacy. The term “predatory drug” is much more relevant.
The drugs used are not unique to sexual assault. Many of them are also drugs of non-medical (recreational) abuse and many have legitimate medical use in the US or abroad.
There are a number of other terms that are commonly used with different meanings. The saying “slipped a Mickey” or “Mickey Finn” originally referred to the drug chloral hydrate and then later became a generic term for being surreptitiously dosed with any drug. The term “roofied” first referred to being drugged with flunitrazepam (Rohypnol). However, more recently, the term is often used for surreptitious drugging, with no specific reference to the actual drug involved. “Good Night, Cinderella” or “Boa Noite, Cinderella” is a term from Brazil used in reference to GHB or to predatory drugs in general (Thomson, 2000, Hines, 2009).
Many of these drugs are also used in other crimes such as credit card fraud (i.e., waitress or bartender), blackmail (i.e. public figure, married person), robbery, “just for laughs” pranks, human trafficking (i.e. to facilitate a kidnapping or establish addiction and control) or even to facilitate murder.
The Drugs of Sexual Assault
This section gives you an idea of the wide array of drugs that can and have been utilized in DFSA. It is not exhaustive of all possibilities and doesn’t cover all effects possible from the drugs or the combination with alcohol. While most of the drugs have the overlapping qualities to some extent of resulting in amnesia or mental or physical impairment to making informed consent, the resulting behavior can vary significantly.
Alcohol--Still Number One
Flunitrazepam (roofies or Rohypnol)
Other benzodiazepines
GHB or its “analogs” GBL and BD
Other sedative-hypnotics
Barbiturates
Muscle relaxants
Antihistamines and other over-the-counter products
Animal tranquilizers
Motion sickness/nausea prevention pills
Narcotic analgesic
MDMA and hallucinogens, including marijuana
Any medication, over-the-counter (OTC) products and even vitamins and supplements the victim may have taken need to be considered in order to rule out accidental intoxication from interactions between medications or other substances ingested and alcohol. Even so-called energy drinks can affect individuals. Some of them contain alcohol, such as the original Four Loko, as well as stimulant substances. While the energy drinks are primarily thought of as stimulants, they can overload individuals to the point of a heart attack or other serious episodes, and especially if mixed with other drugs and alcohol can cause individuals to pass out. A 23.5 ounce can of Four Loko was found to contain alcohol equivalent to four cans of beer and caffeine equivalent to two tall cups of coffee (DeGazette, 2014).
Alcohol is present in a high percentage of sexual assaults simply because it is the “background” drug of the dating and social world where sexual assault is more likely to occur. But because of its sedative properties, it can also be a weapon of DFSA. The SAMHSA 2011 study found that alcohol was a factor in 60 percent of the intentional poisonings reviewed. The simplest DFSA would be to “double shot” a person’s drinks. So, while three drinks may seem reasonable to the victim during a given time period, in fact, the equivalent of six may have been consumed and impairment may slip up on the unsuspecting person. Absinthe and Everclear are even more intense than regular alcoholic beverages, providing unusual ways to increase alcohol levels.
Absinthe, also called “the green fairy,” is an anise-flavored, highly alcoholic beverage (90-148 proof), no longer banned in the US and many other countries. It is derived from botanicals, including wormwood (thujone), and traditionally is green in color but may also be colorless. It is not generally bottled with added sugar, thus is considered a “spirit” rather than a “liqueur.” It would likely have to be concealed in an exotic drink, unfamiliar to the victim.
On the other hand, Everclear is unflavored, though some note it provides a burning sensation if you drink it straight, and it reportedly produces a lot of vomiting episodes. It is colorless. It is grain alcohol produced in 151 and 190 proof. Because of the high proof, it is banned in some areas but like anything else, readily available anyway on the Internet.
The effects of alcohol are dependent on factors such as the amount consumed (the number of drinks and type of drink and size of the container), weight and gender of the consumer, amount and type of food in the stomach at the time, the amount of alcohol consumed on a regular basis, and personal health conditions. The actual content of drinks can vary greatly but the effects of specific amounts of alcohol are well documented and standardized. Thus, for purposes of impaired driving, a cut off of .08 is the standard, though it possible to be too impaired to drive at a lower level for some individuals. It is much more difficult, for example, with marijuana to set a specific level in the body that would constitute assumed impairment.
In most basic terms, people burn off roughly one “standard drink” per hour.
It is important to document what type of drinks the victim ordered and knowingly consumed and any details about later drinks (observed by witnesses, for example). It helps in establishing actual quantities and determining impairment potential at least up to a point. At a private residence or other unregulated settings there would be no standards for how drinks are made. But if this occurred at a bar or restaurant, it is important to determine the facility’s set recipes for these drinks.
“Benzodiazepine” Family Members
The class of drugs called benzodiazepines (often referred to as “Benzos”) is made up of commonly prescribed tranquilizers, anti-anxiety, anti-seizure and muscle relaxing drugs that are basically central nervous system (CNS) depressants. There are at least 37 drugs in this category, though some are not approved for medical use in the US and thus lesser known in this country.
Benzos have five primary effects:
--Hypnotic (tending to cause sleep)
--Anxiolytic (tending to reduce anxiety and produce relaxation; use as a pre-medication for surgical procedures)
--Anti-seizure (tending to reduce likelihood of seizures or convulsions; used in alcohol withdrawal)
--Muscle relaxant (tending to reduce muscle tension and related pain)
--Amnestic (tending to disrupt long and/or short term memory)
Each benzo causes these primary effects to varying degrees. Thus diazepam (Valium) is a relatively strong hypnotic with a short onset of action causing rapid induction of sleep, but others such as alprazolam, lorazepam and clonazepam are weaker as a hypnotics but more powerful as an anxiolytic, reducing anxiety. This difference determines what conditions they are most commonly prescribed to treat. Diazepam does, however, have a long half-life (half of the active drug leaves the body over a specific time) and duration of action which includes active metabolites that linger and exert their actions for a prolonged period (Dubois et al., 2008)
GHB And Its Analogs
GHB and its two primary analogs, gamma-butyrolactone (GBL) and 1,4 butanediol (BD or BDO), of all the drugs used to commit the crime of drug-facilitated sexual assault, are the most difficult chemicals to deal with in terms of analysis and interpretation because of the speed with which they leave the body.
GHB is usually in sodium salt form, either white or off-white, that is readily soluble in water and is most commonly bought and consumed as a liquid. GBL is an industrial solvent that is a heavy-duty degreaser or paint stripper. It is easily converted to GHB by merely adding sodium hydroxide (drain cleaner) or baking soda. The pH level should be adjusted so that it is no longer drain cleaner, but in the case of “bad” GHB a victim may report a burning sensation and in extreme cases may suffer burns of the esophagus, usually more likely after vomiting. But consuming GBL directly, without the conversion, is commonly done since the human body actually makes the conversion to GHB quite rapidly, within approximately ten minutes. BD, on the other hand, is not as easily turned into GHB by a non-chemist and is usually consumed directly. BD is also converted to GHB by the human body, perhaps a few minutes slower than the in vitro conversion of GBL to GHB. In a living person, usually only GHB will be found in blood or urine, even if they consumed GBL or BD. But in a death case, unconverted GBL or BD might be found in stomach contents if death occurred rapidly.
GHB is processed rapidly through the human body. It is basically gone from blood within about four hours and urine in about 12 hours. Some sources will cite six to eight hours for GHB to clear from blood but four hours is most likely. Urine is the preferred sample, taken as quickly as possible. Another challenging aspect of identifying GHB is that everyone has a small amount of naturally occurring GHB in their body, called “endogenous” GHB. Thus most labs now use a cutoff in urine of 10 mg/L. Naturally occurring urine levels of GHB usually range between 0 and 8 mg/L, but these levels can fluctuate within that range for an individual person. There is also an extremely rare genetic condition, 4-hydroxybutyric aciduria, in which an individual naturally produces dramatically excessive levels of GHB. This usually leads to neurological abnormalities such as mild or moderate mental retardation, ataxia, convulsion and speech disorders. They may be diagnosed as autistic at age two or three and then develop the full range of symptoms in late teen years.
Interpreting GHB levels in a death case can be complex. After death the level of GHB in the blood can increase as an artifact of death over time (if the body isn’t found relatively quickly). There is no magic number for a cut off. The most effective way to determine if a GHB level in blood is from ingestion of GHB is to compare it to GHB levels urine and/or vitreous (eye fluid). Those are better samples as GHB levels don’t change significantly in those fluids if properly stored. Most coroners retain blood samples, but may or may not keep urine or vitreous, especially in smaller agencies. In the case of a decomposed body, vitreous and urine samples may be gone, and the only GHB level may come from heart blood or liver tissue. Great care should be taken in interpreting a blood level standing alone in such a case. History of the person as to possible use or exposure to GHB is critical at that point.
GHB causes behavioral and neurologic changes. The dosing range is small as GHB has a steep dosage curve, meaning a tiny increase in dose can have a dramatic difference in effects. Low doses can cause a pleasant state of relaxation and tranquility, sensuality, mild euphoria, a tendency to verbalize and some drowsiness. Higher doses can cause adverse effects such as confusion, dizziness, drowsiness, nausea, vomiting, incontinence (fecal and urinary), agitation, loss of peripheral vision, hallucinations, short-term amnesia, to uncontrollable shaking or seizures, combativeness, bradycardia, respiratory depression, apnea and coma or death.
A person can go from an alert state to unconscious (or dead) within ten to 15 minutes. The effects last only three to four hours and the person may awaken feeling unusually refreshed, rather than a hangover sensation, due to the rapid clearance of the drug. The average person (witness) may assume that the person is just drunk on alcohol, an assumption that may not garner sympathy from a jury.
The two most common myths about GHB are 1) you can’t die from GHB alone and 2) just let a person overdosing on GHB “sleep it off.” People can and have died from ingestion of GHB alone, but the risk does increase with alcohol or other drugs, especially depressants. In a study of 226 documented GHB-related deaths a full one third were from GHB alone. And, while most people do sleep off a GHB overdose, many others have died from lack of medical care. People who believe the myth have stood by while their “friend” is unconscious and barely breathing or even experiences adverse effects such as profuse vomiting, turning blue, seizures, etc. Still they fail to seek medical care until it is too late, and cardiac or respiratory arrest has occurred. People brought to the ER in a GHB overdose while still breathing have a good possibility of survival. (Zvosec et al, 2007).
GHB is in both Schedule I (no medical use) and Schedule III (general prescriptions) due to a political compromise in the US Congress. Prescribed GHB (Xyrem is the only trade name in the US at this time) is Schedule III, but if a patient abuses the drug, sells or gives it away or uses it in a crime, then it is to be treated as a Schedule I drug. Theoretically, it is closely monitored. GHB was approved for the combination of narcolepsy and cataplexy, and later for narcolepsy in general. It is also being used for fibromyalgia “off label” (unapproved by the Food and Drug Administration but doctors are allowed to go beyond approval). The FDA denied the application for Xyrem to be used for fibromyalgia so it is being prescribed off label for that condition. Because it is off label, patients pay a high price as insurance companies will not pay for unapproved drugs. This has led to chatter on narcolepsy and fibromyalgia message boards about how to make it and offers to buy or sell Xyrem.
Xyrem is administered only at bedtime with elaborate instructions for two doses during the night. Patients are told to be in bed before taking the first dose (due to episodes of falling, sleep walking, sleep cooking, etc). The alarm is set for four hours and then the second dose is taken to achieve a full night’s sleep. Xyrem patients, even taking it as directed at the therapeutic doses, have experienced episodes similar to what drugging victims report, including vomiting, amnesia, incontinence (both urinary and fecal), bizarre behavior, talking nonsensically. There have been a few deaths on Xyrem, taken as directed, and sexual assaults of patients asleep on Xyrem (such as a college student in a dormitory) according to reports from FDA investigators at the evaluation hearings on GHB. A student in a dorm, for example, would need to tell roommates about the drug because in an emergency she might not be arousable and would need to be rescued. This means others would know of her vulnerable condition, putting her at risk of sexual assault.
GHB is notoriously a sexual stimulant for many people. Some patients on Xyrem have reported increased sex drive at bed time as well. DFSA victims may exhibit this increased sex drive as well, with no recall of it and no intent to participate.
GHB and its analogs have no distinctive odor. The odor may vary from a mild, not unpleasant odor to a strong repulsive odor, depending on how it was made and what other ingredients are included. Pure GHB may be nearly tasteless, but commonly available GHB typically has a salty or soapy taste to some degree, from mild to strong. It is, however, easily masked by fruity or unusual drink combinations, etc. “Co-administration of ethanol and other drugs of abuse may confound accurate assessment of symptoms produced by GHB administration alone.
It is important to note that there are other “active analogs” as well as several “inactive analogs” of GHB. The active analogs, other than GBL and BD, do not convert to GHB but do have similar effects. This means that they will not show up in GHB testing. Fortunately, they have not become popular. The “inactive” analogs are chemically related but do not produce similar physiological effects. They are of concern only in that uneducated drug seekers would not necessarily know the difference and might try them anyway since the names are similar. The chemicals 2,3 butanediol and 1,3 butanediol, for example, are considered inactive GHB analogs. While these inactive analogs are not expected to produce the same intoxicating effects on the brain, they are toxic and potentially fatal. Use of 2,3 butanediol was reported in a Minnesota case involving the assault of a young boy. It would be expected to produce toxic effects that might result in incapacitation (sick versus intoxicated) as it did in that case.
Ketamine - Stealth or Voluntary?
Ketamine is an anesthetic drug traditionally used in veterinary practices for surgery, and in human medicine as a battlefield anesthetic, in burn wards and in pediatrics. Unlike traditional anesthetic drugs, ketamine does not necessarily drop vital signs (heart rate, blood pressure), but has an intense pain block mechanism. This makes it extremely valuable in a battlefield environment where it is a life or death issue and in burn wards where blocking pain while debriding wounds is crucial. While used in veterinary clinics for surgery, where resuscitation equipment is at hand, some veterinarians do not use it in the field (farm animal calls, for example) because of the risk that the patient simply stops breathing. Ketamine notoriously causes flashbacks but has been used in pediatrics, children under five.
In 2001 in Tempe, Arizona, Antonio Julio Sanchez, a college student at the time, and Mazen Diamond, former ice cream shop owner, were accused of drugging women in bars, taking them to their apartment and sexually assaulting them. Their drug of choice was ketamine. They even videotaped their assaults, including assaults of other unidentified victims. One victim regained awareness during the assault and screamed, alerting a neighbor. They pled guilty in 2002 but disappeared before sentencing. The Tempe Fugitive Team, including a federal Marshall, began looking for them in 2011 in a cold case review. Tracking through family and friends and aliases, Sanchez was arrested in Miami and Diamond in Atlanta in May 2013. Both were living with girlfriends and children (Coe, 2013).
Ketamine may not be encountered frequently being used in DFSA as a weapon deployed by the suspect compared to other drugs. But, it may also be encountered in voluntary intoxication cases where the victim has taken ketamine voluntarily, such as at a rave or club. This may leave the victim vulnerable to abuse while in a catatonic state that may last 30 minutes or more. Sexual predators have been known to frequent raves and other locations where use of drugs such as ketamine, GHB and MDMA are common, resulting in a ready pool of potential victims under the influence voluntarily. The impaired speech, attention, thought processes and memory make people on ketamine ideal candidates for DFSA.
PCP is also a dissociative anesthetic, like ketamine and GHB. It may not be an excellent choice for a DFSA drug as the victim could have violent episodes and present a hazard to both self and suspect. But clearly PCP ingestion would limit one’s ability to give or withhold consent.
Sleeping pills all induce sleep, but can also produce a variety of other side effects, especially when mixed with alcohol or other drugs and depending on dosage.
The hypnotic drug zolpidem has been widely prescribed for insomnia. It is detectable in the human body a relatively short time, depending on the instrumentation used. It can cause sleepwalking with bizarre behavior, sleep driving, impaired balance and amnesia, even when taken as directed. Abusers drink coffee with Ambien to stay awake and experience tripping effects and strange visuals.
Chloral hydrate, the original “Mickey Finn” drug, is a hypnotic that is prescribed for insomnia and is used as a relaxing agent before surgery. It may cause nausea, slow/shallow breathing, mood changes, sleepwalking, impaired balance, dizziness and residual sedation (“hangover effect”). There is a screening test specific to chloral hydrate but would not be included in common testing panels.
Barbiturates are CNS depressants that may be used as sedative hypnotics or anticonvulsants and can produce levels of mood effects from sedation to hypnosis to deep coma and anesthesia. Thus they can and have been used for sexual assault. They are not as readily available as benzodiazepine drugs. A relatively small dose error can cause overdose and risk of coma or death.
Fortunately, these drugs have fairly long detection times. Barbiturates that are short and intermediate acting are detectable in urine 24-72 hours while long acting barbiturates may be detected up to seven days. Common symptoms of barbiturate intoxication and overdose include: Altered level of consciousness, difficulty in thinking, drowsiness or coma, faulty judgment, incoordination, shallow breathing, slowness of speech, sluggishness, slurred speech, and staggering. The amount of time a victim would be impaired varies greatly.
Anti-Histamines And OTC Products
There are DFSA drugs that are available as over-the-counter (OTC) products. Dextromethorphan and diphenhydramine have been identified in DFSA cases and will likely require a specific request for testing, depending on the lab service your agency uses.
Dextromethorphan (Robitussin, DXM, Coricidin Cough & Cold, aka “skittling,” “robo-tripping”) has been widely abused recreationally throughout the US. As a cough suppressant, doses range from 10 to 30 mg and is not dangerous at that level. But abusers have been known to take multiple pills to achieve doses such as 150 mg (similar to marijuana or alcohol intoxication), 350 mg (LSD type hallucinations) or 500 mg or more (equal to ketamine dissociation and possible coma or death). Given to someone covertly it could cause impairment. An abuser might be taken advantage of while in a voluntarily impaired state.
Diphenhydramine (Benadryl, Sominex) is an anti-histamine used for allergies and motion sickness. It is also used to help with sleep as it typically causes drowsiness. It has been used in DFSA cases.
Kava and melatonin are supplements that in significant quantities or with other drugs can be impairing. They are available over the counter and are mentioned to show how easily impairing substances can be found by creative suspects. Kava is a plant from the South Pacific islands that has been sold for stress and anxiety relief, restlessness, insomnia, and is used by island native cultures routinely. However, growing concerns about its safety (liver damage from even limited use, for example) has resulted in it being banned in some countries. Kava can cause drowsiness and impaired coordination. Melatonin is a hormone that can also be bought as a supplement. It is used to regulate sleep and thus causes drowsiness. For some people it can also cause very vivid dreams or prolonged morning grogginess.
Scopolamine (Transderm-Scop, Scopace) is used for preventing nausea associated with motion sickness (transdermal patch), postoperative nausea, some muscle spasm problems and other intestinal problems. It can cause drowsiness, blurred vision, dizziness, confusion, trouble speaking, mood swings, muscle weakness, warm skin, unconsciousness. It has been used to obtain confessions or secret information, including in robberies of men assumed to be rich to obtain access to their alarm codes, bank accounts, and other valuables. It has been a particular problem in Columbia. Drug “mules” (humans transporting drugs for dealers) who swallow balloons or condoms of drugs may be given high doses of scopolamine to keep them from vomiting during transport. They often have little recall of their journey. Thus scopolamine has been called the “Zombie Drug,” (a term also now used in reference to the Russian-based drug Krokodil, allegedly a flesh-eating drug, desomorphine).
According to a Department of State 2012 statement regarding diplomatic security issues in Columbia, “One common and particularly dangerous method that criminals use in order to rob a victim is through the use of drugs. The most common has been scopolamine. Unofficial estimates put the number of annual scopolamine incidents in Colombia at approximately 50,000. Scopolamine can render a victim unconscious for 24 hours or more. In large doses, it can cause respiratory failure and death. It is most often administered in liquid or powder form in foods and beverages. The majority of these incidents occur in night clubs and bars, and usually men, perceived to be wealthy, are targeted by young, attractive women.” (OSAC 2012)
Scopolamine is also referred to as burundanga and is one of the chemicals found in Jimson Weed (Datura). Since the growth of the Internet, dozens of variations of the story have been circulated via email warning of the “new” drug burundanga which would be given to an innocent person impregnated in a business card; the person would then become impaired from touching the business card and would be robbed or assaulted. While the drug exists, it would not work in the way described but this email periodically makes the rounds.
Opiate-Type Drugs
All narcotic analgesics may work for DFSA, especially when mixed with alcohol or other drugs. A DFSA suspect with access to opiates may simply use them rather than seek more notable DFSA drugs. Narcotic analgesics are drugs that relieve pain, can cause numbness and induce a state of unconsciousness. They can cause drowsiness, lightheadedness, constipation, dry mouth, weakness, cold clammy skin. The effects can be intensive by ingestion of alcohol or other drugs.
MDMA And Other Hallucinogens
Though we typically think of depressant, sleep-causing drugs as the key to drug-facilitated sexual assault, hallucinogens also impair a person’s ability to give or withhold consent. Hallucinogens may isolate the person from understanding and controlling their environment and could even make them dangerous to themselves or to the suspect.
MDMA (chemical name 3,4-methylenedioxy-methamphetamine) is particularly troubling as a DFSA drug in terms of the consent issue and is currently surfacing regularly in reported cases. Voluntary use of MDMA by the victim also complicates analysis of the case, giving the suspect a chance to claim he didn’t know the victim was under the influence of anything. Since it is a stimulant with hallucinogenic properties, as opposed to a depressant with sedative properties, the impairment levels are different and more subtle.
Unlike GHB, which can lower body temperature, MDMA and similar drugs cause an increase in body temperature. Thus a victim may comment on being hot or witnesses may notice signs of temperature increase such as removing clothing items or sweating.
Bear in mind that the term Ecstasy originally referred specifically to the drug MDMA. But, often the pills sold as Ecstasy contained a variety of drugs (a stimulant mixed with a hallucinogen to try to mimic MDMA, for example), variations of MDMA (related drugs, analogs) or were totally fake (little or no actual drug effect). It became an “umbrella” term. Ravers are easy targets for dealers; if it looks like an MDMA pill, if someone says it is MDMA, if it causes any effects, then it’s acceptable. This led to the “Molly” era. Molly is touted as “pure MDMA” to get away from that unknown quantity called Ecstasy. But in the world of drug dealers, honesty isn’t guaranteed. So the mixture of drugs in what someone takes as Molly is still an issue.
MDMA is an entactogen, meaning it provides emotional and social effects. It belongs to the phenethylamine class of psychoactive drugs. The desired effects are warm, touchy-feeling sensations, emotional closeness and openness. Their pupils are dilated, and yet they do not feel pain from bright lights shining in their eyes. They are captivated by colors, light, textures. Thus at raves and in clubs they enjoy light shows with intense strobe lights and the pounding beat of music. MDMA also causes teeth grinding and muscle spasms, yet they won’t recall them as painful. There have been reports of users accidentally burning themselves by dropping a cigarette and then saying it felt good, so they did it again on purpose. Users may be seen caressing the rough pavement and proclaiming how good it feels. If alcohol or other drugs are involved, the effects may also include loss of memory, etc. Polydrug involvement is common. And some people have adverse reactions to MDMA, including paranoia, anxiety, nausea, overheating, etc.
Clearly in such an abnormal state they may not be capable of sound judgment or recognition of harm. Teens interviewed in a Dateline show about addiction talked about their abuse of MDMA and other drugs. One teen described how a man offered her a ride home and then wanted sex in payment. She said she didn’t want to have sex but, because of her worn-down condition from all the drugs she had done that night, she didn’t resist and felt she “owed” him anyway. She, like so many others who fall into harm’s way in that manner, did not report it as a sexual assault but accepted it as part of the lifestyle. Because of MDMA’s release of large amounts of serotonin and energizing effects, users may feel fatigued and depressed for a few days after use.
MDMA was ground up and put in salsa in one case. This was done to dose three teens who were sharing salsa and chips. The brother of one of the victims prepared the salsa and then invited his friends to come over and sexual assault them in their disinhibited state.
In Monterey Park, California, in an even more unusual manner, a Vietnamese waiter enticed Asian females to his house, not as a date, but with promises that he was also a hairdresser. He would offer to cut and color their hair to save them money. Once at his house he would make exotic drinks and include a piece of “candy” in the drink and encourage them to consume the entire drink and especially the “candy.” The first victim tasted the fancy, multi-layered drink. It seemed so sweet that she didn’t think it contained significant alcohol. She drank it all and ate the so-called candy. She was then sexually assaulted by the suspect and was confused by her own body reaction. She had no sexual interest in the suspect and said she knew she did not want to have sex with him. But, her body responded, because of the effects of the drug, and part of her brain found the “touch” pleasurable. She did come forward to make a report but was hesitant to agree to prosecute because of this confusion in sensations. When the second victim came forward, the first victim did agree to prosecute. The effects of DFSA drugs and specifically MDMA were explained to the jury.
The second victim had a different experience. Lured in the same manner to his house, she stated she did not drink alcohol and refused his exotic drink. He went so far as to take a mouthful of the drink himself and then tried to kiss her to get the liquid into her mouth. She resisted and it became a forcible rape, rather than a DFSA. He was convicted on all counts in 2014 and sentenced to 30 years to life.
A study funded in 2000 by the National Institute of Drug Abuse (NIDA) on ecstasy and associate sexual risk among urban youth found that MDMA was among the top drugs used voluntarily for “better sex.” They found that 48 percent of MDMA users in the study reported using it to improve sex and that this involved an increase in risky behavior such as sex in more exposed places, riskier forms of penetration (such as anal sex).
With MDMA and GHB, gender issues may become blurred and DFSA victims may end up engaging (with little or no recall) in same sex or opposite sex activities that are abnormal for them. Comments from the NIDA study highlight the blurred line effect, of both unplanned sex and gender issues.
Similar problems of consent and reality control would apply to a variety of other hallucinogenic drugs, which will not be exhaustively listed here. If a victim’s toxicology tests returns with other hallucinogenic or unusual drugs, work with a drug expert (trained officer, pharmacologist or toxicologist, etc.) to see if that drug would explain what the victim experienced and how it fits into the entire circumstance.
Marijuana Impairment
Marijuana can also cause impairment that can contribute to DFSA, especially when mixed with alcohol or other drugs. Intake may be voluntary or by trick or device (i.e., consuming pot edibles without knowing the item contained marijuana).
Studies have shown that being under the influence of marijuana nearly doubles the risk of a driver being involved in a motor vehicle crash resulting in serious injury or death. “Most experts agree that marijuana slows decision making, decreases peripheral vision, and impedes multitasking—all important factors in safe driving. Marijuana has a wide spectrum of behavioral effects, making it as difficult to classify as a stimulant, sedative, tranquilizer, or hallucinogen. At recreational doses, marijuana effects include relaxation, euphoria, diminished inhibitions, a sense of well-being, disorientation, altered perceptions of time and space, lack of concentration, impaired memory, drowsiness, sedation, and mood changes. Stronger doses can intensify those reactions.
The Bottom Line
We do not live in a TV CSI World. The real world is not perfect and there are evil people out there. Furthermore, not all police officers, detectives and prosecutors are drug experts. So, it is wise to do the best you can to protect yourself. Yes, that means the traditional things of watching your drink, maintaining control of your circumstances as best you can, being with people you trust, etc. But ponder the possibilities and realize that IF it does happen to you, respond immediately. Get to a hospital or police station to report the incident. Request a URINE sample be taken immediately (not hours later) and specify that it be held for FORENSIC purposes. Advocate for yourself and seek knowledgeable support.
To police officers, detectives, nurses, doctors, prosecutors and judges, I recommend that you work hard to make drugging crimes, especially DFSA, much more difficult to get away with. Knowledge makes the difference.