A study of blood and urine alcohol concentrations in cases of alleged drug-facilitated sexual assault in the United Kingdom over a 3-year period

This paper details the alcohol concentrations found in a selection of 1,014 cases of claimed drug-facilitated sexual assault analysed at The Forensic Science Service, London Laboratory between January 2000 and December 2002. Where appropriate, either a whole blood sample and/or a urine sample was analysed for alcohol, common drugs of abuse and potentially stupefying drugs. The samples were collected from a complainant within 12 h of an alleged incident in 391 of the 1014 cases analysed. Of these, the majority (81%) contained alcohol. The presence of alcohol itself was not surprising as most of the alleged incidents were associated with social situations such as at a public house, bar, night-club or party, where it is expected that alcohol would have been consumed. However, 233 (60%) of the 391 cases had a high back-calculated figure, where high is defined as greater than 150 milligrams per 100 millilitres (150 mg%). Some of these samples were also found to contain illicit drugs. This is the first paper to our knowledge which discusses in detail the significance of the alcohol concentrations found in cases of this type.     

Analysis of clinical forensic examination reports on sexual assault

Medical-forensic examination of sexual assault victims and alleged offenders is a common task of many forensic institutes. In the current study, the results from samples taken at the Institute of Legal Medicine, Hanover Medical School, during a period from 2005 to 2007 were retrospectively evaluated. In total, 292 victims (283 females and nine males) and 88 suspects were examined. At the time of the assault, 41.8% of the victims and 43.2% of the alleged perpetrators were under the influence of alcohol. Injuries were found in 84.9% of the victims and 39.8% of the suspects. Thirty victims (10.3%) reported having been choked or strangled. Cytology was performed in 218 victims. In 81 cases (38.0%), sperm could be detected in vaginal swabs up to 3 days post-assault. In seven (18.9%) out of 37 anal samples, evidence of sperm could be found 24 h post-assault. None of 22 oral samples was positive for sperm. Out of 301 sexual assault cases, 171 could be proved by means of medical-forensic examination. In summary, our evaluation shows that an early medical-forensic examination of both victim and suspect can secure numerous medical findings. Furthermore, persons intoxicated by alcohol, handicapped persons and persons with psychiatric disorders are more vulnerable to become a sexual assault victim.     

Sexual assault statistics from the Republic of Ireland for 2004-2005

The Republic of Ireland, like all other countries, has strict laws governing the crimes of rape and sexual assault. Victims of such assaults are treated in sexual assault treatment units where evidential material is gathered and forwarded to the forensic science laboratory (FSL).This paper represents the first published study from the Republic of Ireland of the time, day and month most frequently encountered in sexual assault cases presented to the FSL. In addition, the study examines the location and nature of the assault, together with such factors as the age of the victim, relationship to the suspect and degree to which the victim has a clear recollection of the events. The study covers information from 890 cases submitted to the FSL in the time period January 2004 to December 2005. The most common age category of victim was 16-30, the most likely time of occurrence was Saturday night/Sunday morning during the summer months of June, July or August. The assailant will most likely be known to the victim even if only recently met. Loss of memory mainly associated with the consumption of alcohol was a significant factor in many of the cases. The figures were compared to international studies with no significant differences between our findings and other studies. We also compared our results to a similar study in 1995-1996 and found little difference except for the number of the victims who were non-Irish nationals: 3% in the 1995-1996 study but by 2004-2005 that figure had risen to 11%.     

Forensic urinalysis of drug use in cases of alleged sexual assault

The results of 3303 analyses of urine samples, collected in an independent testing programme from individuals who claimed to have been sexually assaulted and believed that drugs were involved, were examined in detail. Of the samples provided, 2026 (61.3%) proved positive for one or more substances. Alcohol, either alone or in combination with other drugs, was by far the commonest substance found, being present in 1358 samples (67.0% of positives). Cannabis was the second most prevalent drug, present in 613 samples, (30.3% of positives). Detailed examination of the testing results does not support the contention that any single drug, apart from alcohol, can be particularly identified as a 'date rape' drug. Rather, the alleged sexual assaults may often take place against a background of licit or recreational alcohol or drug use, where alcohol and other drugs are frequently taken together. The extensive forensic database examined here does not support the concept of a commonly occurring 'date rape' scenario, in which the victim's drink is covertly 'spiked' with a tablet, capsule or powder containing a sedative-hypnotic. This research highlights the need for the early collection of forensic samples in cases of alleged sexual assault. Law enforcement agencies and health professionals should establish guidelines and procedures to ensure that appropriate forensic samples (blood and urine) are collected in a timely manner following allegations of possible drug mediated sexual assault.     

Drug-facilitated sexual assault in Ontario,Canada: Toxicological and DNA findings

The purpose of this study was to determine which persons reporting sexual assault to a hospital-based treatment centre may have been covertly drugged and to provide information about whether a sexual assault may have occurred.Each consecutive adolescent and adult presenting at a sexual assault treatment centre was screened for drug-facilitated sexual assault (DFSA). Urine was collected and tested for central nervous system active drugs. Oral, vaginal, and/or rectal swabs were tested for male DNA. Unexpected drugs were defined as those not reported as having been voluntarily consumed within the previous 72 h. Positive swabs for unexpected DNA were determined by whether the person reported having had consensual intercourse in the previous week.A total of 184 of 882 eligible participants met suspected DFSA criteria. Mean age was 25.8 years (SD = 8.5), 96.2% were female and 64.7% White. Urine samples were positive for drugs in 44.9% of cases, alcohol in 12.9%, and both drugs and alcohol in 18.0%. The drugs found on toxicological screening were unexpected in 87 of the 135 (64.4%) cases with a positive drug finding and included cannabinoids (40.2%), cocaine (32.2%), amphetamines (13.8%), MDMA (9.2%), ketamine (2.3%), and GHB (1.1%). Male DNA was unexpected in 30 (46.9%) of 64 cases where it was found.Among those persons presenting to a sexual assault treatment centre with a suspicion of DFSA, the presence of unexpected drugs and male DNA was common, lending support for their contention that they had been intentionally drugged and sexually assaulted. Most unexpected drugs found were not those typically described as ‘date rape drugs’.     

The optimal timing of forensic evidence collection following paediatric sexual assault

BackgroundForensic evidence collection following sexual assault has an important medico-legal role. Despite the advent of DNA profiling, research into the optimisation of forensic biological specimen collection is limited. This has led to inconsistent and variable guidelines for forensic evidence collection. The guidelines in this jurisdiction (Victoria, Australia) recommends that specimens be collected up to 7 days following sexual assault in some circumstances. The aims of this study were to determine the optimal times post sexual assault for the collection of forensic biological evidence in paediatric cases (aged 0–17 years).MethodsA retrospective review of paediatric sexual assault cases seen by the Victorian Forensic Paediatric Medical Service (VFPMS) between 1 January 2009, and 1 May 2016, was undertaken. Specimen site and collection times post assault were collated from VFPMS medico-legal reports and compared with the forensic evidence analysis results reported by the Victoria Police, Forensic Services Department. In addition, a survey of recommended forensic specimen collection times post assault in the different Australian jurisdictions was undertaken for comparison.ResultsWithin the 6 year 5 month period studied there were 122 cases consisting of 562 different forensic specimens that were collected and analysed. 62 (51%) of cases produced one or more positive forensic result and, of the 562 specimens collected, 153 (27%) were positive for one or more of foreign DNA, spermatozoa, semen or saliva. Foreign DNA was more likely to be found if forensic specimens were collected during the first 24 h after the assault as compared with those collected at 25–48 h, (p < 0.005). Similarly, spermatozoa were identified more frequently on swabs collected at 0–24 h compared to 25–48 h (p < 0.002). Foreign DNA was not identified beyond 48 h post assault and spermatozoa were not identified beyond 36 h. Saliva and semen were not identified beyond 24 h. The youngest victims with positive forensic evidence were 2–3 years old. The survey of current forensic specimen collection practice in Australia shows that the guidelines for timing of forensic evidence collection in child sexual assault cases is highly variable between jurisdictions.ConclusionsOur results highlight the importance of collecting forensic specimens as a matter of urgency, regardless of age, within the first 48 h post assault. Although there is need for further research, the findings indicate a need for the re-evaluation of current guidelines for specimen collection in paediatric sexual assault cases.     

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

PurposeA 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.MethodsDatabases 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.ResultsThe 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.ConclusionsThis 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.     

Toxicological findings in cases of alleged drug-facilitated sexual assault in the United Kingdom over a 3-year period

This paper outlines the toxicology results from 1014 cases of claimed drug-facilitated sexual assault (DFSA) analysed at the Forensic Science Service, London Laboratory between January 2000 and December 2002. Where appropriate, either a whole blood sample and/or a urine sample was analysed for alcohol, common drugs of abuse and potentially stupefying drugs. The results were interpreted with respect to the number of drugs detected and an attempt was made to distinguish between voluntary and involuntary ingestion from information supplied. Alcohol (either alone or with an illicit and/or medicinal drug) was detected in 470 of all cases (46%). Illicit drugs were detected in 344 cases (34%), with cannabis being the most commonly detected (26% of cases), followed by cocaine (11%). In 21 cases (2%), a sedative or disinhibiting drug was detected which had not been admitted and could therefore be an instance of deliberate spiking. This included three cases in which complainants were allegedly given Ecstasy (MDMA) without their knowledge. Other drugs detected included gammahydroxybutyrate (GHB) and the benzodiazepine drugs diazepam and temazepam. Another nine cases (1%) involved the complainant being either given or forced to ingest pharmaceutical tablets or an illicit drug.     

Prevalence of mental health problems and deliberate self-harm in complainants of sexual violence

The Haven Whitechapel, a sexual assault referral centre, provides a forensic service and after care to victims of serious sexual violence across North East London. Survivors of sexual assault display psychological sequelae including elevated rates of suicide ideation/attempts. Prevalence of mental health problems of 121 forensic cases seen between June and August 2004 was established. Of female clients aged over 13 years 8% had learning difficulties, 21% gave a past history of deliberate self-harm (DSH) and 20% psychiatric history. We formally assessed levels of safety and vulnerability prior to clients leaving the Haven. When mental health problems were identified additional screening questions were asked, followed by a flow chart outlining appropriate care pathways. Such practice was carried out over 6 months (September 2004 to February 2005). Of the 240 clients, 8% reported learning difficulties, 26% DSH and 21% psychiatric history. 4% of clients required urgent follow-up and 3% immediate referral to a psychiatric liaison team. There is a high background prevalence of mental health problems and DSH in our study population. Vulnerable people are at increased risk following sexual violence. Risk needs to be recognised and addressed. These findings have implications for the expansion of the SARC network.     

Comparative study of spermatozoa detection using the genital swab versus bedside smear slide technique in sexual assault patients

BackgroundSpecimen collection from sexual assault victims is an essential part of practice in forensic medicine. Semen analysis is a forensic test used to confirm sexual contact. Two methods of specimen collection were compared in this study: the genital swab and bedside slide smear.Materials and methodsA retrospective chart review was performed in the Division of Clinical Forensic Medicine, Siriraj Hospital, Thailand. Data were collected on microscopic spermatozoa detection in the external and internal genitalia, the time interval from assault to visit, and the history of condom use and genital cleansing. McNemar's test was used for comparison between the genital swab and bedside slide smear techniques.ResultsIn total, 724 case files from 2009 to 2013 were reviewed. The genital swab technique yielded a higher detection rate than did the bedside slide smear technique in both the external genitalia (37.0% vs. 31.8%, respectively) and internal genitalia (40.8% vs. 34.1%, respectively). Collection of a genital swab only missed positive cases in 4%–6% of negative swabs. When considering both the external and internal genitalia, the genital swab still yielded a higher rate of positive results than did the slide smear (45.9% vs. 39.0%, respectively). Examination of the victim within the first 3 days produced the highest spermatozoa detection rate (46.3%).ConclusionsThe genital swab is the preferred specimen collection method for spermatozoa detection in adult sexual assault victims. However, collection of both a swab and slide specimen may be considered in some cases. Collection of specimens later than 3 days after the assault greatly decreases the rate of spermatozoa detection.     

Continuing education programme - Victorian Institute of Forensic Medicine

With the increasing requirement of the courts for forensic experts to engage in ongoing education, a continuing education programme (CEP) was developed in the field of clinical forensic medicine at the Victorian Institute of Forensic Medicine in 1996. This programme has been described and was initially established to provide a means of education for the contracted forensic medical officers who provide forensic services to the police via the Institute throughout the State of Victoria. Owing to the sparsity of the population and the considerable distances between forensic practitioners, the CEP was designed to cater for individuals who are working alone: in effect, a distance education programme. Forensic pathologists expressed interest in the programme and it was subsequently modified to include forensic pathology cases. Currently, the programme caters for both clinicians and pathologists, and takes the form of four to five cases with related questions which are circulated several times per year. The cases include a mixture of both challenging and ordinary procedural types that may present to practitioners working in either clinical forensic medicine or forensic pathology, or both. The areas covered include: * injury interpretation * procedural matters in relation to adult and child sexual and physical assault * pharmacology/toxicology interpretation of findings * medico-legal issues (e.g. confidentiality, consent, etc.) * issues relating to alcohol and drugs * traffic medicine * clinical and legal aspects of sudden natural death * suspicious deaths * suicide * interpretation of findings at autopsy * fitness for interview * fitness to plead * psychiatric issues * general clinical medical issues. The presentation of each case includes relevant and appropriate details/findings and may include photographs. A series of questions follow which are answered in either short answer or multiple-choice format. The answers are returned and are correlated by a review panel of forensic physicians and pathologists, and a commentary with the response outcomes is distributed to all those involved. This also includes pertinent references. The cases presented here and in subsequent issues are selected from this programme.     

Alcohol consumption as a risk factor for sexual assault: A retrospective analysis

The aim of this study was to establish whether there is a correlation between alcohol consumption and reported sexual assaults among young people in the UK. A retrospective analysis of all cases between 01/05/2011 and 30/04/2012 involving complainants between the ages of 12 and 25 was carried out at the Lancashire SAFE Centre. In total 286 cases were included. Case notes were audited for evidence of alcohol consumption by the complainant in the 24 h prior to their assault. Further information regarding amount of alcohol consumed and any other drugs involved was also collected. In total it was found that 70.6% of complainants had consumed alcohol before being assaulted. This percentage was noted to vary with the complainant's age, ranging from 0% (age 12) to 100% (age 24). Of those who had consumed alcohol, complainants in 76.2% of cases had drunk more than the recommended daily alcohol intake, and almost a third had also taken drugs. There was only one case of suspected covert drug administration, and one forcible drug usage; in all other cases alcohol or drugs were taken voluntarily. Stranger rape (including where the complainant had known the assailant only briefly, such as meeting them the same day) was more common in complainants who had consumed alcohol. In summary, alcohol consumption often precedes sexual assaults among young people in the UK. This study therefore recommends the more widespread use of public awareness campaigns to highlight the risk of rape associated with excessive alcohol consumption.     

Sexual assault and legal resolution: querying the medical collection of forensic evidence

Very little is known about the role of medical evidence in the legal resolution of sexual assault cases. A retrospective review of hospital and police records was conducted to determine whether medico-legal evidence was related to the police laying of charges. Data were obtained from 187 female sexual assault victims who presented to a large urban hospital-based sexual assault treatment center and the police in Ontario, Canada between January 1 and December 31, 1994. Using stepwise logistic regression medico-legal variables were tested while controlling for non-medical factors. Neither the collection of sperm, semen and/or saliva nor the documentation of clinically observed injuries was significant in predicting an arrest and charge. In contrast, non-medical variables such as the victim's age, use of alcohol, resistance and relationship to the assailant, and the corroborating evidence of a witness were related to charge-laying. We question the value of uncritically continuing to collect medical forensic evidence.     

Methanol related deaths in Edirne

In this retrospective autopsy study, a detailed analysis of methanol related deaths in Trakya region of Turkey is presented and departmental autopsy records, toxicology and histopathology results are analyzed. We found that methanol poisonings comprise 2.83% of all forensic autopsies (n:18), 88.8% of the cases were male, most of the victims were aged between 41 and 45. Blood methanol concentrations range widely from 55 to 479 mg per 100ml. Ethyl alcohol was detected in 44.4% of the cases. Most of the cases died in hospital and were poisoned through the consumption of alcoholic beverages from illicit sources and colognes. It is important for physicians to be aware of methanol poisoning symptoms and for forensic pathologists to obtain samples for toxicology during autopsies. Some preventative strategies including to routine control of the stores, to prevent the production of illegal alcoholic beverages, etc. should be developed.     

The role of drugs and alcohol in rape

Alcohol and drugs have been inextricably linked with sexual assault. Media coverage has increasingly highlighted the health risks facing intoxicated women and more recently identified the risk of rape as an additional hazard. Using a sample of rape cases reported to the police between 1999 and 2004, this paper establishes that rapes involving intoxicants (alcohol and/or drugs) are distinguishable from those which do not. Further analysis discovered that the identity of the intoxicated parties (i.e. men, women, neither or both) is important in differentiating rapes. Results report differences by location of assault, victim offender relationship, victim and offender characteristics and offence behaviours. A consistent finding from the analysis is that the victim's state of sobriety or inebriation appears more significant than that of the offender. The implications for crime prevention and directions for future research are discussed.     

The proportion of false-positives in positive Seratec® prostate-specific antigen SemiQuant test results in postmortem screening for seminal fluid

Prostate-specific antigen (PSA) tests are used in forensics to conduct rapid screening for semen in vaginal swab samples from alleged victims of sexual abuse. Although PSA membrane tests have been applied to autopsy specimens, no study has evaluated predictors of false-positive test results in relation to factors such as age, cause of death, postmortem interval, drugs, and alcohol. This study describes the results obtained with the Seratec® PSA SemiQuant Kit test in 283 deceased women, with or without a history of sexual assault. Overall, 18.4% (52/283) of the vaginal swab samples tested positive for PSA. However, 63.5% (33/52) of the PSA-positive vaginal swab samples had no sperm detected. The proportion of false-positives in positive PSA results was 94.4% in those aged over 60 years. Multivariate logistic regression for PSA-positive samples showed that the proportion of false-positives in positive PSA results increased with the age of the deceased. However, the cause of death, postmortem interval, and presence of drugs or alcohol in the blood or urine of the deceased did not affect the PSA determination. These results show that PSA membrane tests are relatively unreliable and can be misleading, especially when derived from vaginal swab samples of older women, obtained at autopsy. In forensic cases, positive PSA screening test results may have an impact on subsequent legal actions and criminal charges brought against the accused. These findings are important for both forensic pathologists and the police to ensure accurate screening of older women in cases of suspected sex crimes.