A Systematic Review of Materials Used in Sexual Violence against Women
Azadeh Memarian
1
(
1- Department of Forensic Medicine, Mazandaran University of Medical Science, Sari, Iran
)
Kamran Aghakhani
2
(
2- Department of Forensic Medicine, School of Medicine, Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
)
Leyla Abdolkarimi
3
(
3- Department of Forensic Medicine, Shahid Ragaei Cardiovascular Medical and Research Center, Tehran, Iran
)
Maryam Ameri
4
(
4- Department of Forensic Medicine, School of Medicine, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
)
Siamak Soltani
5
(
5- Department of Forensic Medicine, School of Medicine, Rasool -Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
)
Keywords: Rape, Rape of Women, Drugs, Sexual Assault, Drugs Used in Sexual Assault,
Abstract :
Drug-facilitated sexual assaults (DFSA) are crimes that remain largely underrecognized by the public and may not receive sufficient attention from health and legal policymakers. The primary objective of this systematic review was to investigate individuals affected by drug-facilitated sexual assault (DFSA) in order to inform the development of effective health and policy strategies. To conduct this study, a comprehensive search was performed for relevant studies published between 2018 and 2021. The search followed PRISMA guidelines and was conducted in internationally recognized databases, including Web of Science, Science Direct, Scopus, PubMed, and Google Scholar. A total of 39 studies that met the inclusion criteria were selected for analysis. The findings of the review revealed that the most commonly identified substances involved in DFSA were alcohol, benzodiazepines, cannabinoids, methamphetamine, and amphetamines. In contrast, traditional drugs were found to be used less frequently by perpetrators. Most hospitals used liquid chromatography-mass spectrometry (LC-MS) and gas chromatography-mass spectrometry (GC-MS) for substance identification. Additionally, blood and urine were the most commonly analyzed biological matrices for detecting these substances. Based on the findings, it can be concluded that alcohol and various drugs, including benzodiazepines, cannabinoids, methamphetamine, and amphetamines, were the most frequently associated with drug-facilitated sexual assaults. These results highlight the need for targeted health and policy interventions to raise awareness and mitigate the occurrence of DFSA.
1. Dartnall E., Jewkes R., 2013. Sexual violence against women: the scope of the problem. Best Pract Res Clin Obstet Gynaecol. 27(1), 3–13.
2. Jina R., Thomas L.S., 2013. Health consequences of sexual violence against women. Best Pract Res Clin Obstet Gynaecol. 27(1), 15–26.
3. Krahé B., 2018. Violence against women. Curr Opin Psychol. 19, 6–10.
4. Flood M., Pease B., 2009. Factors influencing attitudes to violence against women. Trauma Violence Abuse. 10(2), 125–142.
5. Kalra G., Bhugra D., 2013. Sexual violence against women: Understanding cross-cultural intersections. Indian J Psychiat. 55(3), 244–249.
6. Porat R., Gantman A., Green S.A., Pezzuto J.H., Paluck E.L., 2024. Preventing sexual violence: A behavioral problem without a behaviorally informed solution. Psychol Sci Public Interest. 25(1), 4-29.
7. Garcia-Moreno C., Heise L., Jansen H.A., Ellsberg M., Watts C., 2005. Violence against women. Sci. 310(5752), 1282–1283.
8. Bjørnseth I., Szabo A., 2018. Sexual violence against children in sports and exercise: A systematic literature review. J Child Sex Abus. 27(4), 365–385.
9. Sumner S.A., Mercy J.A., Saul J., Motsa-Nzuza N., Kwesigabo G., Buluma R., Marcelin L.H., Lina H., Shawa M., Moloney-Kitts M., Kilbane T., 2015. Prevalence of sexual violence against children and use of social services—seven countries, 2007–2013. MMWR Morb Mortal Wkly Rep. 64(21), 565.
10. Hanson R.K., 1990. The psychological impact of sexual assault on women and children: A review. Ann Sex Res. 3(2), 187–232.
11. Krebs C.P., Lindquist C.H., Warner T.D., Fisher B.S., Martin S.L., 2009. College women's experiences with physically forced, alcohol-or other drug-enabled, and drug-facilitated sexual assault before and since entering college. J Am Coll Health. 57(6), 639–649.
12. Hall J.A., Moore C.B., 2008. Drug facilitated sexual assault – a review. J Foren Leg Med. 15(5), 291–297.
13. de Souza Costa Y.R., Lavorato S.N., de Campos J.J., 2020. Violence against women and drug-facilitated sexual assault (DFSA): a review of the main drugs. J Foren Leg Med. 74, 102020.
14. Hagemann C.T., Helland A., Spigset O., Espnes K.A., Ormstad K., Schei B., 2013. Ethanol and drug findings in women consulting a Sexual Assault Center – Associations with clinical characteristics and suspicions of drug-facilitated sexual assault. J Foren Leg Med. 20(6), 777–784.
15. Maublanc J., Dulaurent S., Morichon J., Lachâtre G., Gaulier J.M., 2015. Identification and quantification of 35 psychotropic drugs and metabolites in hair by LC-MS/MS: application in forensic toxicology. Int J Legal Med. 129, 259–268.
16. Takitane J., Pimenta D.S., Fukushima F.M., Gomes V., Leyton V., 2017. Aspectos medico-legais das substancias utilizadas como facilitadoras de crime. Saúde Ética Justiça. 22(2), 66–71.
17. Moher D., Liberati A., Tetzlaff J., Altman D.G., 2010. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Int J Surg. 8(5), 336–341.
18. Fiorentin T.R., Logan B.K., 2019. Toxicological findings in 1000 cases of suspected drug facilitated sexual assault in the United States. J Forensic Leg Med. 61, 56–64.
19. Armstrong J., Harris K., Wylie C., Isoardi K.Z., 2023. Suspected stonefish envenomation in Queensland over eight years: a retrospective series. Clin Toxicol. 2, 61(11), 956-60.
20. Bertol E., Di Milia M.G., Fioravanti A., Mari F., Palumbo D., Pascali J.P., Vaiano F., 2018. Proactive drugs in DFSA cases: Toxicological findings in an eight-years study. Foren Sci Int. 291, 207–215
21. Poulsen H., McCarthy M.J., Baker J., Verma A., Moir H.J., Brodie T., Thatti B., Trotter G., Rooney B., 2021. Toxicological assessment of the role of alcohol and drugs in drug-facilitated sexual assault cases in New Zealand. J Anal Toxicol. 45(1), 44–52.
22. Quintana J.M., García-Maroto Á., Moreno O., Manzanero A.L., 2020. Characteristics of drug-facilitated sexual assault in Spain. J Investig Psychol Offender Profil. 17, 215–223.
23. Tiemensma M., Davies B., 2018. Investigating drug-facilitated sexual assault at a dedicated forensic centre in Cape Town, South Africa. Foren Sci Int. 288, 115–122.
24. Dempsey S.K., Rodgers C.L., Stout P., Lee D., 2022. Evaluation of suspected drug-facilitated sexual assault cases in the city of Houston from 2014 to 2020. J Forensic Sci. https://doi.org/10.1111/1556-4029.15146
25. Carfora A., Campobasso C.P., Cassandro P., Petrella R., Borriello R., 2022. Long-term detection in hair of zolpidem, oxazepam and flunitrazepam in a case of drug-facilitated sexual assault. J Anal Toxicol. 46(1), e16–e20.
26. Grela A., Gautam L., Cole M.D., 2018. A multifactorial critical appraisal of substances found in drug-facilitated sexual assault cases. Foren Sci Int. 292, 50–60.
27. Lee H.H., Chen S.C., Lee J.F., Lin H.Y., Chen B.H., 2018. Simultaneous drug identification in urine of sexual assault victims by using liquid chromatography tandem mass spectrometry. Foren Sci Int. 282, 35–40.
28. García M.G., Pérez-Cárceles M.D., Osuna E., Legaz I., 2021. Drug-facilitated sexual assault and other crimes: a systematic review by countries. J Foren Leg Med. 79, 102151.
29. Dermitzaki S., Nystazaki M., 2021. Use of ketamine as a date drug: A systematic scoping review. Int J Psychol Res Rev. 4, 52.
30. Almofti N., González-Rubio S., Ballesteros-Gómez A., Girela E., Rubio S., 2022. Green nanostructured liquids for the analysis of urine in drug-facilitated sexual assault cases. Anal Bioanal Chem. 14, 1–1.
31. Moran G.A., Ccoscco C.A., Alcántara K.J., Ramos V.T., Pérez V.C., 2022. Chemical submission in cases of alleged crimes against sexual freedom 2016–2018, Lima, Peru. Span J Leg Med. 48(1), 10–16.
32. Kluk E., Trigueiro T.H., de Assis Berteloni G.M., Lourenço R.G., 2022. Mulheres em situação de violência sexual sob efeito de drogas facilitadoras de abuso sexual. Res Soc Dev. 11(8), 0911830538.
33. Valle R., Bernabé-Ortiz A., Gálvez-Buccollini J.A., Gutiérrez C., Martins S.S., 2018. Intrafamilial and extrafamilial sexual assault and its association with alcohol consumption. Rev Saude Publica. 52, 1, 1-3.
34. Skov K., Johansen S.S., Linnet K., Nielsen M.K., 2022. A review on the forensic toxicology of global drug-facilitated sexual assaults. Eur Rev Med Pharmacol Sci. 26, 183–197.
35. Hagemann C.T., Helland A., Spigset O., Espnes K.A., Ormstad K., Schei B., 2013. Ethanol and drug findings in women consulting a Sexual Assault Center – Associations with clinical characteristics and suspicions of drug-facilitated sexual assault. J Foren Leg Med. 20(6), 777–784.
36. Anderson L.J., Flynn A., Drummer O., Gerostamoulos D., Schumann J.L., 2019. The role of voluntary and involuntary drug and alcohol consumption and premorbid mental health factors in drug-facilitated sexual assault. Foren Sci Med Pathol. 15, 382–391.
37. Moore J.L., Goldberg A.P., Barron C., 2021. Substance use in a domestic minor sex trafficking patient population. Pediatr Emerg Care. 37(4), 159–e162.
38. Meneses V.M., Mata D.C., 2022. Prevalence of five commonly analyzed cannabinoids in forensic toxicology casework from Orange County CA, USA, from 2016 to 2019. J Anal Toxicol. 46(4), 449–456.
39. Champion A., Oswald F., Pedersen C.L., 2022. Forcible, substance-facilitated, and incapacitated sexual assault among university women: A Canadian sample. J Interpers Violence. 37(13–14), 11198–11222.
40. Bidstrup J.E., Busch J.R., Munkholm J., Banner J., 2022. Impact of the Covid-19 lockdown on sexual assault cases in Eastern Denmark – a retrospective clinical forensic study. Forensic Sci Med Pathol. 18(2), 125–132
41. Singh G., Singh P., Jyoti P., 2020. Date rape drugs in sexual assaults: a threat to Indian society. Eur J Mol Clin Med. 7(07), 2020.
42. Gudmundseth R., 2022. Drug facilitated sexual assault and toxicological findings in patients after sexual assault (Master's thesis). NTNU. 43, 1-3.
43. Sandal C., 2020. Drug-facilitated sexual assault. Workplace Health Saf. 68(3), 155.
44. Rossi S.S., Vecchio S., Odoardi S., Anzillotti L., Chiarotti M., Serpelloni G., Locatelli C., 2019. Analytical protocol for the screening of psychotropic/incapacitating drugs in alleged drug-facilitated crimes. Foren Chem. 14, 100168.
45. Fulga A., Neagu A.I., Ciubara A., Musat C.L., Neagu M., Fulga I., 2019. Pro-active drug facilitated sexual assault using sedative-hypnotic medication. Rev Chim. 70(11), 4083-4085.
46. Escayola E.N., Vega C.V., González R.B., Díez N.S., 2022. Presencia de sustancias psicoactivas en las víctimas de violencia sexual en la provincia de Alicante (España) durante los años 2016-2020. Rev Esp Med Legal. 49(1), DOI:10.1016/j.reml.2022.06.001
47. Moran G.A., Ccoscco C.A., Alcántara K.J., Ramos V.T., Pérez V.C., 2022. Sumisión química en casos de presuntos delitos contra la libertad sexual 2016-2018, Lima, Perú. Rev Esp Med Legal. 48(1), 10-16.
48. McCormack D., Subburamu S., Guzman G., Calderon C., Darapaneni R., Lis R., Sima N., Sperling J., Corbo J., 2022. Traumatic injuries in sexual assault patients in the emergency department. West J Emerg Med. 23(5), 1-7.
49. Berteloni G.M., 2021. Violência sexual facilitada por drogas: caracterização e experiências de mulheres atendidas em um hospital especializado do Paraná. 43, 4.
50. Tadros A., Sharon M.J., Hoffman S.M., Davidov D.M., 2018. Emergency department visits for sexual assault by emerging adults: is alcohol a factor? West J Emerg Med. 19(5), 797.
51. O’Callaghan E., Ullman S.E., 2022. Differences in women’s substance-related sexual assaults: force, impairment, and combined assault types. J Interpers Viol. 37(3-4), 1348-1376.
52. Basile K.C., Smith S.G., Liu Y., Lowe A., Gilmore A.K., Khatiwada S., Kresnow M.J., 2021. Victim and perpetrator characteristics in alcohol/drug-involved sexual violence victimization in the US. Drug Alcohol Depend. 226, 108839.
53. Littleton H., McConnell A., Messman T.L., Layh M., 2021. Typologies of rape victimization experiences among women attending college: a latent class analysis. Psychol Women Q. 45(2), 229-242.
54. Arbanas G., Marinović P., Buzina N., 2022. Forensic psychiatric evaluations of people charged with rape in Croatia. Med Sci Law. 62(2), 97-104.
55. Weng T.I., Chen L.Y., Chen J.Y., Chen P.S., Hwa H.L., Fang C.C., 2020. Characteristics of analytically confirmed illicit substance-using patients in the emergency department. J Formos Med Assoc. 119(12), 1827-1834.
56. McConnell A.A., Messman-Moore T.L., Gratz K.L., DiLillo D., 2020. Beyond the force–substance dichotomy: examining the experience of combined and incapacitated type rapes and their relation to PTSD symptoms. J Interpers Viol. 35(23-24), 5853-5876.
57. Cerdas L., Arroyo C., Gómez A., Holst I., Angulo Y., Vargas M., Espinoza M., León G., 2014. Epidemiology of rapes in Costa Rica: characterization of victims, perpetrators and circumstances surrounding forced intercourse. Foren Sci Int. 242, 204-209.
58. Xifró-Collsamata A., Pujol-Robinat A., Barbería-Marcalain E., Arroyo-Fernández A., Bertomeu-Ruiz A., Montero-Núñez F., Medallo-Muñiz J., 2015. A prospective study of drug-facilitated sexual assault in Barcelona. Med Clin. 144(9), 403-409.
59. Kintz P., Cirimele V., Villain M., Tracqui A., Ludes B., 2002. Soumission chimique: approches pratiques en toxicologie médico-légale. Ann Toxicol Anal. 14(4), 361-364.
60. Kintz P. (ed.), 2014. Toxicological aspects of drug-facilitated crimes. Elsevier. 3(3), 1-4.
61. Du Mont J., Macdonald S., Rotbard N., Bainbridge D., Asllani E., Smith N., Cohen M.M., 2010. Drug-facilitated sexual assault in Ontario, Canada: toxicological and DNA findings. J Foren Leg Med. 17(6), 333-338.
62. McGregor M.J., Ericksen J., Ronald L.A., Janssen P.A., Van Vliet A., Schulzer M., 2004. Rising incidence of hospital-reported drug-facilitated sexual assault in a large urban community in Canada: retrospective population-based study. Can J Public Health. 95, 441-445.
63. Mehling L.M., Johansen S.S., Wang X., Doberentz E., Madea B., Hess C., 2016. Drug facilitated sexual assault with lethal outcome: GHB intoxication in a six-year-old girl. Foren Sci Int. 259, 25-31.
64. Djezzar S., Questel F., Burin E., Dally S., French Network of Centers for Evaluation and Information on Pharmacodependence, 2009. Chemical submission: results of 4-year French inquiry. Int J Legal Med. 123, 213-219.
65. Pelletti G., Garagnani M., Rossi F., Roffi R., Banchini A., Pelotti S., 2018. Safe drugs in drug facilitated crimes and acute intoxications in Northern Italy. Foren Sci Med Pathol. 14(4), 442–449.