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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
Albino Gomes
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
Albino Gomes
DRUG FACILITATED SEXUAL VIOLENCE
THE CHALLENGES TO INVESTIGATING DRUG-FACILITATED SEXUAL
ASSAULT The victim’s lack of resistance
Inconsistent or untrue statements
Delayed reporting
Albino Gomes
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
Albino Gomes
COMMON DRUGS
DRUGS IN ABUSE
DRUG FACILITATED SEXUAL VIOLENCE
ROHYPNOL (Flunitrazepam)
Albino Gomes
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
Albino Gomes
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
Albino Gomes
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
Albino Gomes
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).
Albino Gomes
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
Albino Gomes
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”
Albino Gomes
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
Albino Gomes
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
Albino Gomes
DRUG FACILITATED SEXUAL VIOLENCE
Albino Gomes
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
Albino Gomes
BARRIERS TO PROSECUTION
DRUG FACILITATED SEXUAL VIOLENCE
Albino Gomes
DRUG FACILITATED SEXUAL VIOLENCE
FORENSIC NURSING
Grazie !!!
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