Epidemiology of Drug-Facilitated Crimes and Drug-Facilitated Sexual Assaults

Samira Djezzar, Nathalie Richard and Marc Deveaux

Administration of certain psychoactive substances without the victim’s knowledge in order to facilitate criminal acts is a serious forensic problem. Only limited data are available concerning the frequency and current trends of drug-facilitated crime. As no standardized procedure has been defined, this chapter will present various examples of the data collection procedures used in some countries (France, USA, Canada, United Kingdom, Ireland, Australia, Germany, the Netherlands, Belgium, Norway, Denmark, Sweden, Italy and Spain), comprising surveys, responses to charity help lines, government statistics and data published by forensic and non-forensic scientists. Toxicological screening and analysis in blood, urine and hair should be routinely offered according to a strict protocol to achieve a comprehensive assessment in each individual case. The detailed results of the French national survey are presented, together with the various preventive and regulatory measures applied. Such a survey allowed the identification of cases of drug-facilitated crime and to study the substances involved and the modus operandi.

Keywords

chemical submission; drug-facilitated crime; drug-facilitated sexual assault; epidemiology; prevalence; psychoactive substances

1 Introduction

Drug-facilitated crime (DFC) is a general term that includes robbery, money extortion, deliberate maltreatment of vulnerable people (children, including Munchausen by proxy syndrome; the elderly; the disabled; and/or mentally ill people), rape and sexual assault: drug-facilitated sexual assault (DFSA) is a subset of DFC.1–3

DFCs are criminal acts carried out by means of administering covertly a psychotropic substance to a person with the intention of impairing behavior, state of awareness, perceptions, degree of consciousness, judgment, decision-making capacity or anterograde memory.

Substances used in DFCs are usually odorless or tasteless, dissolve readily in beverages (alcoholic or non-alcoholic), are fast acting, effective at a low dose, have a short plasma half-life, are potent central nervous system (CNS) depressants, mimic severe alcohol intoxication or sedation, and cause anterograde amnesia.

The most frequently used drugs (a total of ≈100 molecules are described to be potentially active in DFC) are prescription and over-the-counter medications: benzodiazepines and Z-drugs, antihistamines, non-benzodiazepine sedatives, some neuroleptics and gammahydroxybutyric acid (GHB). All these drugs have to be considered alone or in conjunction with alcohol, cannabis, 3,4-methylenedioxy-N-methylamphetamine (MDMA), cocaine and other drugs of abuse. The key is that the drugs assist or facilitate the crime or the sexual assault. A list of substances which have been encountered at least once in DFC/DFSA cases is give in Table 2.1, according to refs.1,4,5

While the covert use of drugs to facilitate crime has occurred over the centuries, this phenomenon has developed during the past 20 or so years, and DFCs (including DFSAs) have been highlighted by an increase in the reporting of these crimes by victims worldwide and by an increase in positive analytical results. The upsurge in adjudication by the legal system has also increased awareness.

Because of the large number of unreported rapes, the prevalence of sexual assaults is underreported. This is why the prevalence of DFSAs is unlikely ever to be recognized.

As stated in the UNODC guidelines from 2011,1 information available on DFC is primarily based on anecdotes and the data collection procedures may be very different from one country to another. It could be national or regional surveys (by toxicologists, psychiatrists, emergency units), responses to charity helplines, governmental (Ministry of Justice, Ministry of Health) statistics, or local or regional data published sporadically by scientists in scientific journals or presented in national or international meetings. The international scientific associations where DFC cases are regularly and actively presented during their annual meetings are: French Society of Analytical Toxicology (SFTA); The International Association of Forensic Toxicologists (TIAFT); Society of Forensic Toxicologists (SOFT); International Association of Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT); European Association of Poisons Centers and Clinical Toxicologists (EAPCCT); American Academy of Forensic Sciences (AAFS); and Society of Hair Testing (SoHT). This list is not comprehensive. Unfortunately forensic scientists do not always publish their results and numerous oral or poster presentations in different meetings are not immediately published or not published at all in scientific journals, and this can lead to some of the collected data being lost. However, one must be aware of the publication of the abstracts of national meetings in international peer-reviewed journals: for example, the abstracts of the French annual meeting of pharmacovigilance are published in Fundamental Clinical Pharmacology and are easily accessible.6

In this chapter, the authors develop how the prevalence of DFC is evaluated, focusing on DFSA. As this aspect is well studied in France, the focus will be on French organizations, together with data from other countries in the world (Europe, America, Australia). It appears that little information and statistics are available in these countries and none at all in Asia.

2 Epidemiological Data on Drug-Facilitated Crime in France

2.1 Introduction

The sedative and amnesic effects of benzodiazepines (BZD) are well known and are the basis for their use as anaesthetic premedication. However, in 1982, Poyen7 reported first in France the possibility of criminal behavior under the influence of these molecules. Other pharmacological effects of benzodiazepines are also used for DFCs, such as decreased resistance or defense reactions, poor assessment of danger and emotion modification.

The first clinical descriptions in France date from the early 1980s.7,8 Subsequent publications of sporadic cases or small series of DFCs failed to accurately reflect the reality and extent of the problem,9 especially as these publications were often based on the same cases, mostly in the Ile-de-France region.10,11 These publications describe the same modi operandi, the same victim profiles and use of the same substances. In 2000, Marc et al.12 reported a series of 23 cases of sexual assault in the context of DFC using BZD in the eastern Ile-de-France region; 22% of these cases had voluntarily consumed alcohol, thereby potentiating...