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Abstract
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From: 30th meeting of SFTA- 59th meeting of TIAFT - September 2022
Aim
Although much has been written on the subject of drug facilitated sexual assault (DFSA) or victim of blackout, no epidemiological study has yet been conducted in Switzerland to evaluate the occurrence of GHB and other drugs in this context. GHB is frequently mentioned on social networks and in the media as the most regularly used substance in DFSA, but often without being based on scientific studies. In order to have an assessment of the situation, political authorities asked our laboratory to systematically screen for GHB in samples obtained in case of DSFA or blackout, and driving under the influence of drugs (DUID), with the aim to assess the occurrence of voluntary or involuntary GHB use in Western Switzerland.
Method
All DFSA, blackout and DUID cases received in 2021 in our laboratory were routinely tested for the presence of GHB at non-physiological concentrations by enzymatic assay with a urine cut-off of 10mg equivalent GHB/L. All positive cases were confirmed by gas chromatography coupled to mass spectrometry (GC-MS) using a cut-off of 6mg/L in urine and 1.5mg/L in whole blood. All DFSA and blackout cases were also analyzed by GC-MS, to ensure the absence of false negative cases. When requested by the justice, other substances such as ethanol, benzodiazepines, cannabinoids, cocaine, amphetamines, opioids, antidepressant, and other psychoactive substances were screening in urine and/or blood, by immunoassays, head-space gas chromatography coupled to flame ionization detector (HS-GC-FID), GC-MS, and/or liquid chromatography coupled to tandem mass spectrometry or high resolution mass spectrometry (LC-MS/MS; LC-HRMS (orbitrap)).
Results
60 DFSA and blackout cases and 633 DUID cases were included in the study. Women predominated over men in the DFSA and blackout group (77%), while men predominated over women in the DUID group (90%). Median age in the DFSA and blackout group was 23, and median age in the DUID group was 30. The median delay to obtain urine after the event was 12hours in case of DFSA and blackout, and 2hours for DUID cases. The median delay to obtain whole blood after the event was 12hours in case of DFSA and blackout, and 1.5hours for DUID cases. The presence of GHB at concentration above the cut-off was detected in 1 DFSA and blackout case (130mg/L in blood and 730mg/L in urine), and in 3 DUID cases (78mg/L, not detected, and not detected in blood, and 660mg/L, 8.6mg/L, and 25mg/L in urine, respectively). These cases concerned only men. For these 4 cases, other substances were also detected. Thus, for the DFSA and blackout case, methamphetamine, methylphenidate, zolpidem and pregabaline were detected, and in the DUID cases, methamphetamine was detected in one case, ethanol, cocaine and cannabis were detected in another case, and 3-MMC was detected in the last case. When analyzed, ethanol was detected in 48% of DFSA and blackout cases, cannabinoids in 17%, benzodiazepines and Z-drugs in 10%, antidepressant in 9.8%, cocaine in 6.5%, amphetamines in 6.5%, methylphenidate in 4.8%, and opioids in 2.1%. Median concentration of ethanol after back calculation was 2.07g/kg in DFSA and blackout cases.
Conclusion
The results obtained, showing a very limited voluntary or involuntary use of GHB, are comparable to those obtained in other international studies. For the first time in Switzerland, a study was conducted for the evaluation of the occurrence of GHB in blood and urine specimens from victims of alleged sexual assault or blackout, and DUID cases. The results showed that GHB is very rarely consumed and used in DSFA or blackout cases, in comparison to other psychoactive drugs.
Language: en |