Sexual Assault and Drug Ingestion

  • Alcohol, drugs and other substances are sometimes used to sedate or overpower victims. In recent literature, the most frequently used drugs, commonly referred to as “date rape drugs,” are Rohypnol, Gamma Hydroxyl Butyrate (GHB), and Benzodiazapines, although other drugs may also be utilized.
  • Often, these drugs are mixed with alcohol and/or other beverages to incapacitate the victim, usually without the victim’s knowledge. Once the victim recovers from the effects of the drug, retrograde amnesia may make it difficult to recall events. Consequently, sexual assault victims may not be aware of the assault or even of how they were drugged.
  • Signs and symptoms of drug facilitated sexual assault include drowsiness, lightheadedness, dizziness, fatigue, decreased blood pressure and memory loss. Some of these symptoms may last several days.
  • The examiner should be aware of the possibility of the use of these drugs or other drugs and discuss this with the patient. The patient should be asked to describe any symptoms that may indicate the use of a drug and, if indicated, the examiner should offer to collect samples for a blood and/or urine toxicology screen for the presence of such drugs in the patient’s body.
  • Rohypnol, Benzodiazapines, and GHB generally can be detected in the blood anywhere from 4-36 hours after ingestion and in the urine up to 72 hours after ingestion.

Deciding Whether/When to Test

In any of the following circumstances, the possible evidentiary value of collecting a blood and/or urine sample for the identification of drugs should be discussed with the sexual assault patient:

  • If the patient or accompanying person (e.g., family member, friend or police officer) states the patient was or may have been drugged;
  • If the patient suspects drug involvement because s/he has no recollection of the event(s);
  • If, in the opinion of the examiner, the patient’s medical condition appears to warrant toxicology screening for optimal patient care and/or evidentiary purposes (e.g., patient presents with drowsiness, lightheadedness, dizziness, fatigue, decreased blood pressure, memory loss, impaired motor skills, etc).
  • Blood and/or urine sample collection for toxicology testing should be done only with patient consent. In order for the patient to give informed consent, discuss the following information with the patient. It may be helpful to involve a sexual assault crisis counselor in such discussions.
  • The ability to detect and identify any drugs present depends on collection of blood and/or urine within a very limited time period following ingestion.
  • There is no guarantee that testing will yield positive results.
  • Testing is not limited to so-called “date-rape drugs” and may reveal other drugs that the patient may have voluntarily ingested.
  • Failure or refusal to undergo testing when indicated by circumstances as described above may negatively impact any criminal investigation and/or prosecution.
  • If the patient consents to toxicology screening, samples should be collected even if the patient is undecided about reporting the assault to the police. (See page 19 of the Technical Guidelines for “Control Number” instructions in such circumstances. Samples should be transported according to transfer procedures set out on page 62)

Consent for Toxicology Testing

  • Testing for the presence of drugs and/or alcohol in the system of a sexual assault patient is not suggested or required unless medically indicated or indicated by the patient’s case history.
  • Fully review the Consent for Toxicology Screen form with the patient in order to help the patient understand to what s/he is consenting. If the patient consents to testing, retain signed form in patient’s medical record.
  • If the decision is made to collect samples for toxicology testing:
    • Collect blood sample at the same time as Step 1 of the CT100 Sexual Assault Evidence Collection Kit (See page 35);
    • Collect urine sample after all steps of the CT100 Sexual Assault Evidence Collection Kit have been completed.
  • If the patient consents to toxicology testing, samples should be collected even if the patient is undecided about reporting the assault to the police.
  • Hospital labs should not generally be used for forensic toxicology testing. Samples should be collected using the CT 400 Kit and sent to the crime lab for analysis.