SEXUAL ASSAULT TOXICOLOGY The New Zealand Experience

1
SEXUAL ASSAULT TOXICOLOGYThe New Zealand
Experience

• Diana Kappatos
• Forensic Toxicologist

2
What is a Drug Facilitated Sexual
Assault

• A sexual assault that occurs when a persons
  ability to consent is interfered with by a drug
  that has been taken voluntarily or involuntarily.

3
What consent?

• No legal definition of consent in NZ but
  generally accepted to mean a consent freely
  given by a rational and sober person so situated
  as to be able to form a rational opinion about
  the matter to which he/she is consenting to.
  Stephens Digest of criminal Law,
  9th Edition
• Crimes act 1961 s128A (1) defines that physical
  resistance and protestation are not needed to
  show lack of consent to sexual connection.

4
Study undertaken of cases received at ESR during
the period 2002 to 2008

• Number cases studied 582
• Females 546 (94)
• Males 36
• Number cases reported
• Loss of memory 286 (49)
• Drowsy 47 (8)

5
(No Transcript)
6
The New Zealand Experience

• Alleged DFSA is NOT usually a drink spiking
  scenario (Mickey Finn) but more commonly
  situations involving voluntary alcohol and drug
  use, including the mixing of alcohol with
  recreational drugs, prescription medicines or OTC
  medicines.

7
Drugs detected

• Alcohol 282
• Cannabis 160
• Cocaine 1
• LSD 1
• GHB 0

• Stimulants
• Methamphetamine 30
• MDMA 10
• Amphetamine 2
• Party pills 29
• CNS depressants
• Benzodiazepines or zopiclone 30
• Analgesics 34
• Anti-depressants 6
• Anti-psychotics 2
• Others 30

8
Combination of drugs detected

• Based on cases where specimens were collected
  eight hours or less after alleged incident (189
  cases)
• No alcohol or drugs detected 14
• One drug detected 134
• Alcohol 107
• Cannabis 14
• Stimulants 7
• CNS depressants 6
• More than one drug detected 41

9
(No Transcript)
10
Alcohol is the most common drug associated with
sexual assault

• It is difficult to predict how impaired a person
  would be at any particular blood alcohol
  concentration without the knowledge of the
  persons tolerance for alcohol
• Memory loss may be associated with alcohol
  intoxication regardless of the degree of
  tolerance to the effects of alcohol

11
Stages of Acute AlcoholicInfluence/ Intoxication

• (Based on a study by Dubowski, University of
  Oklahoma, 1997)
• Blood Alcohol Concentration Stage Symptoms
  Include
• mg
• 10-50 Subclinical Nearly normal behaviour
• 30-120 Euphoria Decreased inhibitions
• Effects judgement and control
• 90-250 Excitement Emotional instability
• Drowsiness
• Loss of critical judgement Impairment
  of perception,
• memory and comprehension

12
Stages of acute Alcoholic Influence/Intoxication

• (Based on a study by Dubowski, University of
  Oklahoma, 1997)
• Blood Alcohol Concentration Stage Symptoms
  Include
• mg
• 180-300 Confusion Disorientation
• Mental confusion
• 250-400 Stupor Impaired consciousness
• Sleep or stupor
• 350-500 Coma Complete unconsciousness
  Possible death
• greater than 450 Death Respiratory
  arrest

13
Cannabis

• Cannabis use was found in 160 cases studied,
  alcohol was also present in half of these cases
• Cannabis is the most widely used illicit drug
• Cannabis produces a pleasant, dreamy high
• Subjective symptoms of cannabis intoxication
  usually peak 10 to 15 minutes after smoking
  cannabis and usually lasts about 1.5 to 4 hours,
  but occasionally may last longer
• There are cannabis receptors in the parts of the
  brain used for memory and learning, as well as
  for balance and coordination
• Cannabis tends to enhance the effect of alcohol

14
Benzodiazepines and Zopiclone

• Prescribed to treat anxiety and/or induce sleep
• Found in 30 cases
• People on sedatives appear similar to people
  under the influence of alcohol
• Slowing of reflexes and thought patterns
• Drowsiness sleep
• Loss of memory while under the influence of the
  drug cases by impairment of newly learned
  information into long term storage
• If alcohol and sedatives are taken together,
  their CNS depressant effect would be at least
  additive

15
Victims 12 to 20 years old

• 12 to 15 years old (71)
• Alcohol (30)
• range 26 to 331 mg (average 129 mg)
• Cannabis (26)
• 16 to 20 years old (127)
• Alcohol (63)
• range 57 to 300 mg (average 153 mg)
• Cannabis (39)

16
Items that had been spiked with drugs in New
Zealand

• Orange juice with diazepam
• Beer with zopiclone
• Wine with doxepin
• Wine with zopiclone
• Spaghetti with sildenafil (Viagra)
• Tea with zopiclone
• Wine with zopiclone

Items found associated with alleged assailant

• GBL
• Isobutyl nitrite

17
Challenges faced by DFSA investigators

• Delay in reporting
• Reluctance for complainants to report honestly
  their voluntary drug use
• No one laboratory test will detect all potential
  drugs used
• Some drugs are excreted form the body quickly
  (for example GHB not detect in urine 8 hours
  after ingestion)

18
(No Transcript)
19
Analyses of Hair for DFSA

• The drug remains in the hair until the hair is
  cut
• If delay is longer than 72 hours you need to
  consider hair
• Challenges with hair analysis
• One off exposures may be difficult to detect
• Negative results may be misleading
• It doesnt always prove ingestion
• Hair treatments can affect results
• Washing of hair can slowly wash the drug out (
  dont wait longer than 6 months)

20
Analyses of Hair for DFSA

• Sedatives
• Diazepam (Propam, Stesolid)
• Temazepam (Normison)
• Zopiclone (Imovane)
• Alprazolam (Xanax)
• Clonazepam (Paxam, Rivotril)
• Oxazepam (Ox-pam)
• Stimulants
• Methamphetamine
• MDMA
• BZP
• Analgesics and Opiates
• Morphine/heroin
• Codeine
• methadone

21
DFSA Future Test?

• GHB (Liquid Fantasy) in hair
• Used by body builders, and linked to drink
  spiking (sedative effects)
• Half life less than 1 hour in blood
• Urine test only detects it for 8 hours
• Produced endogenously
• Developing a test that will help establish
  whether the GHB in hair is from normal bodily
  production or from spiking or other use

22
DFSA Toxicology Research

• Future projects
• Co-localisation of drugs with emergency
  contraception (synthetic progestogens) in hair
• GHB-Glucuronide
• Extending the window of detection in urine to 96
  hours
• Alcohol use/abuse
• Alcohol metabolites
• Correlation of alcohol consumption and metabolite
  profiles