Rape

sedation and amnesia to the extent that their victims cannot resist or may not be aware of a sexual assault. About 25% of the 1400 women who contact the Canadian Sexual Assault Centre each year report that drugs were a factor in a rape. Drug-facilitated rape is most commonly linked to the surreptitious administration of flunitrazepam (Rohypnol) or of a newer arrival, gamma hydroxybutyrate acid (GHB). Reports from the police and emergency departments suggest that use of these drugs, particularly GHB, in sexual assaults is increasing. Routine tests to detect the drugs are not widely available, prompting one Ontario Liberal MPP to push the province to provide immediate testing for women who suspect they have been victims of date rape. Well intentioned though that initiative may be, widespread testing is already available for the drugs most commonly used in date rape: alcohol, marijuana, benzodiazepines, cocaine, heroin and amphetamines. Any substance that is administered to lower sexual inhibition and enhance the possibility of unwanted sexual intercourse is potentially a date-rape drug. Of 2003 urine samples submitted by rape treatment centres across the United States within 72 hours of a suspected drugfacilitated rape, GHB was detected in only 3% of the samples and flunitrazepam in less than 1%; alcohol was detected in 69% of the samples, marijuana in 18% and cocaine in 5%. Physicians should be aware of the mechanisms and clinical management of flunitrazepam and GHB intoxication, but they should also be aware that, when a drug-facilitated rape is suspected, alcohol is the substance most likely involved.