Drug Facilitated Sexual Assault (DFSA) in a chemsex context: Challenges in determining imputability

Aim

Presenting two cases of DFSA by New Psychoactive Substance (NPS) intake in a chemsex context. In the first case, the victim (15-year-old male) consumed a single glass of alcohol offered by the suspect and experienced complete amnesia of subsequent events. On site, two bottles, a syringe, powder in bulk, two powder rails and crystals were seized. In the second case, the victim (30-year-old male), following voluntary consumption of 3-MMC in a chemsex context, reported being injected with 3-MMC, which was followed by a black-out and hospitalization.

Method

Biological samples (blood and urine) were analysed by GC-MS, LC-MS/MS and LC-HRMS, seized products by GC-MS, LC-DAD and LC-MS/MS.

Results

In the first case, victim's blood analysis (sampled approximatively 5 hours post event) revealed GHB absorption (31 μg/mL), confirmed by urine analysis (194 μg/mL). No alcohol was detected. Cathinones (3-CMC and 3-MMC) were identified in urine only. For the suspect, tadalafil (0.08 μg/mL) was detected in blood and cathinones (3-CMC and 3-MMC) in urine. Both bottles contained GBL (93.4% and 2.3%), the syringe carried traces of GBL, the crystals consisted 3-CMC (94.7%), the powder 3-MMC (92.8%) and both powder rails were found to be 3-CMC (91.7%). In the second case, victim's blood analysis (sampled approximately 40 hours post event) revealed alpha-PHP (estimated at 100ng/mL), oxycodone (3.4ng/mL), diazepam (estimated at 121ng/mL) and its metabolites. In urine, alpha-PHP, oxycodone, diazepam and its metabolites were also detected, as was midazolam. In both cases, various substances commonly found in chemsex contexts were identified: phosphodiesterase inhibitors, cathinones, GHB. In the first case, the victim claimed consuming only one glass of alcohol. According to the results of the analysis, the victim ingested GBL/GHB and two different cathinones, possibly without her knowing. Although cathinones are stimulants, the combination of alcohol and GBL/GHB could explain the blackout described by the victim. The substances identified in the victim's samples were all found in the products seized from the suspect. In the second case, the declared 3-MMC use was not detected, possibly due to its elimination in the 40-hour interval before sampling. The presence of alpha-PHP, which the victim denied consuming, suggests prior or simultaneous administration during the event. Diazepam and midazolam were administered at the hospital, and oxycodone's origin remains unclear but is probably not contemporaneous with the events, given the substance's half-life.

Conclusion

The number and diversity of substances likely to provoke DFSA in a chemsex context make the handling of these potential cases complicated. Discrepancies between victims’ consumption declarations and analytical results can have various origins: unknowing administration, involuntary consumption (different composition, impurity, etc.), erroneous or false declarations.

These factors significantly challenge the formal determination of DFSA cases.