Toxicological findings in Swedish cases of suspected drug-facilitated sexual assault (DFSA).

Suspicion of proactive drug-facilitated sexual assault (DFSA) where the perpetrator covertly administers psychoactive drugs to the victim has been reported in considerable proportions from sexual assault centers and forensic units all over the world. Substances implicated in DFSA are often referred to as 'date-rape drugs'. This study investigated toxicological findings in cases of suspected proactive DFSA presenting to the Emergency Clinic for Rape Victims in Stockholm, Sweden within 48 h of the assault. Urine samples for toxicological analysis were collected on the first visit to the clinic. During follow-up 10-14 days later, participants provided a control urine sample and reported voluntary intake of alcohol, recreational and prescription drugs in connection with the assault according to a standardized protocol. Urine samples were subjected to extensive toxicological LC-MS/MS analysis that covered common recreational drugs and >100 DFSA-associated substances. 31 out of the 55 women who presented to the clinic after a suspected proactive DFSA during the study period returned for follow-up and completed the study. Almost all women (97%) reported voluntary alcohol intake in connection with the assault, which exceeded 70 g ethanol in half of the cases. Unexpected toxicological findings were made only in five cases (16%), with the most common substance being cocaine. No typical date-rape drug was identified in cases where involuntary intake was considered likely. In conclusion, the greatest risk factor exploited by perpetrators of DFSA appears to be voluntary alcohol intoxication, while toxicological evidence of illicit drugging is rare.