From The New England Journal of Medicine
Sexual assault has become a complicated issue over the past decade and poses many difficulties in prevention and diagnosis. With the availability of disabling drugs such as "ecstasy," the phrase "slipped a Mickey Finn" has taken on new meaning, not only for the victim but also for the investigative team. This multiauthored book describes the fundamental differences between sexual assault and drug-facilitated sexual assault and points out the difficulties drugs pose in forensic studies. According to this book, drug-facilitated sexual assault can be "the perfect crime in a pill." The victim, out at a social event, meets and mingles with a respectable-looking person, who secretly slips (gamma)-hydroxybutyric acid or ecstasy into the victim's drink. The victim, totally unaware, becomes incapacitated and is then taken by the perpetrator to an apartment or private site where she is raped, sodomized, and photographed while unconscious. She later awakes and is unaware of what has happened, save for the bruises or the lethargic aftermath of the drug. She may only realize 24 to 48 hours later that she has been sexually assaulted, at a time when diagnostic studies may be too late. Although the book focuses on forensic issues, it covers the various experiences, symptoms, and memories of victims and the characteristics of assailants, and it describes settings where drug-facilitated sexual assault commonly occurs. There are major differences between the perpetrators of drug-facilitated sexual assault and perpetrators of forcible or coercive rape. There is rarely violence during drug-facilitated sexual assault, and rarely do the attackers display remorse. These assailants use drugs that are available to them: some may use their own barbiturate or benzodiazepine prescription, and those employed in health care may use various hypnotics or sedatives in their possession. Most of the book deals with the various classes of drugs used in this type of assault and their availability, metabolism, and biologic activity in the victim's specimens. Although alcohol is the drug most commonly used in drug-facilitated sexual assault (accounting for one third of cases), marijuana and lysergic acid diethylamide are used in 18 percent of cases and cocaine in 8 percent, and (gamma)-hydroxybutyrate and flunitrazepam (a benzodiazepine) are becoming ever more popular and readily obtainable. The authors note that (gamma)-hydroxybutyric acid can be made in a kitchen from industrial solvents and paint remover. There are simple instructions on the Internet for making these products. The book targets as its audience clinicians, laboratory-services staff, police officers, district attorneys, the staff of hospital emergency departments and urgent-care settings, and even college administrators, all of whom may confront the issue of "date rape." All the contributors recommend the use of teamwork in working with victims of drug-facilitated sexual assault and in solving the cases. The team consists of the victim, the sexual-assault nurse examiner (or the equivalent), the sexual-assault response team (or the emergency-department equivalent), the prosecutor and his or her staff, the laboratory analysts, and expert witnesses, all of whom understand the ramifications of drug-facilitated sexual assault. The sexual-assault nurse examiner and sexual-assault response team play an extremely important part but are not routinely available. As with any multiauthored book, there is a great deal of repetition. Each chapter could stand alone as a separate article. However, the message is worth the repetitive reading. This book is definitely timely. David S. Rosenthal, M.D.
Copyright © 2002 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS.
"This book is addressed to the primary stakeholders including police, medical professionals, lawyers, and forensic scientists...The reader will find this book worthwhile...a good overview of the many important considerations that are required to conduct comprehensive investigations, through forensic analyses and successful prosecutions."
-Philip M. Flogel, Commander Crime Scene Operations, New South Wales Police, for AUSTRALIAN JOURNAL OF FORENSIC SCIENCES
"...This book does an excellent job of summarizing the scientific evidence, considering practical challenges, and synthesizing them into a useful resource. This reference will be of interest to anyone who encounters drug-facilitated crimes. The forensic toxicology is very detailed...I am not aware of any other book that addresses the topic of drug-facilitated crimes comprehensively. Rated 4 Stars!"
-Ken Bizovi for DIVINE (FORMERLY DOODY'S REVIEWS)
"...is written for all those involved in the investigation of these crimes...focuses on the idea of teamwork for a successful investigation. The first portion of the handbook deals with the history of drug-facilitated crimes...The next portion addresses the difficulties surrounding the investigation and finally, the handbook outlines ideas and suggestions to overcome some of the difficulties encountered in these cases." - Law Enforcement Technology, Sept. 2006