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Substance Related Rape
by Hoffmann-La Roche
This article was produced by the Hoffmann-La Roche, the producers of Rohypnol (a pharmaceutical that received a lot of media attention in the 1995-1999 as a "Date Rape Drug"). We are not certain of the date, but it was published either in 1998 or 1999.

WHEN DRUGS ARE USED FOR RAPE: What Counselors Need to Know

Recently there have been a number of reports of sexual assault in which drugs and/or other substances have been slipped into people's beverages. For centuries, rapists have used alcohol to sedate their victims. Today, they can use a wide variety of substances to commit crimes of assault.

Clearly, substance-related rape poses unique difficulties for both survivors and for those trying to reduce their risk of assault. Rape crisis counselors and others involved with helping survivors of sexual assault need to be armed with information that may help survivors and also reduce the risk of this crime. The general advice provided here applies to sexual assault involving any substance. It is important for counselors to recognize, however, that different substances, when misused in this way, can produce very different health risks.

Emotional Effects of Substance-Related Rape
Rape survivors assaulted under the influence of a sedating substance will have additional issues that are likely to affect their recovery -- issues oftentimes involving their inability to recall the incident.

Because survivors will have been heavily sedated, they may not have complete recall of the assault. It is likely that they will be uncertain about exactly what happened and who was involved. The "unknowns" may create tremendous anxiety as survivors are left to fill in the gaps with their imagination. This dynamic exacerbates the loss of control that most survivors feel and that they must overcome in their healing process.

Survivors may not know the identity of their assailants, so added to their concerns is the question: "Whom should they fear?" While most survivors have fears regarding their perpetrator, someone assaulted under the influence of a sedating substance will have more generalized fear. They may find themselves looking at men in various settings wondering, "Is he the one...?"

Eventually, survivors must come to terms with the fact that they likely will never be able to fill in those missing pieces. The questions may remain unanswered. Coming to this resolution is not unlike the process experienced by adult survivors of childhood sexual abuse who have only partial recall of repressed memories.

Additionally, the inability to recall important facts makes prosecution of these crimes extremely difficult. While law enforcement personnel are becoming more aware of the misuse of sedating substances and their effects on victims, there may continue to be some skepticism on the part of those unfamiliar, or inexperienced, in dealing with these types of crimes.

What To Do: To Reduce the Risk of Substance-Related Rape

People can take a number of precautions to reduce their risks:
  1. Do not leave beverages unattended.
  2. Do not take any beverages, including alcohol, from someone you do not know well and trust.
  3. At a bar or club, accept drinks only from the bartender, waiter, or waitress.
  4. At parties, do not accept open container drinks from anyone.
  5. Be alert to the behavior of friends. Anyone appearing disproportionately inebriated in relation to the amount of alcohol they have consumed may be in danger.
  6. Anyone who believes they have consumed a sedative-like substance should be driven to a hospital emergency room or should call 911 for an ambulance. Try to keep a sample of the beverage for analysis.

Actions to Take: If Someone Thinks They've Been Drugged

Someone who experiences dizziness, confusion or other sudden and unexplained symptoms after drinking a beverage should call a family member, friend, the police, a doctor, or 911 for help in getting them to a hospital.

If someone believes they have been raped or sexually assaulted, they should:
  1. Get to a safe place and call a rape crisis center if they want information or support. For a toll-free rape crisis hotline, survivors can call (800) 656-4673.
  2. Determine whether or not they want to report to the police. If there is any chance they do want to report the assault, they should not shower, bathe, douche, change clothes, or straighten up the area until the medical and legal evidence has been collected.
  3. If they choose to report, they should first call the police and then go to the hospital to have the medical evidence collection done.
  4. Go to a hospital, clinic, or private doctor for treatment of external and/or internal injuries, tests for pregnancy and sexually transmitted diseases, and support services.
  5. Request a urine test for the presence of sedating substances as quickly as possible. The screening test should include Gamma Hydroxybutyrate (GHB), flunitrazepam (Rohypnol), and other drugs. Every hour matters. Chances of getting proof are best when the sample is obtained soon after the substance has been ingested.

Sedating Substances
For years, counselors have been dealing with substance-related rape, particularly those involving alcohol. But recent media coverage has focused largely on two sedating substances: Gamma Hydroxybutyrate (GHB), a central nervous system depressant that has been investigated as an anesthetic and for treatment of narcolepsy and alcoholism, and Rohypnol (flunitrazepam), a prescription sleeping mediation available outside the Unites States.

Although there has been considerable media attention on these two substances, it is important for counselors to recognize that many other substances can be misused to commit these crimes as well. In investigating any case of sexual assault, counselors need to fully explore the possibility that any number of substances may have been used.

Physical Effects of Sedating Substances
There are several telltale signs that an individual has been drugged. If an individual appears disproportionately inebriated in relation to the amount of alcohol they have consumed, they may have unknowingly ingested one of any number of substances. Sedating substances can temporarily inhibit a person's ability to remain awake and conscious. Someone who has been sedated may experience sudden and unexplained drowsiness and have trouble with motor coordination. Other possible effects include impaired judgment, disinhibition, dizziness, and confusion.

Brief periods of impaired memory also may result from the misuse of sedating substances. This means the person who has been raped may not remember the details of what happened while under the drug's influence. Depending on the drug and the presence of other substances in the person's system, more dangerous side effects may occur.

Even marginally increased doses of GHB have been reported to result in severe adverse effects. These include slowed heart beat, decreased respiratory effort, unconsciousness, seizure-like activity, and coma. Such effects can appear within fifteen minutes of oral ingestion of the drug, and acute symptoms appear to decrease after three to four hours. As with most substances, health risks increase sharply when GHB is mixed with other drugs and/or alcohol. (G.P. Galloway, et al. Gamma-hydroxybutyrate. CSAM News: Newsletter of the California Society of Addiction Medicine. Summer 1996;23;1:1)

Facts on Rohypnol
Rohypnol is a medication that is prescribed by physicians in more than 64 countries for people with severe and debilitating sleep disorders. It also is used in a number of countries as a preanesthetic before surgery or other medical procedures. Rohypnol is manufactured in Europe, Asia Pacific, and Latin America by the Swiss-based pharmaceutical company F. Hoffmann-La Rouche Ltd for medical use in those countries where it has been approved.

Hoffman-La Rouche never sought U.S. Food and Drug Administration approval for Rohypnol in the United States. The medication therefore is not marketed in this country. Drug traffickers, however are illegally smuggling Rohypnol into the United States from Mexico and South America and are selling it as a "street drug." Common street names for Rohypnol include Roofies, Rochies, La Roche, the forget pill, and the date rape drug. On March 5, 1996, the U.S. Customs Service announced a ban on the importation of Rohypnol into the United States, which has begun to have a significant impact on reducing the illegal importation. As efforts to end the diversion of Rohypnol are being implemented, however, there have been reports that other substances, such as GHB, are being used similarly in sexual assault situations.

As a sleeping medication, Rohypnol produces a sedating effect. This property can be enhanced by the dosage, the individual's sensitivity to the medication, and the presence of alcohol. Generally, Rohypnol's effects begin within 20 to 30 minutes of ingestion. The medication's strongest effects occur within one or two hours. Rohypnol's overall sedating effects usually last six to eight hours following a 2 mg. dose. Impaired ability to remember details of events is more likely to occur with larger doses, and particularly when ingested with alcohol and/or other drugs or central nervous system depressants.

As with many other drugs, Rohypnol becomes extremely dangerous when mixed with alcohol, narcotic drugs, and/or other central nervous system depressants. This combination is potentially life-threatening and can be fatal.

Survivors of Rape May Be Able to Prove They Were Drugged
Anyone who thinks they have been drugged should ask the rape crisis center, the hospital emergency room, or the police to run a urine test as soon as possible. Most substances can be detected through appropriate drug testing. The findings of such tests can provide valuable evidence in a court of law if the rape survivor wishes to prosecute the case.

Hoffmann-La Roche has made available a drug testing service for cases of sexual assault in which Rohypnol is believed to be involved. The testing service is free of charge, and the urine sample is handled by an independent, National Institute on Drug Abuse (NIDA)-approved laboratory that follows appropriate chain-of-custody procedures so the findings can be used by the rape survivor in court. Tests show that Rohypnol can be found in the urine for 72 hours after ingestion, and may be present even longer, depending on the person's metabolism and dose.

Because the test results are returned by the laboratory to the rape crisis center that submitted the sample, rape crisis centers can maintain the strict confidentiality of the rape survivor's identity. Rape survivors should be informed that the urine test for flunitrazepam also tests for the presence of other benzodiazepines (the family of compounds to which flunitrazepam belongs), as well as for marijuana, cocaine, and some opiates and barbiturates.

To access the testing service, rape crisis centers can call Hoffman-La Roche at (XXX) XX8-6540
This brochure is being provided through a public service grant from Hoffmann-La Roche. For general information on Rohypnol, please call Hoffmann-La Roche at (XXX) XX0-1076. Many thanks to the DC Rape Crisis Center for their assistance with this brochure