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TOXICOLOGY AND DRUG FACILITATED SEXUAL ASSAULTS WORKSHOP 1a

Saturday 8^th 13.45pm

A victim is subjected to sexual act while they are incapacitated or unconscious due to the effects of alcohol and/or drugs. These effects of the drugs prevent the victim from consenting or resisting. Drug facilitated sexual assaults(DFSA) may result from drink spiking, recreational use of drugs or mixing of prescription drugs with alcohol as well as the use of over the counter medication. Clinical signs of alcohol influence related to blood alcohol levels show significant overlaps. The use of prescription drugs such as benzodiazepines may lead to decreased anxiety may induce sedation or possibly amnesia while GHB another common drugs suspected of use in DFSA may produce drowsiness, euphoria, dizziness, nausea and unconsciousness, the detection and interpretation of levels is difficult. Other hallucinogens have also been used these include MDMA, ketamine, marijuana, antidepressants and antipsychotics. An important issue in the detection of drugs is "do we have the correct specimen/s for analysis"? Often the analytical procedures used are complex and involved with no single test able to give all the answers, at times specific targeted analysis is required. Since the Toxicology Service at the VIFM has been involved in the testing over 700 DFSA cases have been analysed, ~35% of these were positive, while ~15% had alcohol and drugs, with ~18% had alcohol only.

Alex Kotsos

I am a senior Toxicologist and Pharmacologist. I hold a Degree of Bachelor of Science in Biochemistry and Pharmacology (Monash University) and a Degree of Master of Science in Biochemistry (Monash University). I have been involved in the analysis of drugs and poisons and heavily involved in method development and the implementation of new technologies within the toxicology section for over 20years.

I have several peer reviewed publications as well as other presentations.

I have given evidence in coronial, magistrate and county court cases.

I am a gazetted approved analyst under Section 57 of the Road Safety Act.

I am an invited reviewer for an international journal, "Forensic Science International"

Lectured to Monash university students and the Detective training school on forensic toxicology. Active member of a professional societies "The International Association of Forensic Toxicologists" and "The Australian and New Zealand Society for Mass Spectrometry"

OVERVIEW

Toxicology & Drug Facilitated Sexual Assault – Alex Kotsos

Drugs used:

Ethanol remains primary drug – easy to obtain and often voluntary consumption

0.01-0.05 = subliminal

0.03-0.12 = euphoria

0.09-0.25 = excitement

1???? = confusion (sorry missed that one)

Benzos & similar: decreased anxiety, induce sedation, some cause amnesia. Rapid absorption, effective within 30minutes

GHB & Analogs: human body produces natural amounts of GHB as a result of a neurotransmitting (???Gabba??). >10-20mgss/lt would indicate ingestion

Hallucinogens: LSD rare. (Victoria doesn’t test for this so send to another lab)

Barbituates: 2or 3 cases only since began testing in Victoria

All the usual others but I didn’t write anything

Specimens received at the lab:

34% blood and urine, 6% just blood, 60% just urine

If they know what to look for they need less blood (2ml but 5-10ml ideal)

51% of specimens tested had something in them (i.e. positive finding but not necessarily sexual assault drug)

Drugs Detected (700 cases)

18% Amphetamines, 10% cannabis, 11% antidepressants, 7% mixture, 13% benzo’s, 1% antipsychotic, 1% GHB, 1% K

Preferred urine within 48hours but collect if longer as some drugs have longer half life

No single test that will detect all

Usually use immunoassays and sometimes develop techniques as we go.

Alternative specimens:

Saliva, target analysis (you need to know what you are testing for) RBA testing

Hair

Longer period for detection,
18^th century detecting arsenic and mercury
Grows at a rate of 1.0 + 0.5cm/month
Similar matrix (keratin) to finger and toe nails
Difficult to adulterate specimens
Used to detect post exposure to substances for pre-employment testing (i.e could use for athletes or sportsmen)

Why test hair?

Compliance with medical programs e.g. methadone
Can even test for coffee
Segment analysis: chronic use will be present along the length of hair while one off use only in one place along hair strand

Method of analysis

Ideally take from posterior vertex but can be any hair
Root not needed but needs to be identified as which end is which
Cut as close to scalp as possible
In drug facilitated sexual assault cases only useful when complaint is at least a month old
50 strands required
Hair is decontaminated prior to testing, i.e. washed, dried and powdered in a ball mill
The analysis procedure depends on what is being looked for
Much cheaper if you know what you are looking for eg custody case looking for amphetamines

Summary

Reliable, efficient method for THC detection
Segment analysis useful in establishing use or abstinence over time
Only able to say yes something is present not the amount
Currently developing method for D&A in hair (30drugs)
Viable adjunct to blood and urine testing

Notes taken by Maureen Phillips