An approximation to the identification of contexts, experiences, and profiles of victims of drug-facilitated sexual assaults.

This study advances on overcoming a bias limiting the forensic cases studies of drug-facilitated sexual assaults: a narrow study focus, restricted to assaults affecting young women in leisure contexts related to nightlife, party culture, and dating. A new working framework is applied to analyse data from cases received in the National Institute of Toxicology and Forensic Sciences (Madrid, Spain) over the six years between 2012 and 2017. The work throws light on non-previously described contexts, experiences, and profiles of victims, including domestic cohabitation, labour, education, healthcare, women trafficking, and the daily life of people with intellectual disabilities.

Sumisión química por «burundanga» o escopolamina / Drug facilitated crimes by «burundanga» or scopolamine

Introducción: la burundanga o brebaje con escopolamina ha acaparado gran notoriedad en los casos de sumisión química (SQ). El Hospital Clínico San Carlos (HCSC) dispone de una guía de práctica clínica ante la sospecha de SQ. El análisis toxicológico (AT) se realiza en el Instituto Nacional de Toxicología y Ciencias Forenses (INTCF) de Madrid.Objetivoanalizar los casos de sospecha de SQ en el HCSC con detección de la escopolamina en el AT.Métodosestudio observacional retrospectivo de casos registrados como posible SQ en el HCSC con presencia de la escopolamina identificada en el AT entre marzo de 2015 y marzo de 2021.Resultadosen solo uno de 292 (0,3%) registros en el HCSC se identificó escopolamina (128,2 ng/ml) en la orina mediante técnicas de cromatografía de líquidos acoplada a la espectrometría de masas. Un varón de 34 años fue atendido en urgencias por síntomas anticolinérgicos, refiriendo un delito contra la propiedad.Conclusionesla escopolamina es una sustancia identificada de manera excepcional en casos de sospecha de SQ en el HCSC. (AU)

Introduction: Burundanga or potion with scopolamine is a substance that has gained great notoriety in cases of drug facilitated crimes (DFC). San Carlos Clinical Hospital (SCCH) has a clinical practice guide in suspected DFC. The toxicological analysis (TA) is carried out at the National Institute of Toxicology and Forensic Sciences (INTCF) in Madrid.ObjectiveTo analyze cases of suspicion of DFC due to scopolamine in SCCH.MethodsRetrospective observational study of cases registered as possible SQ in the HCSC with scopolamine identified in the toxicological analysis (TA) between March 2015 and 2021.ResultsIn only 1 of 292 (0.3%) records in the SCCH were identified scopolamine (128,2 ng/ml) in urine using liquid chromatography techniques coupled with mass spectrometry. A 34-year-old man was referred to the emergency room for anticholinergic symptoms, referring to a crime against property.ConclusionsScopolamine is a substance identified in an exceptional way in cases of suspected SQ in SCCH. (AU)

Sospecha de sumisión química en sujetos mayores atendidos en un servicio de urgencias hospitalario / Suspicion of chemical submission in older subjects attending a hospital emergency department

La sumisión química (SQ) es considerada un problema de salud y una forma de violencia. Se distinguen formas de SQ proactiva (consumo involuntario de sustancias psicoactivas) y SQ oportunista (consumo voluntario), con finalidad delictiva o criminal, habitualmente robo, sometimiento o agresiones sexuales. El objetivo de este trabajo es describir las características de los casos de sospecha de SQ en mayores de 65 años atendidos en el Servicio de Urgencias del Hospital Clínico San Carlos y el resultado del análisis toxicológico realizado en el INTCF de Madrid (1 abril 2015-2019). Se registraron 12 (8%) casos de sospecha de SQ de 75 (DE 8) años, 8 (66,7%) hombres, con dos perfiles diferentes, todos asociados a robo y en 3 (25%) posible agresión sexual. En 9 (75%) casos se identificaron benzodiacepinas y/o fármacos habituales. La SQ es un problema a tener en cuenta en urgencias y no es exclusiva de población joven

Chemical Submission (CS) is considered a danger to health and a form of violence. There are different forms of proactive CS (involuntary consumption of psychoactive substances) and opportunistic CS (voluntary consumption), with criminal intent, usually theft, submission, or sexual assault. The objective of this work is to describe the characteristics of cases of suspected CS in adults older than 65 years treated in the Emergency Department of the San Carlos Clinical Hospital and the results of the toxicological analysis performed by the INTCF in Madrid (April 1, 2015-2019). There were 12 (8%) cases of suspected CS, with a mean age of 75 (SD 8) years, of which 8 (66.7%) men, with two different profiles, all associated with theft, and in 3 (25%) possible sexual assault. In 9 (75%) cases, benzodiazepines and / or usual drugs were identified. CS is a problem to consider in Emergency Departments and is not exclusive to the young population

Increasing awareness of the severity of female victimization by opportunistic drug-facilitated sexual assault: A new viewpoint.

The victimization of women by opportunistic drug-facilitated sexual assault in leisure contexts was studied in this work by applying a novel approximation. A multifocal analytical strategy based on an intersectional gender-sensitive approach was used to analyse the evidence coming from both forensic case studies and contextual studies about sexual interrelation and drug use. The process of victimization comprises social changes affecting consumption patterns and sexual interaction, intersecting in the hegemonic recreational nightlife model. However, victims experience a range of situations that make it difficult for them to self-acknowledge themselves as such. Widespread myths about the victimization process add to the social questioning faced by victims, stemming from gender-based double standards which condition the expected female behaviors regarding the use of drugs and sexual interaction. The victims usually experience amnesia, lack of injuries and emotional harm, which make difficult the self-acknowledgement as a victim of sexual assault and the reporting of the episode suffered. Consequently, it is an urgent public health need to implement a new viewpoint about the victimization of women by opportunistic drug-facilitated sexual assault in leisure contexts, able to increase awareness of the severity of this form of sexual violence. Society must recognize the existence of this problem within itself to help victims to acknowledge themselves as such, lodge a complaint and seek adequate help. The lack of this social support feeds the perpetuation of the victimization process, which exacerbates the risk of locking victims into spirals of cyclical re-victimization and favors both the underreporting as well as inadequate coping strategies. In addition to focusing on the need to increase awareness of the severity of female victimization by opportunistic drug-facilitated sexual assault in leisure contexts, other recommendations include the use of the term "take advantage", the development of specific criminal approaches, and the in-depth knowledge of the phenomenon via victimization surveys. These steps are necessary for developing well-targeted and evidence-based preventive measures consistent-with-reality.

An ecological working framework as a new model for understanding and preventing the victimization of women by drug-facilitated sexual assault.

An innovative approach towards the holistic and multidisciplinary study of the victimization of women by drug-facilitated sexual assault has been developed. This phenomenon constitutes a significant problem given the narrowing of the gender gap in drug use over the last few decades and the widespread presence of psychoactive substances worldwide. As violence against women and drug misuse intersect in this phenomenon, this intersectional nature emphasizes the need for a novel approach that enables us to go beyond the studies carried out to date. Consequently, a multidimensional strategy incorporating a gender-sensitive approach has been implemented. The study was aligned with approaches recommended by international authorities concerning sustainable development, thus meeting current global challenges. Furthermore, the study was structured based on an ecological model divided into multiple influence levels and integrating the triangular theory of violence. As a result, a new ecological working framework was built as a multilevel platform useful for understanding and preventing the victimization of women by drug-facilitated sexual assault.

[Suspicion of chemical submission in older subjects attending a hospital emergency department]. / Sospecha de sumisión química en sujetos mayores atendidos en un servicio de urgencias hospitalario.

Chemical Submission (CS) is considered a danger to health and a form of violence. There are different forms of proactive CS (involuntary consumption of psychoactive substances) and opportunistic CS (voluntary consumption), with criminal intent, usually theft, submission, or sexual assault. The objective of this work is to describe the characteristics of cases of suspected CS in adults older than 65 years treated in the Emergency Department of the San Carlos Clinical Hospital and the results of the toxicological analysis performed by the INTCF in Madrid (April 1, 2015-2019). There were 12 (8%) cases of suspected CS, with a mean age of 75 (SD 8) years, of which 8 (66.7%) men, with two different profiles, all associated with theft, and in 3 (25%) possible sexual assault. In 9 (75%) cases, benzodiazepines and / or usual drugs were identified. CS is a problem to consider in Emergency Departments and is not exclusive to the young population.

Intoxicación aguda por nuevas drogas de abuso en probables casos de sumisión química oportunista o mixta y chemsex en pacientes con VIH atendidos en urgencias / Acute intoxication by new recreational drugs in probable cases of opportunistic and/or mixed chemical submission and chemsex in emergency department patients infected with human immunodeficiency virus

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La importancia del factor tiempo en el análisis toxicológico de casos de sospecha de sumisión química en un servicio de urgencias hospitalario / Time to toxicologic analysis: a critical factor in emergency department cases of suspected chemical submission

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Sospecha de sumisión química en urgencias: procedimiento de actuación y análisis toxicológico en una serie de casos / Suspicion of chemical submission in a hospital emergency department: procedures followed and toxicological analyses in a case series

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Identificación de la droga de abuso flakka (a-PVP) como sospecha de sumisión química no probada en Urgencias de un hospital terciario / Identification of the drug of abuse flakka (a-PVP) as suspicion of chemical submission in the Emergency Department of a tertiary hospital

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Sumisión química en casos de presuntos delitos contra la libertad sexual analizados en el Instituto Nacional de Toxicología y Ciencias Forenses (Departamento de Madrid) durante los años 2010, 2011 y 2012 / Alleged drug-facilitated sexual assault cases analyzed at the National Institute of Toxicology and Forensic Science (Madrid Department) during the years 2010, 2011 and 2012

Introducción. La sumisión química en relación con los delitos contra la libertad sexual se puede aplicar tanto a los casos de administración subrepticia de determinadas sustancias, como a los casos oportunistas por una mayor vulnerabilidad de la víctima debido al consumo voluntario de las mismas. Material y métodos. Se ha realizado un estudio descriptivo retrospectivo de los casos de agresiones sexuales relacionados con el consumo de sustancias químicas, remitidos durante los años 2010, 2011 y 2012 al Departamento de Madrid del Instituto Nacional de Toxicología y Ciencias Forenses. Se ha recogido información en relación con el perfil de la víctima, el tipo de muestras biológicas remitidas y los resultados toxicológicos. Resultados. De los 306 casos de agresión o abuso sexual remitidos, 107 han cumplido los criterios de inclusión. El perfil de la víctima es el de una mujer española o latinoamericana joven (edad media: 25,9 años), que admite consumo de alcohol previo al episodio, y que sufre de amnesia total o parcial de los hechos. Las muestras remitidas han sido sangre (27,1%), orina (14%) o ambas (57%). El análisis toxicológico ha sido positivo en el 87,9% de los casos, y las sustancias identificadas han sido etanol (61,7%), fármacos (40,2%, fundamentalmente benzodiacepinas) y drogas ilícitas (27,1%, fundamentalmente cocaína), solas o en combinación. Conclusiones. El estudio refleja la necesidad de trabajar en prevención e información de potenciales víctimas y personal sanitario, que una temprana y adecuada toma de muestras son factores claves a la hora de confirmar el diagnóstico, y que las sustancias detectadas, lícitas e ilícitas, pertenecen a un patrón de consumo frecuente en nuestra sociedad (AU)

Introduction. Drug-facilitated sexual assault crimes can be applied in cases of covert administration of certain substances, as well as cases in which the victim voluntarily consumes these same substances. Materials and methods. This study describes retrospectively cases of sexual assault related to the consumption of chemical substances. They were reported to the Madrid Department of the National Institute of Toxicology and Forensic Sciences during 2010, 2011 and 2012. We collected information related to the victim's profile, the type of biological samples given and the results of the toxicological analysis. Results. Out of 306 cases of sexual assault or abuse referred, 107 have met the inclusion criteria. The victim's profile is of a young Spanish or Latin-American woman (mean age: 25.9 years) who admits to consuming alcohol prior to the episode and suffering from total or partial amnesia with regard to the facts. The given samples were blood (27.1%), urine (14%) or both (57%). Toxicological analysis was positive in 87.9% of cases and the substances identified were ethanol (61.7%), pharmaceuticals (40.2%, mainly benzodiazepines), and illicit drugs (27.1%, primarily cocaine) either alone or in combination. Conclusions. This study reflects the requirement to work in prevention and training of potential victims and healthcare personnel, proves that an early and adequate collection of samples are key factors to confirm the diagnosis and identifies that detected licit or illicit substances belong to a frequent consumption pattern (AU)

[Chemical submission, epidemiology and some clues for the diagnosis]. / Sumisión química: epidemiología y claves para su diagnóstico.

The use of chemical substances to control people is not a new event. Indeed, it has been done for centuries. This practice has recenttly acquired a new dimension because of its association with sexual assaults and other type of crimes. The frequency of the association of the use of chemical substances with sexual assaults is behind the term SQ (drug facilitated sexual assauit). The Spaniish term foir this practice, Sumisión Química, comes from the French one, Soumissión Chimique, and has a wide meaning. In this review, the epidemiology of SQ is revised and an analysis of its main involved elements, namely the chemical, the victim and the assailant, is done. Chief clinical signs and clues for the toxicological doiagnosis are also appproached.

Sumisión química: epidemiología y claves para su diagnóstico / Chemical submission, epidemiology and some clues for the diagnosis

El uso de sustancias químicas con el fin de manipular la voluntadde las personas no es reciente, pero en los últimos años ha cobradoun mayor protagonismo por su asociación con agresiones sexuales,robos y otras prácticas delictivas. Precisamente la frecuencia conque se asocia a los delitos sexuales le ha valido el acrónimo anglosajónde DFSA (drug facilitated sexual assault). El término «sumisiónquímica», acuñado recientemente en nuestro idioma, derivadel francés «soumission chimique» e incluye todas las figuras delictivasasociadas a esta práctica. En este trabajo se revisa la epidemiologíade este tipo de cuadros y se hace un análisis de las principalescaracterísticas de las sustancias químicas empleadas, lavíctima y el agresor. Se abordan además los principales signos desospecha diagnóstica y las claves para el diagnóstico toxicológico,en caso de que ésta exista

The use of chemical substances to control people is not a new event.Indeed, it has been done for centuries. This practice has recenttly acquireda new dimension because of its association with sexual assaultsand other type of crimes. The frequency of the association ofthe use of chemical substances with sexual assaults is behind theterm SQ (drug facilitated sexual assauit). The Spaniish term foir thispractice, Sumisión Química, comes from the French one, SoumissiónChimique, and has a wide meaning. In this review, the epidemiologyof SQ is revised and an analysis of its main involved elements, namelythe chemical, the victim and the assailant, is done. Chief clinicalsigns and clues for the toxicological doiagnosis are also appproached

Drogas y teratogenia / Drug of abuse and teratogenicity

Las drogas más usadas en el embarazo siguen siendo el tabaco y el alcohol, dentro de las legales, y el cannabis, seguido de la cocaína dentro de las ilegales. Aunque se ha asociado el consumo de drogas con un amplio abanico de malformaciones estructurales, las drogas de abuso tienen un escaso potencial teratogénico, entendido en el sentido estricto de malformación física, con la excepción del alcohol, que se asocia al síndrome alcohol fetal. Sin embargo, sí se está encontrando asociación entre la exposición prenatal a las drogas de abuso y alteraciones específicas del comportamiento, habitualmente muy sutiles, pero que no deben pasar desapercibidas, y que entran en el concepto actual de teratogénesis. La exposición intraútero a las drogas es un factor de riesgo para la gestación, con frecuencia asociado a otros factores de riesgo concomitantes, como la desnutrición, las enfermedades maternas y la pobreza, y cuyos efectos se solapan, se potencian y se confunden con frecuencia. En este trabajo se abordan de modo resumido los aspectos generales que regulan la teratogénesis (factores que determinan que una determinada exposición pueda ser considerada o no de riesgo, el papel de la placenta, etc), la epidemiología del consumo de drogas durante el embarazo y los factores que dificultan el estudio de estos efectos para estas sustancias. También se hace un análisis de los principales efectos teratogénicos relacionados con las drogas

The problem of the malformed children has concerned the humanity for ever, and this also includes the prenatal exposure to drugs of abuse. Tobacco and alcohol are the most common legal drugs used in pregnancy, and cannabis and cocaine, the most common illegal drugs. The use of drugs has been associated with a wide range of structural malformations, but with the exception of the alcohol and the fetal alcohol syndrome, drugs of abuse seem to have a weak teratogenic potential, in the classical structural malformation conception. Nevertheless, there has been found association between the prenatal exposure to these drugs and specific behavioural alterations, usually very subtle but that should not be ignored. This kind of alterations are now included in the conception of teratogenesis. So, drug use during pregnancy is a risk factor, usually associated to other concomitant risk factors like nutrition deficits, maternal illness and poverty, and these effects are overlapped, potentiated and very often confounded. In this review the main variables involved in the development of teratogenesis (factors that should be take into account in a specific exposition to evaluate the potential risk, the roll of the placenta, etc) are analysed. The epidemiology of the drug abuse in pregnancy and the concomitant factors that make difficult this evaluation are also studied. Finally a review of the main teratogenic effects related to the most common abused drugs was done