Electronic letters to:

Research:
Janice Du Mont, Sheila Macdonald, Nomi Rotbard, Eriola Asllani, Deidre Bainbridge, and Marsha M. Cohen
Factors associated with suspected drug-facilitated sexual assault
CMAJ 2009; 180: 513-519 [Abstract] [Full text] [PDF]
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Electronic letters published:

[Read eLetter] response to Factors associated with suspected drug-facilitated sexual assault
Mark Little   (15 September 2009)
[Read eLetter] “CONTROLL ‘DRUGS’ NOT THE DRUGGING”
ABDUL MAJID WANI   (26 March 2009)
[Read eLetter] Suspected Science
Ronald M. Figurski   (13 March 2009)

response to Factors associated with suspected drug-facilitated sexual assault 15 September 2009
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Mark Little

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Re: response to Factors associated with suspected drug-facilitated sexual assault

mark.little{at}health.wa.gov.au Mark Little

I read with interest the report by Du Mont and colleagues suggesting that 20.9% of women in their study had suspected drug facilitated sexual assault, based on histories given to the researchers (1).

Recently we published our experience of a prospective study of 101 patients who presented to emergency departments believing their drinks had been covertly “spiked’(2). Our findings are rather different to that of Du Mont’s paper (1). We performed sophisticated blood and urine testing on samples taken within 4,5 hrs of onset of symptoms (median). Like Du Mont’s study, 88% of our group were female, with a median age of 23 years. Patients estimated they had consumed a mean number of standard alcoholic drinks as 7.7 +/- 3.9 with the mean blood alcohol concentration being 0.096% on presentation. Twenty eight percent had consumed illicit drugs. We only found 9 plausible cases of drink spiking, and did not identify one case where a sedative drug had been placed in a drink in a pub or nightclub. If drink spiking was to occur, alcohol was the likely agent.

Our study suggested that drink spiking occurs but rarely, however there is a significant issue with illicit drug use and binge drinking of alcohol in our younger population. When people consume alcohol and/or illicit drugs, it makes it much harder for these people to recall what has happened, makes them more vulnerable and at risk of harm.

Yours faithfully

Dr Mark Little MBBS FACEM MPH&TM DTM&H IDHA Emergency Physician and Clinical Toxicologist Mark.little@health.wa.gov.au

References

1. Du Mont J, Macdonald S, Rotbard N et al. Factors associated with suspected drug-facilitated sexual assault. CMAJ 2009;180:513-519.

2. Quigley P, Lynch D, Little M et al. Prospective study of 101 patients with suspected drinking spiking. Emerg Med Australis 2009;21: 222 -228.

Conflict of Interest:

None declared
“CONTROLL ‘DRUGS’ NOT THE DRUGGING” 26 March 2009
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ABDUL MAJID WANI
Consultant Medicine.Hera General Hospital,Makkah, 21955,SAUDI ARABIA

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Re: “CONTROLL ‘DRUGS’ NOT THE DRUGGING”

dr_wani_majid{at}yahoo.co.in ABDUL MAJID WANI

Dear editor, we have gone through the interesting commentary and the research article related to drug use and sexual assualt. Illicit drug use is a global problem and people use these drugs as per availablity and cost is not a issue, neither religion,geographical location, sex,social status and culture(1-3).Alcohol use or other ilicit drug use is a gift of scientific discovery to mainkind as are the nuclear warheads.We did not learn lessons from the devastating destruction of Japanese cities by nuclear bombs and are still perpetuating the spread of these weapons by either not solving the global disputes or by induldging in issues of energy and wealth gain.Imbalance of power and human greed are the problems inherent in human culture. Spread of drug culture has been a historic problem and the European plant Papaver somniferum (Opium Poppy) has travelled throughout the globe (4) along with emperrors and traders .Cultivation of opium and cocaine has become the source of livlihood for millions of people due to nonavailablity of alternative sources of earning.Wastage of billions of dollars on control of illicit drug use and trade could easily be channelised to these areas of cultivation and thus breaking the vicious cycle of production, use and its consequences which are infront of us. Banners and posters in universities, state control, legal action and legislation and other individual state efforts will prove futile unless we address the core issues of cultivation, cause of cultivation and industrial scale production as a “global issue “like “climate change” for which again none but human being is responsible.All this will need political will which must start from where the journey of opium plant started and where the power-base of world lies.Drugging and sexual assault is just one of the crimes related to drugs, murders, gang killing, transmission of infections like HIV, Hepatitis B and C ,alcohol related road traffic accidents and mortalities,ecstaccy and its consequences are few others to mention due to ‘ wonderful drugs’.

COAUTHORS; 1.DR WALEED MOHD HUSSAIN 2. DR MOHAMED I FATANI; 3.DR AHMED IMAM;

1. Drugs and poverty: A literature review File Format: PDF/Adobe Acrobat - View as HTML June 2006 to explore the links between drugs and poverty. ..... disadvantaged areas may experience greater exposure to illicit drugs and drug dealers, ... www.sdf.org.uk/sdf/files/Drugs%20and%20Poverty%20Literature%20Review%2006.0... -

2. BBC - GCSE Bitesize - Islam: drugs Most religious teachings have something to say about using drugs. Facts about drugs. All drugs are classed as either legal or illegal (illicit). ... www.bbc.co.uk/schools/gcsebitesize/rs/sanctity/isdrugsrev1.shtml - 22k

3. Islam Online- Health & Science Section Thousands of young men have wasted their lives because of illicit drugs in ... Islam, it is estimated that the country has around 4 million illicit drug ... www.islamonline.net/english/science/2003/09/article04.shtml

4.Geopium, Geography and Opium, Geopolitics of Drugs - Géographie et ... - [ Translate this page ] Geopolitics and geography of poppy cultivation and opium and heroin production in Asia - Géopolitique et géographie de la cutlure du pavot et de la ... www.geopium.org/ - 75k

Conflict of Interest:

None declared
Suspected Science 13 March 2009
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Ronald M. Figurski

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figurski{at}telus.net Ronald M. Figurski

I read with interest "Factors associated with suspected drug- facilitated sexual assault" but was disappointed with the lack of objective analysis. Drug facilitated assault was defined as cases in which "the person reported a suspicion of having been drugged in combination with at least on of the 16 associated symptoms, gave a valid reason for believing that a sexual assault had occured and presented withing about 72 hours". Your conclusions therefor are valid only in characterizing that population (those who suspect they have been drugged). You did not report if any victims actually had a positive screen for a drug not knowingly self-ingested. You conclude that "Providing access to hospital-based toxicologic screening services with the sensitivity to detect "date rape drugs" would help to meet the needs of victims of drug facilitated sexual assault". This implies your study population did not get sensitive drug screens. Was this the case?

I am an emergency physician in a small town with limited lab services, but cannot imagine failing to obtain a drug screen on someone believing themself a victim of date rape poisoning. I have ordered dozens of such screens and have yet to see a positive result. Discussions with other emergency physicians reveal similar experience. I have no doubt such instances occur, but beleive them to be exceedingly rare (but would be interested in the incidence for your study population).

The lay press has picked up on the story, including the generalized conclusions. Google the key words and you will find numerous press articles quoting this studies conclusion that 20% of sexual assault are drug facilitated (rather than the apt conclusion that 20% of sexual assault victims suspect they have been drugged). This misinformation contributes to a culture of fear and directs attention away from more productive avenues of public awareness and policy, ensuring more victims.

Conflict of Interest:

None declared