Covert administration of drugs in drug facilitated sexual assault: A prospective observational study from Oslo, Norway

Objective To identify drugs in blood and urine samples from victims of sexual assault suspecting exposure to covert administration of drugs, and compare with substances reported taken by the victim. Methods We analyzed forensic blood and urine samples from patients 16 years or older presenting at the Oslo Sexual Assault Centre, Norway, suspecting exposure to covert administration of drugs in relation to the sexual assault. We recorded psychoactive substances reported taken before suspected exposure. Blood samples were analyzed for 64 drugs using ultra-high performance liquid chromatography – tandem mass spectrometry (UHPLC-MS/MS) and an automated enzymatic method for ethanol. Urine samples were analyzed for 39 drugs using liquid chromatography – tandem mass spectrometry (LC-MS/MS), and an additional nine drugs using immunoassay methods. Results We included 50 patients, median age 23 years, 49 were women. Median time from suspected exposure to toxicological sampling was 22 h. Drugs not reported taken were found in 17 (34%) patients, combined with drugs reported taken in nine. In 15 patients we only found drugs reported taken. Unreported drugs found in blood were cocaine in three patients, alprazolam in two, methylenedioxymethamphetamine/methylenedioxyamphetamine (MDMA/MDA) in two, tetrahydrocannabinol (THC) in one, and amphetamine in one. Unreported drugs found in urine were cocaine in eleven patients, MDMA/MDA in three, alprazolam in two, codeine in two, cannabis in one, oxazepam in one, amphetamine in one, and zolpidem in one. Gammahydroxybutyrate (GHB) was not detected in either matrix. Conclusion Unreported drugs were found in 34% of sexual assault victims suspecting covert administration of drugs.