Hagemann Cecilie T, Helland Arne, Spigset Olav, Espnes Ketil A, Ormstad Kari, Schei Berit
Department of Public Health and General Practice, Norwegian University of Science and Technology, P.O. Box 8905, N-7491 Trondheim, Norway.
J Forensic Leg Med. 2013 Aug;20(6):777-84. doi: 10.1016/j.jflm.2013.05.005. Epub 2013 Jun 25.
The purpose of the study was to describe toxicological findings among women seeking health care after sexual assault, and to assess the relationship with so-called proactive DFSA (drug facilitated sexual assault). We also explored associations between ethanol in blood/urine and background data, assault characteristics, and clinical findings. We conducted a retrospective, descriptive study of female patients ≥ 12 years of age consulting the Sexual Assault Center at St. Olavs University Hospital, Trondheim, Norway. They were examined between July 1, 2003 and December 31, 2010, and urine and/or blood were analyzed for ethanol and selected medicinal/recreational drugs. Among the 264 patients included, ethanol and/or drugs were detected in 155 (59%). Of the 50 patients (19%) testing positive for drugs other than ethanol, benzodiazepines/benzodiazepine-like drugs were found in 31, central stimulants in 14, cannabinoids in 13 and opioids in nine. None tested positive for gamma-hydroxybutyrate (GHB). In total, 57 patients (22%) suspected proactive DFSA, but only five had findings of sedative drugs that were not accounted for by self-reported voluntary intake. No cases could unequivocally be attributed to proactive DFSA. Among the 120 patients tested for ethanol within 12 h after the assault, 102 were positive. The median estimated blood alcohol concentration (BAC) at the time of assault was 1.87 g/L. Patients testing positive for ethanol more often reported a public place of assault and a stranger assailant. Higher estimated BAC at the time of assault was associated with higher frequency of suspecting proactive DFSA. Ethanol was the most prevalent toxicological finding in urine/blood from victims of sexual assault, and high ethanol concentrations were often detected. Among the patients suspecting proactive DFSA, very few had sedative drug findings not explained by voluntary intake. It seems like opportunistic DFSA, rather than proactive DFSA dominate among the sexually assaulted attending our SAC.
该研究的目的是描述遭受性侵犯后寻求医疗保健的女性的毒理学发现，并评估与所谓的主动型药物辅助性侵犯（DFSA）之间的关系。我们还探讨了血液/尿液中的乙醇与背景数据、侵犯特征和临床发现之间的关联。我们对挪威特隆赫姆市圣奥拉夫大学医院性侵犯中心咨询的12岁及以上女性患者进行了一项回顾性描述性研究。她们在2003年7月1日至2010年12月31日期间接受了检查，并对尿液和/或血液进行了乙醇及选定的药用/消遣性药物分析。在纳入的264名患者中，155名（59%）检测出乙醇和/或药物。在50名（19%）除乙醇外药物检测呈阳性的患者中，31名发现苯二氮䓬类/苯二氮䓬样药物，14名发现中枢兴奋剂，13名发现大麻素，9名发现阿片类药物。无人检测出γ-羟基丁酸（GHB）呈阳性。共有57名患者（22%）怀疑是主动型DFSA，但只有5名患者发现了镇静药物，且这些药物并非自我报告的自愿摄入所致。没有病例能明确归因于主动型DFSA。在袭击后12小时内接受乙醇检测的120名患者中，102名呈阳性。袭击时估计的血液酒精浓度（BAC）中位数为1.87 g/L。乙醇检测呈阳性的患者更常报告袭击发生在公共场所且袭击者为陌生人。袭击时估计的BAC较高与怀疑主动型DFSA的频率较高有关。乙醇是性侵犯受害者尿液/血液中最常见的毒理学发现，且经常检测到高浓度乙醇。在怀疑主动型DFSA的患者中，很少有镇静药物发现无法用自愿摄入来解释。在我们性侵犯中心就诊的性侵犯者中，似乎机会主义型DFSA而非主动型DFSA占主导。
