Sexual assault and date rape drugs, how to find biological traces of psychoactive substances

From the rape drug, with its emblematic term, we come to the many substances defined as psychoactive. The list of active ingredients that can be used in the case of sexual violence is so long that the National Centre for Addiction and Doping of the Istituto Superiore di Sanità has lined up no less than 79 of them circulating in Italy. They range from sedatives and narcotics such as GBL and GHB, to opiates, stimulants, cannabinoids and hallucinogens: these various compounds can in fact be used to promote violence. The laboratory is a key step in the identification of these substances, as the experts present in Florence at the National Congress of the SIBioC (Italian Society of Clinical Biochemistry and Molecular Biology - Laboratory Medicine) noted.

The National Centre for Addiction and Doping of the Istituto Superiore di Sanità in fact regularly shares new evidence in the field of toxicology with the analysis laboratories. And for experts there is also a document indicating how to behave for the proper conduct of examinations on victims and operational procedures for the determination of substances of abuse in matrices and biologicals in cases of victims of drug-related violence, published in September by the Clinical, Forensic and Doping Toxicology Study Group of the SIBioC itself.

Somehow, the action of the various substances used in violence leads to a depression of the central nervous system resulting in a decrease in inhibition, changes in the state of consciousness, sedation and amnesia. So victims unfortunately find themselves delaying reporting the event and searching for 'traces' of the presence of the compounds used in biological fluids such as blood or urine. But the laboratory can make a difference, also thanks to scientific developments. "The new psychoactive substances used in sexual violence are often the same as those circulating for recreational use, so to speak,' reports Paolo Bucchioni, SIBioC's Clinical, Forensic and Doping Toxicology Study Group. 'Thanks to new technologies, which are more sensitive than in the past, we can identify with certainty the molecules used, even the newest ones, and thus be of help to victims even in legal proceedings. Taking charge takes place with the arrival of the person in the emergency room and the start of the Code Pink protocol, dedicated to victims of violence. 'The first samples taken are blood and urine, which give different results based on when the substance was taken: blood makes it possible to identify what was taken in the previous few hours and urine allows a somewhat broader analysis over time,' the expert points out. It is important to sensitise the victim, informing him or her that in the 30-45 days following the episode of violence he or she can have a keratin matrix (the hair) taken, as this biological matrix can help detect the presence of a narcotic or psychotropic substance even days later'.

Again according to Bucchioni, it is crucial that the person is warned not to carry out any cosmetic treatment before the sample is taken, as this could affect the outcome. 'Not only can these analyses allow substances to be detected at different times of intake, thanks to the different properties of the three matrices, but they can also be analysed at another laboratory if the facility that collected the samples is not equipped with the necessary technology,' comments Bucchioni. This procedure is justified by the fact that, in this context, the priority is to ensure the accuracy and reliability of the analytical data, rather than the rapidity of the outcome, as is the case with analyses carried out for clinical purposes or in diagnostic emergencies'. In this sense, it must be said that the distribution of specialised centres across the territory must be made homogeneous. 'Some regions have several centres, others do not even have one,' continues Bucchioni. 'Their presence is instead essential to make the laboratory data certain and sustainable from a medico-legal point of view and to harmonise the procedures to be implemented nationwide. Faced with episodes of physical violence, it is very important that the medical intervention in an emergency takes into account both the clinical aspects and the subsequent medico-legal implications, and therefore it is necessary that samples are collected and processed carefully to avoid contamination and degradation. To make the system more sustainable, we would need at least one centre per region, with the most innovative technologies and specially trained staff: this is one of the suggestions we have included in the recently published document'.