Drug-facilitated Crimes Research Articles

Drug‐facilitated sexual crime by use of ketamine and diazepam by a gynaecologist

Drug facilitated crimes (DFCs) can be defined as criminal acts carried out by means of administering a substance to a person with the intention of impairing behaviour, perceptions, or decision-making capacity. It also extends to taking advantage of an impaired person after voluntary intake of an incapacitating substance. Crimes include robbery, money extortion, and maltreatment of the elderly, children, or mentally ill patients. Rape or other types of sexual assault are referred to as drug facilitated sexual assault (DFSA). In DFSA cases, the victim is subjected to a sexual act without legal consent as a result of the pharmacological effects of alcohol and/or drug(s). A large number of psychoactive substances have the potential to alter the victim’s state of mind, alcohol being the number one candidate because of its widespread use. Illicit drugs, psychoactive prescription drugs and even over-the-counter medicines are also likely candidates, either consumed alone or in combination with alcohol. The resulting pharmacological effects may include relaxation, euphoria, and lack of inhibition on the one hand and drowsiness, loss of motor function, unconsciousness, and amnesia on the other hand. Information on the frequency of DFC cases is scarce but there has been a significant increase in reports worldwide. However, several factors complicate the registration of the actual number of DFSA cases. Governmental statistics show a general underreporting of sexual assault crimes. The impact that central nervous system depressant drugs have on memory and consciousness might lead to a situation where the victim is not able to remember what has actually happened and chooses not to report the incident. If the incident is reported, police officers often assume that the victim was simply drunk rather than drugged. If an investigation is initiated, the delay between the collection of biological evidence and the alleged assault can be between several hours and more than a day. This case report describes a DFSA case in a medical setting: a gynaecologist was suspected of assaulting a young patient after drug administration. In the presented case, the time delay between the alleged assault and the sampling was 30 h. Evidence collection via a standardized sampling kit and the choice of sample in such cases is discussed. The analytical strategy is described with regard to the choice of methods, uncertainty measurement, and limitations of the methods which are important during interpretation of the analytical results. Finally, interpretation of this specific case, but also interpretation issues of DFSA cases in general, is discussed.

Segmental Hair Analysis after a Single Dose of Zolpidem: Comparison with a Previous Study

Hair is a useful aid and sometimes even the only matrix in the analytical strategy in drug-facilitated crime (DFC) investigations. In this novel study, segmental hair analysis was performed after a single 10 mg dose of zolpidem was given to 20 Chinese volunteers. Hair was collected 1 month after administration and was analyzed using ultra-high-pressure liquid chromatography/electrospray ionization tandem mass spectrometry. Zolpidem concentrations were found to be in the range of 135.0-554.6 pg/mg in the proximal 0-2 cm segments. These results were markedly different from those reported by Villain et al., who used volunteers administered equal doses of zolpidem. The analytical method used, as well as the volunteers' hair color, inter-individual variations such as metabolic capacity, hair growth rate, drug incorporation rates, physical state of the hair, age, gender, body weight, etc. and diffusion from sweat or other secretions are all factors that should be considered when interpreting the DFC results.

Substance use and victimization in violent assaults

The aim of this work was to examine the role of substance use as factor which increase risk of assault. A review of the some of the most important international literature about drug-facilitated crimes is presented here. The whole part of the papers shows a relationship between substance use and risk increase of assault, particularly in family violence and rape. The effects of psychotropic substances use depend on the user's emotional state and on drugs use expectations. This prospective shows that we need to be cautious in interpreting processes of linear causality between abusive behaviour, processes of victimisation, abuses and abnormal sexual behaviours, which are related to the patient's desires, enhanced and validated by drugs.

Illegal Use of Benzodiazepines and/or Zolpidem Proved by Hair Analysis

The abuse and misuse of benzodiazepines and zolpidem are widespread internationally. Their illegal distribution has raised their abuse to a serious level, and they are often misused in crimes. In the present study, 18 cases involving the illegal use of benzodiazepines and/or zolpidem were proved by hair analysis. The drugs were extracted from the hair samples using methanol and analyzed using LC-MS/MS. The cases were classified according to case history: five of illegal use in medical staff, eight through inappropriate or illegal distribution, and five related to drug-facilitated crimes. Among the 18 cases, zolpidem was identified in eight, alprazolam in seven, diazepam in six, and clonazepam in four. The drug concentrations ranged from <LOQ to 6.47ng/mg. Due to the ready supply and potential for criminal misuse of these drugs, programs for prescription drug monitoring and supervision of those handling these drugs are both recommended.

A rapid and accurate UPLC/MS/MS method for the simultaneous determination of zolpidem and its main metabolites in biological fluids and its application in a forensic context

Zolpidem (ZPD) is an imidazopyridine derivative used as a new type of hypnotic and is commonly used in drug-facilitated crimes. A rapid, sensitive, and specific ultra-performance liquid chromatography–tandem mass spectrometry (UPLC/MS/MS) assay method for the simultaneous determination of zolpidem and its main metabolites zolpidem 6-carboxylic acid (ZCA) and zolpidem phenyl-4-carboxylic acid (ZPCA) in biological fluids was developed and validated. Aliquots of 0.1mL blood or urine specimens were used for the analysis, and zolpidem and its metabolites were extracted in a single step using acetonitrile (containing 0.1% formic acid) precipitation. The supernatant was then dried, and 100μL methanol was added. The separation was performed on an Acquity™ UPLC HSS T3 (100mm×2.1mm, 1.8μm) analytical column by API 4000Q ultra-performance liquid chromatography–tandem mass spectrometry. Positive ionisation tandem MS detection in the multiple reaction monitoring (MRM) mode was used. The mobile phases consisted of either acetonitrile or water containing 20mmol/L ammonium acetate and 0.1% formic acid, and the flow rate was 0.5mL/min. The chromatographic separation time was 4min, and calibration curves for human blood were generated over the range of 0.1–300ng/mL for ZPD, 0.1–500ng/mL for ZPCA and 0.1–200ng/mL for ZCA. For urine, the linear range was 0.1–600ng/mL for ZPD and ZPCA, and 0.1–300ng/mL for ZCA. The limit of detection was 0.05ng/mL and the limit of quantitation was 0.1ng/mL for ZPD, ZCA and ZPCA. The linear correlation coefficients were greater than 0.9995. Both the inter-day and intra-day precisions were less than 15%, the recoveries were in the range of 70.0–98.3%, the matrix effects were approximately 79.5–99.0%, and the process efficiency was between 60.7% and 94.4%. This method allowed for the determination of zolpidem and its metabolites in human blood and urine and may be applied to forensic toxicological analyses.

Hair analysis for doxylamine

Doxylamine is one of the first effective antihistamine agents to have been discovered. The compound is also used as a sedative night-time cold and allergy relief drug and for its antiemetic effects. The first case involving sedation linked to the use of doxylamine as a drug-facilitated crime and subsequent impairment of a 21-year-old female victim is reported. Due to the long delay between the alleged crime and clinical examination, collection of blood or urine was of little value. Hence, the laboratory developed an original approach based on hair testing by liquid chromatography–tandem mass spectrometry. A lock of hair from the victim was collected 5 weeks after the suspected administration. After cutting into small pieces, about 20 mg of hair was incubated overnight in a phosphate buffer (pH 8.4). The aqueous phase was extracted with 5 ml of a mixture of methylene chloride/diethyl ether (80/20), in presence of haloperidol-d4, used as internal standard (IS). The hair extract was separated on an XTerra MS C18 column using a gradient of acetonitrile and formate buffer. Detection was based on two daughter ions: transitions m/z 271.3–182.1 and 167.0 and m/z 380.2–169.2 for doxylamine and the IS, respectively. In the hair of the woman, doxylamine was detected in the proximal segment (0–3 cm) at a concentration of 37 pg/mg. The concentration was compared with those obtained after a single dose and after daily dose administration. In the hair of four subjects receiving a single 15-mg dose and collected 4 weeks later, doxylamine was detected in the proximal segment at 18–52 pg/mg. After daily 15-mg doses for at least 4 months, the hair concentrations of three subjects under doxylamine therapy were 840–2050 pg/mg.

Methods For The Analysis of Nonbenzodiazepine Hypnotic Drugs in Biological Matrices

Zopiclone, zolpidem and zaleplon (Z-drugs) are nonbenzodiazepine hypnotic drugs that are used for the treatment of insomnia. These drugs were developed with the intent to overcome some disadvantages of benzodiazepines, such as dependence and next day sedation. In general, the nonbenzodiazepine hypnotic drugs are administered in oral doses daily and are widely biotransformed in the body. A large number of analytical methods based on chromatographic and electrophoretic techniques for the quantification of Z-drugs and their metabolites in biological matrices have been reported. In this review, the bioanalytical methods for Z-drugs were reviewed with the focus placed on sample preparation procedures and the separation techniques used. Furthermore, as these drugs are also reported as drugs of abuse or in drug-facilitated crime, screening methods that simultaneously cover these drugs and also other drugs of abuse were included in this review.

Exploiting adsorption and desorption at solid–liquid interface for the fluorometric monitoring of glibenclamide in adulterated drinks

Nowadays, the use of a drug to modify a person's behavior with criminal intentions has become a growing public concern. In fact, stealthy drink spiking with certain drugs can cause the incapacitation of a potential victim of assault and in extreme cases can even lead to death. Belonging to the group of drugs used to commit drug-facilitated crimes is glibenclamide, which not only exhibits high sedation secondary effects but when subject to an overdose intake can lead to intense hypoglycemic episodes that could end with death. Suicide attempts and homicides through overdose with glibenclamide have already been reported.In this work and for the first time, it was developed a new methodology for detection of glibenclamide in spiked liquid samples (teas) by fluorometry (λex=300nm; λem=404nm). The novel methodology was also implemented in a miniaturized and portable automatic flow system based in the concept of multipumping with an in-line pre-separation unit. The separation of the drug from the liquid samples was achieved through adsorption of the drug into activated charcoal packed within a mini column followed by elution with a solution composed by ethanol, hydrochloric acid and the surfactant CTAB (70%, 1.0molL−1, 0.01molL−1, respectively). The results allowed to obtain a linear working range for glibenclamide concentrations of up to 50mgL−1 (r=0.9999) and the detection limit was about 0.81mgL−1 of glibenclamide.

Value of the concept of minimal detectable dosage in human hair

The influence on drug incorporation of melanin affinity, lipophilicity, and membrane permeability is of paramount importance. Despite their high lipophilicity, some drugs have quite low incorporation rate into hair, suggesting that the higher incorporation rates of basic drugs (cocaine, amphetamines.) than neutral (steroids, benzodiazepines, cannabinoids…) or acidic ones are strongly related to the penetrating ability of the drug to break through the membrane based on the pH gradient between blood and the acidic hair matrix. When using hair analysis as a matrix during investigative analysis, e.g. workplace drug testing, doping, driving under the influence, drug-facilitated crime, the question of importance is to know whether the analytical procedure was sensitive enough to identify traces of drugs; this is particularly important when the urine sample(s) of the subject was positive and the hair sample(s) was negative. It has been accepted in the forensic community that a negative hair result cannot exclude the administration of a particular drug, or one of its precursors and the negative findings should not overrule a positive urine result. Nevertheless, the negative hair findings can, on occasion, cast doubt on the positive urine analysis, resulting in substantial legal debate and various consequences for the subject. The concept of minimal detectable dosage in hair is of interest to document the negative findings, but limited data is currently available in the scientific literature. Such data includes cocaine, codeine, ketamine, some benzodiazepines and some unusual compounds. Until laboratories will have sensitive enough methodologies to detect a single use of drug, care should be taken to compare urine and hair findings.

Hair analysis of drugs involved in drug-facilitated sexual assault and detection of zolpidem in a suspected case

In drug-facilitated crimes, victims are subjected to nonconsensual acts while they are incapacitated by the effects of a drug. A specific LC-MS/MS protocol for determining benzodiazepines and hypnotics at low concentration in hair specimens was developed and validated in order to target the allegedly administered drugs on a chronological basis. In the case hereby reported, a 26-year-old woman claimed to have been sexually assaulted after being administered an allegedly drugged coffee, but toxicological analysis of urine and blood provided no evidence of any drug intake. Subsequently, a second woman accused the same man of sexual abuse. Hence, the suspect was prosecuted. Specimens were collected from four subjects (two alleged victims, the suspect and his wife) and segmental hair analysis was performed. The results revealed that zolpidem was present at low picogram per milligram concentration in three out of eleven segments of hair specimen obtained from the first of the alleged victims, offering plain evidence of single or sporadic exposure, whereas the agent was detected in the high picogram per milligram range in the hair collected from suspect's wife, coherently with therapeutic administration. The presence of interfering signals typical of the keratin-containing matrix was found and possible hair degradation by cosmetic treatments was investigated by electron microscopy, so as to obtain a judicious interpretation of the analytical findings.

Disposition of ketamine and norketamine in hair after a single dose

As a rapid-acting dissociative anesthetic, ketamine has been used in drug-facilitated crimes. The aim of this study is to investigate the disposition of ketamine and its main metabolite norketamine in hair after a single dose of ketamine. Four healthy volunteers were recruited into the study. Hair was collected 1, 2, 3, 4, 8, 12 and 16weeks after a single oral dose of ketamine solution (10mg) and analyzed by liquid chromatography/electrospray ionization tandem mass spectrometry. The wet cotton swab wiped the scalp of the subjects at 1h, 24h, 48h and 1week after administration. Maximum hair concentrations (C (max)) for ketamine and norketamine were 19.0 ± 6.5 and 18.7 ± 13.3pg/mg, respectively. Except for the first week, the ratio of ketamine to norketamine in most of segments (87.5%) was greater than 1. All the cotton swab samples collected at 24 and 48h were positive. The results from cotton swabs and the concentrations of ketamine and norketamine in hair segments collected at different times showed that some of ketamine and norketamine incorporated into hair originated from sweat and sebum on the scalp of the subjects.

Segmental hair analysis using liquid chromatography–tandem mass spectrometry after a single dose of benzodiazepines

In China, benzodiazepines are the most frequently observed compounds in cases of drug-facilitated crime. Sensitive, specific, and reproducible methods for the quantitative determination of 18 benzodiazepines in hair have been developed using LC–MS/MS. Fourteen volunteers had ingested a single 1–6 mg estazolam tablet. Hair was collected 1 month after administration. All the proximal segments were positive for estazolam. With increased dosage, estazolam can be detected in the 2–4 cm segments in some subject's hair. Even some of 4–6 cm segments were positive. Hair analysis was applied to two authentic criminal cases. Full-length hair samples collected 5 weeks after the offense were cut into segments of 2 cm from the root, analyzed and quantified. The clonazepam concentrations measured in the first two segments for V#1 and V#2 were 15.47 and 11.93 pg/mg, respectively. However, both the 4–6 cm and the 6–8 cm segment of V1# remained positive, while those of V#2 were negative. It needs more substantial guidelines to use segmental hair analysis in drug-facilitated crime.

Gamma-Hydroxybutyrate in Urine and Serum: Additional Data Supporting Current Cut-Off Recommendations

Besides the use of Gamma-Hydroxybutyrate (GHB) as a recreational drug, use of GHB as an agent in drug-facilitated crime should also be considered. In these cases, there is often a delay of several hours from the incident to collection of the samples. As GHB has a very short plasma half-life, the window of detection is small and in the majority of these specimens, levels of GHB are low. Because GHB is naturally occurring in humans, discrimination between endogenous and exogenous GHB is complicated, particularly in those samples with low concentrations. In this study, endogenous GHB levels of 50 serum and 50 urine samples were determined by GC-MS after conversion to trimethyl-silyl-derivatives. Concentrations in serum ranged from 0.62 to 3.24 mg/L (mean = 1.14 mg/L; median = 0.97 mg/L) and from 0.64 to 4.20 mg/L (mean = 1.21 mg/L; median = 0.96 mg/L) in urine. Based on this substantial data, the current suggested lower cut-off of 4 mg/L in ante mortem serum samples could be confirmed. For urine, we propose the lower cut-off of 6 mg/L instead of 10 mg/L to avoid false negative interpretation.

A tendency for re-offending in drug-facilitated crime

The authors present 3 cases that demonstrate a return to DFC following periods of inactivity. The offences occurred in Paris and its suburbs and in each of the cases there were two distinct periods of activity by the offenders with 2, 8 and 22 victims attributed to each of the perpetrators. To 20 mg of decontaminated and cut hair, 100 pg/mg of clonazepam-d4 was added as internal standard. Hair specimens were extracted with CH 2Cl 2/ether after incubation overnight at 56 °C in pH 7.6 buffer. Extractions were performed on blood and urine using Toxi-tube A ® with 5 ng/mL of clonazepam-d4. The residues were analyzed by LC–ESI-MS/MS. Calibration curves in blood and urine (0.5–500 ng/mL) were prepared by spiking aliquots of blank fluids ( r 2 > 0.9816 for all drugs). LOD in body fluids ranged 0.5–10 ng/mL. Calibration curves in hair (0.5–100 pg/mg) were prepared by spiking aliquots of blank hair ( r 2 > 0.9877 for all drugs). LOD in hair ranged 0.5–5 pg/mg. Case #1: Two young women were raped with an interval of approximately 1 year between the incidents. Lorazepam (present, <2 pg/mg) was detected in hair obtained from the first victim, and zolpidem (19 pg/mg) in hair of the second one. The offender was in jail between the two offences. Case #2: The offender approached a total of 8 men and women who were aged over 50 years. The offender was in jail between the two series of respectively 3 and 5 victims. Zopiclone was detected in victims’ hair ( n = 7) at concentrations 13–42 pg/mg. Case #3: The offender stole thousands of Euros using credit cards obtained from 22 different wealthy victims. He employed a cocktail of up to 6 drugs made up of: flunitrazepam, clonazepam, doxylamine, cyamemazine, zolpidem and lorazepam. Drugs were detected in all victims’ hair ( n = 18) at concentrations in the range 1–81 pg/mg for all drugs. Between the two series (of respectively 4 and 16 victims) the offender spent 6 months in jail, and then police spent 6 months looking for him while he was under judiciary control prior to his judgment. Segmental hair analysis permits retrospective information on drug exposure and should be considered in the investigation of drug-facilitated crimes not only to prove single exposure but also when there has been any appreciable delay in samples being obtained for analysis. Indeed, in 56% cases reported in this paper, due to the long time that elapsed between offences and the opportunity to obtain samples for analysis hair analysis was considered the only viable matrix to investigate the possibility of drug involvement in the crimes. Our experience demonstrates that the incidence of re-offending in DFC after a period of inactivity (often due to imprisonment) may be of concern, notably in big cities.

La soumission chimique : un problème de santé publique ?

Drug-facilitated crime (DFC) is well known to the public, yet general practitioners and other physicians are unfamiliar with this issue, largely because toxicology is not part of the medical curriculum. This often leads to diagnostic errors. The frequency of DFC is underestimated, often owing to late examination and analytical problems. On 24 December 2002 the French authorities issued a circular defining DFC as "the administration of a psychoactive drug without the victim's knowledge, as a means of aggression"; and listing places where victims can be managed On 19 July 2005, the French Agency for Health Product Safety (Afssaps) sent a letter to all professionals potentially concerned by this issue, offering guidelines for both medical personnel and laboratory staff conducting toxicological investigations. One difficulty in drug identification is that the doses administered are often low. Toxicology laboratories need sophisticated equipment and expertise to ensure that the perpetrator is prosecuted or, alternatively, to rule out DFC. More information is needed, not only for the public but also for physicians and toxicologists. Benzodiazepines and related compounds are identified in about 75% of DFC cases.

Automated determination of diazepam in spiked alcoholic beverages associated with drug-facilitated crimes

In this work, a multipumping flow system (MPFS) coupled to a photodegradation unit was developed, for the first time, for the determination of diazepam (a benzodiazepine) in spiked alcoholic beverages by fluorimetry. The main features of MPFS such as, high portability, versatility and straightforward automation and control combined with the efficiency and simplicity of photodegradation and the selectivity and sensitivity of fluorimetric detection makes the developed analytical methodology an attractive tool and a valuable contribution for the prevention of drug-facilitated crimes (DFC). Drug-facilitated crimes involve the unauthorized administration of strong central nervous system depressant drugs, which have the capability of preventing victims from resist to the action of the perpetrator or fighting off. Most often, the drugs identified as being used in DFC are surreptitiously placed in drinks served to potential victims in entertainment places, like night clubs. Five commercial alcoholic beverages (Eristoff ®, Smirnoff ®, Bacardi ®, Dry Gin ® and Brazilian Cachaça 51 ®) spiked with diazepam were analyzed by the proposed methodology, and the results revealed good agreement with those obtained through a HPLC comparison procedure. Relative deviations comprised between −1.97 and 2.05% were achieved, and additionally, the application of a paired t-test, revealed the absence of any statistical difference for a confidence level of 95% ( n = 5). The detection limit was approximately 2.02 mg L −1.

Knock-Out Drugs

Knock-out drugs are used to facilitate the commission of a crime, generally either robbery or sexual assault. Although media reports on the use of knock-out drugs have become more frequent, there are no robust epidemiological data on the incidence of drug-facilitated robbery or sexual assault, presumably because many crimes of these types do not enter into official statistics. The authors describe the modes of action and toxicological means of detection of the substances most frequently used as knock-out drugs on the basis of a selective literature research on the terms "drug-facilitated sexual assaults" (DFSA) and "drug-facilitated crimes" (DFC). The most frequently used drug in cases of sexual assault is still alcohol (ca. 40% to 60%), followed by illegal drugs (cannabis, cocaine). The presence of involuntarily consumed medications and drugs of abuse is demonstrated by routine toxicological analysis only in relatively few cases (ca. 2%). The substances most commonly found are benzodiazepines, followed by other hypnotics. In Europe, the illegal substance gamma-hydroxybutyric acid (GHB, "Liquid Ecstasy"), often mentioned as a "date-rape drug," is only rarely detected with sufficient medicolegal certainty. This may be due to its rapid elimination (it is detectable in blood for up to 8 hours, in urine for up to 12 hours) as well as its physiological occurrence in the body. If the toxicological analysis of blood and urine is negative in a case of suspected DFSA, then the analysis of a hair sample about four weeks after the assault can detect the presence of drugs consumed at that time. If the victim has long hair, it may be possible to detect knock-out drugs taken more than four weeks earlier. In Europe, convictions for drug-facilitated crimes are comparatively rare, mainly because of the difficulty of demonstrating conclusive evidence. A careful medical history and physical examination and the careful taking of biological samples for toxicological analysis form the basis for the detection of drug-facilitated crimes.

Soumission chimique : administration de psychotropes à l’insu d’une victime à des fins d’agression: Étude prospective de 52 cas au sein d’une unité médico-judiciaire

Little is known about the rate of crimes that are facilitated by the administration of psychoactive products without the victim's knowledge. This study analyzes the cases collected over a two-year period in a forensic unit in Paris.The study covers the period from January 1, 2005 and December /31, 2006. It includes crime victims who consulted for toxicological testing in the forensic unit of the Hôtel Dieu in Paris, after filing a criminal complaint describing symptoms suggestive of chemical submission (amnesia, impaired vigilance or behavior) and whose toxicological tests indicated the presence of a psychoactive product that they had not been aware of taking. The tests used chromatographic techniques on blood, urine, hair, and food or drink residue.Toxicological testing identified 52 cases of drug-facilitated crimes, primarily for theft and sexual abuse (including rape). The psychoactive products were most often incorporated in drinks, half of them alcoholic beverages. Benzodiazepines accounted for 77% of the cases. Other substances, found more rarely, included antihistamines, neuroleptics, and GHB.Appropriate samples must be taken from victims rapidly to enable toxicological analysis. Chromatographic analysis must supplement immunological analysis, which is not sufficiently specific or sensitive. The collection of this information must continue in order to quantify the phenomenon and monitor the emergence of new products.

The Role of Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS) to Test Blood and Urine Samples for the Toxicological Investigation of Drug-Facilitated Crimes

The authors present an overview of the drug-facilitated crime (DFC) phenomenon, especially in France. Recently, there has been an increase in reports of incidents (mainly sexual assaults and robbery) as well as in scientific publications and congress presentations on the topic. From enquiries conducted nationally, a list of drugs reportedly associated with DFC was established and includes benzodiazepines and benzodiazepine-like drugs (zolpidem, zopiclone), minor tranquilizers and neuroleptics, barbiturates, narcotics, hallucinogens, and anaesthetics. Some of these molecules are specific to France in DFC cases. A study using healthy volunteers who had taken benzodiazepines (lorazepam, bromazepam, flunitrazepam, clonazepam), zolpidem and zopiclone, showed that the only way to increase the duration of detection of these drugs is to use liquid chromatography-tandem mass spectrometry (LC-MS/MS) to test blood and urine samples. The very high sensitivity of this method appears to be an essential condition to document the cases, because the drugs tested were still detectable in urine at least 6 days after the ingestion of one therapeutic dose. Limits of detection were always lower than 0.5 ng/mL in urine. The actual list of molecules and metabolites the authors screened for in urine and blood by LC-MS/MS, in every DFC, is given in detail: 25 benzodiazepines and benzodiazepine-like drugs, 11 minor tranquilizers and neuroleptics, 2 barbiturates, 12 narcotics, 4 hallucinogens, and 1 anaesthetic. However, the distinction between continual therapeutic use of a psychotropic drug or illegal narcotic and a single ingestion has to be documented by sequential analysis of hair, again with LC-MS/MS.

Guidance for Improved Detection of Drugs Used to Facilitate Crimes

Reports of drug-facilitated crimes have significantly increased since the mid-1990s. When individuals report that they were robbed or assaulted while incapacitated by a drug, toxicologic testing may be needed to help substantiate the alleged victim's claims. Most often, these cases have involved strong central nervous system depressant drugs, which have the capability of preventing individuals from consenting to the action of the perpetrator or fighting off their attackers. For all intents and purposes, the drug acts as the offender's weapon, so many jurisdictions require analytical proof of its presence for criminal charges of the drug-facilitated crime to be filed. This article provides information on the manner in which drug-facilitated crimes occur, the drugs that are used to commit these crimes, and recommendations to improve the detection of these drugs through toxicologic analyses.