Drug-facilitated sexual assault (DFSA) is a sexual assault (rape or otherwise) committed on a person after the person has become intoxicated due to the consumption of any mind-altering substance, such as alcohol, or has been intentionally administered another date rape drug. Predator rape is another name for DFSA rape. Alcohol and drugs are involved in 75% of all acquaintance rapes. When drugs are combined with or without alcohol, they cause a loss of consciousness and the ability to consent to sex. 
Alcohol-assisted rape is the most common form of sexual violence against women, according to researchers.
 A DFSA, like other types of rape, is a physical violence crime that can be the result of sexual hedonism and entitlement.
The majority of DFSA victims are women, while the majority of perpetrators are men.
Sexual assaults on men and women who have voluntarily consumed alcohol or drugs are common and not new, with the 1938 film Pygmalion mentioning it. It’s also not uncommon to put something in someone’s drink to render them unconscious. (See also Mickey Finn.) However, in the mid-1990s, law enforcement agencies began to notice a pattern of women being drugged covertly for sexual assault and rape with date rape drugs: odourless, tasteless incapacitating drugs that may cause anterograde amnesia.   The female victim would lose awareness of her surroundings if she drank alcoholic beverages, whether coerced or in a mutually relaxed environment. She may regain consciousness hours later in a different location, with signs of sexual interference, such as missing or disorganized clothing, bruises, the presence of semen, or vaginal or anal soreness. She may experience wooziness, weakness, or confusion due to her substance use and may have little or no memory of what happened to her.    Her attacker may be gone in some cases; in others, he may act as if nothing unusual has happened, perhaps offering to drive her home or to a hospital.
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Not all DFSAs are similar to non-drug-facilitated date rape. DFSAs can arise between employers and employees, particularly when an employee is vulnerable, for example, because they are undocumented or cannot risk losing their job for any other reason. According to researchers, in such cases, an employer may take a vulnerable employee out to dinner and then drug and sexually assault the victim. DFSAs can also exist between landlords and tenants, as well as between small business owners and their customers. According to researchers, in these cases, the perpetrator is frequently socially inept, lives alone, and has little established intimacy with others. : 451–456 DFSAs can occur in a healthcare setting, such as a dentist’s or doctor’s office, and are frequently used for anaesthesia. Finally, they can happen within families, with the perpetrator raping a child or a vulnerable family member, for example.
Male-on-male DFSAs almost always occur in social or school settings, such as men raping foster sons, men picking up hitchhikers, and sadomasochistic killers like Jeffrey Dahmer and John Wayne Gacy, who immobilized their victims with sedation before sexually assaulting and murdering them.
: 454–453 Most DFSA perpetrators work alone, but some collaborate with male friends, a male and female couple, and brothers. A female accomplice could be used to gain the trust of a female victim. : 454–453 Paul Bernardo and Karla Homolka, Canadian serial killers, drugged Karla’s younger sister Tammy with diazepam and raped her; a year later, they drugged her with halothane and raped her again, and she choked on her vomit and died.  
Sexual Assault Facilitated by Psychedelics
Psychedelic-enhanced sexual assault (PFSA) is a subtype of DFSA. Individuals under the influence of many psychedelics are as susceptible to suggestion as they are during hypnosis. Experts believe this is at least partly why people (particularly women) with a history of sexual violence are more vulnerable to PFSA. PFSA is frequently committed by the person who supplied the “journeyer” with the psychedelics. Because the perpetrator allegedly acts as a shaman in cases where PFSA includes sexual penetration, it is sometimes referred to as shamanic rape.   
According to law enforcement officials, DFSA perpetrators generally share four characteristics: they have access to sedating drugs and understand their effects; they have access to a setting (often a home or workplace) where the rape will not be interrupted while it is taking place, they can establish at least a small amount of trust with an intended victim, and they have the plan to avoid arrest and prosecution, which may include re-dressing the victim, telling the victim that they are not guilty,
: 451 According to researchers, DFSA perpetrators are opportunistic and non-confrontational. They rarely threaten, force, batter, or mutilate their victims, and they never carry weapons, steal from them, or destroy their property. They are less likely to have a history of physical violence. They are frequently invested in their careers or communities and are not culturally marginalized. : 457 
According to some researchers, DFSA perpetrators are sexually interested but unable to find sexual partners and are motivated solely by sexual desire.
Others claim that some perpetrators (who may videotape the rape for later viewing) are motivated to dominate and control someone for sexual purposes.
Researchers disagree on whether perpetrators are fulfilling a genuine compulsion. Some argue that there is little evidence that the desire to commit DFSA is uncontrollable. In contrast, others argue that the “astonishing frequency” with which some perpetrators repeat the offence indicates some degree of compulsion. All DFSA perpetrators are extremely likely to re-offend. : 454–457
Perpetrators of the DFSA are stereotyped as personable, intelligent, and attractive. This is sometimes true, but not always. : 454–457 There is no evidence that DFSA perpetrators network, either online or offline, though they can occasionally be found on sites where the effects of recreational drugs are discussed. : 458 Because drugging the victim allows the perpetrator to overpower them easily, perpetrators can commit DFSA at any age, and some perpetrators are over 60, according to researchers. : 454–457
Different drugs and alcohol have different effects on the body’s consciousness, but all drugs impair the ability to consent. This can be a traumatic experience for DFSA victims.  According to one study of general population American women who thought they were victims of DFSAs, 81% knew the alleged perpetrator before the rape. A similar study of college students discovered that 83% knew the alleged perpetrator before the rape. 
Non-consensual drug administration poses clinical risks.
Dangers of Overdose
To completely incapacitate the subject and reduce the risk of legal repercussions, the perpetrator may overdose on the subject. The subject may also be allergic to the drug used, overly sensitive to its effects and side effects, or taking a prescription drug voluntarily that has dangerous interactions with the administered drug. Respiratory depression or coma, with or without lethal consequences, may occur, particularly when the drug is combined with alcohol. Benzodiazepine drugs, in particular, are known to be extremely dangerous when combined with alcohol, potentially leading to severe respiratory depression. Risks are also increased in subjects with no tolerance to the administered drug.
Reports on crime, prosecution, and statistics
If the event is reported, the presence of date rape drugs can be detected in various ways following the event, most notably through urine samples (for a few days) and hair samples (for weeks or even months).
 However, the main impediment to actual statistics is the confusion and lack of memory caused by these drugs. It is impossible to know how frequently DFSA occurs because victims are often unaware of what happened to them, whether anything happened, who was involved, or how, or the usually clear facts required to file a formal report. As a result, incidents are far less likely to be reported. Because of the amnesic effects and cognitive impairment associated with date rape drugs, victim self-reporting is an unreliable source of statistical data because many victims have no idea what happened to them. Without specialized drug toxicology, which is frequently unavailable to victims within a short time frame when viable testing of samples has historically been available, any attribution or classification is conjecture.
The drugs are also extremely difficult to detect.
It is difficult to test for the presence of these drugs because they are quickly eliminated from the body due to the very small amounts of drugs typically administered to achieve these effects. The absence of confirmation through toxicology cannot be equated with empirical data in and of itself.
Alcohol consumption is a major risk factor for date rape.
 One study found six (0.5%) positive for Rohypnol, 97 (8%) positive for other benzodiazepines, 451 (38%) positive for alcohol, and 468 (40%) negative for any of the drugs tested for in 1,179 urine specimens from victims of suspected DFSAs in 49 American states. A similar study of 2,003 urine samples from suspected DFSA victims discovered that less than 2% tested positive for Rohypnol or GHB.  A three-year study in the United Kingdom discovered that 2% of 1,014 rape victims had sedatives in their urine 12 hours after the assault.   According to a 2009 Australian study, tests were unable to identify a single case where a sedative drug was likely to have been illegally placed in a drink in a pub or nightclub out of 97 patients admitted to the hospital believing their drinks had been spiked, despite nine plausible cases from within the study. On the other hand, the patient’s mean blood ethanol concentration (BAC) at the time of presentation was 0.096%.  According to one study (Ham & Burton, 2005), only 2% (21 cases) of 1014 claims of drug-facilitated sexual assault in the UK over three years showed evidence of possible deliberate spiking.
A UK study concluded that there was “no evidence to suggest widespread date rape drug use” in the UK, with no cases involving Rohypnol and only two involving GHB out of 120 examined.
Prosecution and the criminal justice system
Reporting and investigation of crimes
A DFSA victim is less likely to report their rape at all, especially if the victim is still suffering from the physical or mental side effects of the drug they were given or are unsure of what exactly happened. Victims are often hesitant to report because they do not recall or comprehend what happened to them. Victims who were raped after willingly consuming alcohol or drugs are especially hesitant because they may face charges for illegally using a substance. Almost all rape victims, particularly DFSA victims, are terrified of being blamed for their assault , and they may feel shame or guilt. They may also want to protect their friends, especially young ones.  
Investigators are trained to focus on determining whether a sexual act occurred that met the local legal definition of rape or sexual assault, whether the victim was under the influence of alcohol or drugs and thus could not give willful consent, whether there were witnesses, identifying the alleged perpetrator, and determining whether he had access to drugs suspected of being used in the DFSA.
Detection and evidence
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Because a successful prosecution is more likely if there is physical evidence that a victim was drugged, a DFSA victim should seek medical attention within 72 hours of the assault. After 72 hours, urine tests are much less likely to detect the presence of drugs because most will have been metabolized and eliminated from the body, resulting in a false negative.    Ideally, the victim’s first urine after the assault should be tested for drugs; if possible, they should collect it in a clean container to give to medical authorities.   The effect on the victim’s urination can indicate whether benzodiazepines or GHB were used in a DFSA: benzodiazepines cause urinary retention, while GHB causes urinary incontinence. 
Urine is not the only way to detect drugs in the body. Medical authorities may also take blood and hair samples from the victim, as these can reveal evidence for weeks or months rather than days. Hair samples are typically collected 14 days after drug exposure (though they can be collected as soon as 24 hours) to allow for drug absorption and growth. Hair testing can thus extend the detection window for rape drugs to weeks or even months.  Victims should try to describe the effects of the drug as best they can because most laboratories will not perform a broad drug screen, and knowing the effects of the drug will help law enforcement authorities know which drugs to test for. Rape victims’ advocates advise them to tell investigators if they have recently used drugs recreationally because those drugs may be detected in the drug screen, and pre-disclosure will have the least negative impact on the victim’s credibility.  
In the United States, law enforcement agencies usually pay for drug testing as part of a rape kit if requested. If victims request drug testing, especially if they have not filed a police report, their insurance will frequently refuse to pay for the test, forcing them to pay for it themselves.   Testing kits for detecting certain drugs in drinks before consumption are commercially available but were deemed unreliable in 2002.  
Punishment and prosecution
All rape prosecutions are difficult, but DFSA prosecutions are especially difficult. Many DFSA victims have anterograde amnesia due to the drugs they were given, making it impossible to understand or describe what happened to them.  Because the perpetrator used drugs to immobilize the victim, they could not physically defend themselves, so there would be no evidence such as fingernail scrapings, scratches, or bite marks.  Furthermore, if the victim was voluntarily consuming alcohol or other drugs, law enforcement officials and jurors are much less likely to believe what they say. They are more likely to blame them for being victimized. 
According to researchers, DFSA perpetrators never confess, and appeals to their conscience are ineffective.
: 454–453 In Connecticut, drug-assisted sexual assault is considered rape, so the offender will be charged with sexual assault in the first degree, a class B felony if convicted. If the victim is under 16, the offender will be charged with a class A felony. 
In many parts of the world, whether or not a drug was used is irrelevant to whether or not a specific incident is a rape. In countries such as the United States, the legal definition of rape includes a lack of consent when the victim is unable to say “no” to intercourse, whether the effect is due to drugging or simply alcohol consumption.  However, it is frequently difficult for victims to come forward and for prosecutors to bring cases to trial. Victims may find it difficult to determine whether they consented or not or whether they were drugged intentionally or unintentionally. Prosecutors face difficulties proving intent or lack of consent when the rape or assault occurred without witnesses (especially in a private home). Both parties were under the influence of drugs or alcohol because neither could legally consent. Without independent proof of forced drug consumption or sexual activity, accusations are rarely brought to court.
Rapists may be released because their victims were deemed too untrustworthy or because the victims drank excessively or voluntarily took drugs. If rape or assault is proven, drug use will almost certainly increase the severity of the case. In Indiana, rape is elevated from a Class B to a Class A felony when the perpetrator drugs the victim or knows their drink has been spiked.
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