Toxicological screening with drug of abuse and alcohol test in victims older than 16 years of sexual violence in the Center for Sexual Violence in Gelderland South and Central.

Sexual violence occurs when someone is forced to perform sexual acts and/or has
experience with manual, oral, vaginal or anal sex (1). In the Netherlands, 22%
of all women and 6% of all men experience sexual violence during their lives
(2). At the Center for Sexual Violence Gelderland-Zuid en -Midden (CSG-GZM),
11%-24% of the victims who had sought help suspected that the rape had taken
place under the influence (ref 1,2,3). Anderson et al. show in a systematic
review that there is a higher risk of sexual violence if there is alcohol in
combination with the intake of other drugs (4) In the Netherlands, drug testing
is not standard practice during acute care in a CSG.
A distinction is made between proactive and opportunistic rape while
intoxicated. A rape in which the victim used drugs/alcohol without knowledge or
under duress is called a proactive rape under the influence. An opportunistic
rape under the influence is spoken of if the victim has voluntarily used
alcohol or drugs (3,5,6). The media mainly warns against proactive rape. It is
known that under the influence of narcotics boundaries fade. The experience of
aid workers shows that many victims doubt the credibility of their case if
narcotics were involved. As a result, victims are more likely to remain silent,
not to tell friends or family, and not to report it to the police (7). It is
conceivable that this doubt only increases if there is an opportunistic rape
and that the victim blames herself. Because we do not routinely test for
substance use in the Netherlands when patients request help from a CSG, no
exact figures are known about sexual violence in combination with the voluntary
or involuntary intake of drugs. In the experience of care providers, insight
into this is important for coping with the trauma. If it turns out that drug
intake (voluntarily or involuntarily) occurs more often than we think, this
information can also be used for prevention. Young people can be warned about
the danger of excessive alcohol use, in combination with drug use, but also of
covert drugging

By means of this study we want to determine how many victims of sexual
violence, who seek help within 72 hours at the CSG Gelderland Zuid-Midden
(CSG-GZM), have alcohol and/or drugs in their urine, voluntarily or
involuntarily. To make it clear how big the problem is. We want to use the data
for prevention.

prospective cohort study

Estimated risk load: low
Patients will be given a short questionnaire, must submit urine and 1
venipuncture will be performed. It is true, however, that venipuncture is
already performed as standard for most patients who present for CSG, so no
additional procedure will be performed for many patients.