WHEN SOMEONE ALLEGES that they’ve been seriously sexually assaulted, their chances of ‘obtaining justice’ in the form of an effective police investigation and successful criminal prosecution can be surprisingly low.

In the United Kingdom, it is staggeringly low; fewer than 4% of reported rape offences lead to criminal charges, of which roughly half result in a subsequent conviction.

It is strikingly low in Ireland, where around a fifth of (‘filed’) sexual offence reports lead to prosecution, and the actual conviction rate is described in the Irish legal literature as ‘extremely low’ (possibly just 0.3%).

I suspect that most people know about the main ‘rape myths’ that are said to lie behind these miniscule levels of conviction. These include ‘victim-blaming’, ‘misunderstandings’ over consent, ‘false rape claims’, the repeated assertion that ‘men can’t be raped’, and so on.

However, I would add one other problem in how reports of serious sexual assault are dealt with, and that is the cynicism of some medics when it comes to the topic of ‘date rape drug’ use.

In this regard, I write as a former emergency physician who has spent decades in different urban emergency departments (EDs), where claims that someone’s drink was ‘spiked’ were not uncommon, but scepticism among older healthcare professionals was not unusual.

This is a very serious suggestion on my part, so I must set out my case carefully, as with any medical hypothesis.

In a nutshell, I will define the problem, consider its potential scale, explain why healthcare professionals are ‘wary’ of the diagnosis, and – finally – describe my own recent ‘epiphany’ – that is, why I now believe that clinicians need to ‘tweak’ their approach to those who fear they’ve been victims of a chemically-facilitated assault.

‘Spiking’ someone’s drink means adding a drug to that drink without the drinker’s knowledge in order to alter their physical or mental state. It is typically done for the purposes of robbery, drug facilitated sexual assault (DFSA), or as a ‘prank’.

But a key difficulty in the management of drink tampering is the dearth of reliable data.

A 2022 Global Drug Survey of 22 countries found that 2% of nearly 8,000 respondents believed they’d been ‘spiked’ in the previous year, mostly in clubs or bars, with about a fifth reporting a sexual assault during the incident. However, only about 7% of the suspected cases had been reported to the police.

Analysis by An Garda Síochána indicates that there were 52 cases of suspected ‘spiking’ incidents reported in 2023, compared with 107 in 2022, with much lower numbers in the previous decade.

Most reported incidents occurred in licensed premises and nearly 90% of victims were females aged 18-25 years. It is notable that jabbing with a needle (a related ‘scourge’) was reported in just over a quarter of Irish cases in 2020-2023 and, up to the end of January 2024, there had been 31 charges or summons related to 12 unique suspected ‘spiking’ incidents.

My career in emergency medicine began in the early 1980s, but it wasn’t until the early-to-mid 1990s that – like many of my........

© TheJournal