- Email: [email protected]
When drugs are used for rape
he use of alcohol a n d s e d a t i n g s u b s t a n c e s by rapists is a centuries-old practice. Today numerous legal a n d illegal drugs can be m i s u s e d to s e d a t e people involuntarily. Because t h e s e drugs can be covertly a d d e d to b e v e r a g e s in a social setting, subs t a n c e - i n d u c e d rape p o s e s unique difficulties for health professionals, law enforcement officials, and rape crisis counselors, as well as rape survivors and those trying to r e d u c e their risk of assault. Many s e d a t i n g s u b s t a n c e s can be m i s u s e d and cause similar symptoms; c o m b i n e d with alcohol, their effects are magnified. The inability of the rape survivor to r e m e m b e r t h e details of the event as a result of the s e d a t i n g effects h e i g h t e n s the difficulty in gathering information that could help p r o s e c u t e the rapist. Drug tests are now available that m a y help in collecting e v i d e n c e and identifying the s u b s t a n c e s t h a t were used. A n d a n e w federal law, the Drug-Induced Rape Prevention a n d P u n i s h m e n t A c t of 1996, sets prison terms of up to 20 years for anyone convicted of using a n y controlled s u b s t a n c e with the intent to commit a violent crime, including sexual assault.
T
Availability of drug testing Hospital ED p e r s o n n e l should collect e v i d e n c e , including urine samples that Wfli[~be~s u b m i t t e d for testing, a c c o r d i n g to strict c h a i n - o f [,, c ~~f , o d y procedures, which will be critical if the case is prosecuted. Even if the rape survivor chooses not to report the incident to law enforcement authorities, drug t e s t i n g can be important to identify s u b s t a n c e s used. A free drug t e s t i n g service has b e e n m a d e available to hospital e m e r g e n c y departments, rape crisis centers, a n d law enforcement a g e n c i e s by HoffmannLa Roche (Figure 1). Roche initiated the program bec a u s e of c o n c e r n a b o u t reports t h a t one of its Robert Armstrong, is vice president, Medical Affairs, Roche Laboratories,Nutley,New Jersey. J Emerg Nurs 1997;23:378-81. Copyright © 1997 by the Emergency Nurses Association. 0099-1767/97 $5.00 + 0 18/1/83721
378 Volume 23, Number 4
Legal a n d illegal d r u g s c a n b e m i s u s e d to s e d a t e p e o p l e involuntarily. B e c a u s e t h e s e d r u g s c a n b e covertly a d d e d to b e v e r a g e s in a social setting, s u b s t a n c e - i n d u c e d rape p o s e s u n i q u e difficulties.
m e d i c a t i o n s , flunitrazepam (Rohypnol), h a d b e e n m i s u s e d in this way. Rohypnol is a prescription medication available in 80 countries worldwide for the t r e a t m e n t of severe and debilitating sleep disorders. This t e s t i n g program, a c c e s s e d by calling (800) 608-6540, uses an i n d e p e n d e n t forensic toxicology laboratory certified by the U.S. D e p a r t m e n t of Health and H u m a n Services that follows strict chain-of-custody procedures. The laboratory has highly sophistic a t e d e q u i p m e n t capable of identifying a w i d e range of a m p h e t a m i n e s , barbiturates, b e n z o d i a z e p i n e s (including flunitrazepam), cocaine, marijuana, codeine, heroin, and morphine through a t h r e e - s t a g e assay. Results are returned in about a w e e k to the hospital e m e r g e n c y department, rape crisis center, or law enforcement a g e n c y that s u b m i t t e d the sample. Although m e d i a reports have focused on just a few s u b s t a n c e s , including Rohypnol, g a m m a hydroxybutyrate (GHB), a central nervous s y s t e m d e p r e s s a n t that is m a n u f a c t u r e d illegally in the United States, and ketamine, a veterinary anesthetic, t e s t results show t h a t a m u c h wider range of s u b s t a n c e s is b e i n g used. From June 1996 through May 1997, 266 t e s t s were performed on urine samples of rape survivors who app e a r e d to have s y m p t o m s of drug-related sexual assault. Ninety p e r c e n t of the samples s u b m i t t e d for analysis were o b t a i n e d within 72 hours of ingestion of the s u s p e c t e d substance, and the a v e r a g e time for
Armstrong/JOURNAL OF EMERGENCYNURSING
The incidence of substances being misused to facilitate sexual assault is increasingly reported in some parts of the country. Numerous substances may cause symptoms of drowsiness, lack of muscle coordination and confusion, especially if combined with alcohol. A new urine test is available, free of charge to law enforcement agencies, rape crisis centers and hospital emergency rooms, that may help determine which substancewas used and document the evidence for legal purposes.
The test is a series of three assaysdesignedto detect certain drugs in the urine, including alcohol, amphetamines, barbiturates, benzodiazepines, cocaine, GHe, marijuana and opiates. • The first assay,Abuscreen ONTRAK°, screens for benzodiazepines, it is a self-containedurinalysis test that provides easily inlerpreted results in less than three minuteswithout the use of instrumentation,and is designedto be used on site. • The second assay,Abuscreen ONLINE®, is a series of automatedinstrument-baseddiagnostic tests designed specifically to detect benzodiazepines in urine. It also can delect amphetamines, barbiturates, cocaine, marijuana and opiates. • The third and final assay,gas chromatography/massspectrometry(GC/MS), is a more specific chemical analysis that confirms the results of the ONTRAKand ONLINE tests. If a benzodiazepineis detected,the assay will determinewhich one it is. If flunitrazepam (Rohypnol), GHB (gammahydroxybutyrate)or alcohol is present in the sample, the assaywill confirm this.
This service is available free of chargeto law enforcement, rape crisis centers and emergency rooms investigating cases of sexual assault.
The urine sample should be collected from the victim immediately to increasethe likelihood that the drug wig be detected by the assays. In the case of Rohypnol, doses of a single 1 mg tablet have been detectable in the urine for 60 to 72 hours after ingestion. The amount of drug in the victim's urine at any particular time depends on the person's metabolism, the amount of drug consumed, and the length ol time that elapsed since the drug was ingested. You should refer to your local laws and proceduresregarding collection of samples and chain of custodyrequirements.
Although the sample may be usable for up to seven days when stored at room temperature, it should be stored in a refrigerator or freezer to minimize degradation. The timing of the actual testing of the sample is less criticaI. If the sample is frozen, the test can be administered effectivelyeven months later.
To access the testing capability, call 1-800-608-6540. You will be given an authorization number and a Federal Express account number. You also wgl be provided with instructions to ship the specimen to ElSohly Laboratories, ]nc (ELI), the independent, DHHS-certified forensic toxicology laboratorythat conducts the analyses. This laboratoryfollows strict chain-of-custodyprocedures in handling samples.
Follow your normal chain-of-custodyprocedures in collecting and handling the urine sample. Place a security seal containing the authorization number across the cap of the bottle. Using the FedExaccount number you were given when you called the 800-number, send Ihe urine sample in a liquid-tight container in a leak-proof bag in a protective cardboard box with a copy of the authorization and chain-of-custodyforms via FedExPriori[y Overnight delivery to ElSohiy Laboratories. Oncethe sample is received,test results will be reported in about ten days to the person completing the authorization form. FOR TESTING, CALL:
1-800-608-6540 For general information about drugs and assault, call: 1-800-720-1076
EISohly Laboratories, Inc. 5 Industrial Park Drive, Oxford, MS 38655 Tel: 601-236-2609 Fax: 601-234-0253 Testing is provided as a service from Heffmann-La Roche Inc. Nutley, New Jersey 07110-1199
Figure 1 Poster shows details of drug testing for sexual assault victims.
August 1997 3 7 9
JOURNAL OF EMERGENCY NURSING/Armstrong
Other Drugs 5 Barbiturates 1 Amphetamines 17 deine 2 *None Found 155
Cannabinoids 39 Morphine/Opiates 2 Cocaine 23
Flunitrazepam 3
Other Benzodiazepines 46
Figure 2 Drug test results of urine samples from 266 reported rape cases in which drug use was suspected. The chart shows amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, and opiates. It does not show alcohol, gamma hydroxybutyrate (GHB), or other substances; tests for these began in March 1997. More than one substance was present in some samples.
A free d r u g t e s t i n g s e r v i c e h a s b e e n m a d e available to hospital emergency d e p a r t m e n t s , rape crisis centers, and law enforcement agencies by H o f f m a n n - L a Roche.
i n g e s t i o n to u r i n e s a m p l e w a s at 27 hours. Only t h r e e c o n t a i n e d R o h y p n o l - - o n e of t h e s e w a s a s p e c i m e n c o l l e c t e d 10 to 13 hours after i n g e s t i o n in Texas; t h e s e c o n d 18 h o u r s after i n g e s t i o n in M i n n e s o t a ; a n d t h e t h i r d 13 h o u r s ' later in A r k a n s a s . O n e h u n d r e d t e n s a m p l e s c o n t a i n e d e v i d e n c e of oJ;her controlled s u b s t a n c e s - - m a r i j u a n a , cocaine, a m p h e t a m i n e s , codeine, morphine, and other benzodiazepines. Testing for GHB a n d alcohol b e g a n in M a r c h 1997 a n d r e s u l t s a r e n o t i n c l u d e d h e r e (Figure 2).
Signs and symptoms of drug ingestion A l t h o u g h t h e effects of s e d a t i n g s u b s t a n c e s m a y vary a c c o r d i n g to t h e a m o u n t i n g e s t e d a n d t h e a m o u n t of alcohol or o t h e r d r u g s c o n s u m e d w i t h t h e s e d a t i n g s u b s t a n c e , t h e m o s t frequently o b s e r v e d s y m p t o m s i n c l u d e t h e following: • A p p e a r a n c e of i n t o x i c a t i o n d i s p r o p o r t i o n a t e to t h e a m o u n t of alcohol c o n s u m e d , or d e s p i t e l a c k of alcohol c o n s u m p t i o n
380
Volume 23, Number 4
• Unexplained drowsiness and impaired motor coordination • Dizziness, confusion, i m p a i r e d j u d g m e n t , a n d loss of i n h i b i t i o n • I m p a i r e d ability to r e m e m b e r details. B e c a u s e Rohypnol, like s o m e o t h e r d r u g s of its class, is p r e s c r i b e d to t r e a t s e v e r e s l e e p d i s o r d e r s , its e x p e c t e d a c t i o n s i n c l u d e anxiolytic, a n t i c o n v u l s a n t , a n d s e d a t i v e effects, a s well a s s l o w i n g of p s y c h o m o tor p e r f o r m a n c e a n d m u s c l e relaxation. N u m e r o u s o t h e r s u b s t a n c e s m a y c a u s e similar s y m p t o m s . W h e n u s e d properlyl R e h y p n o l p r o d u c e s s e d a t i v e effects w i t h i n 20 to 30 m i n u t e s , r e a c h e s p e a k effect in 2 hours, a n d s u b s i d e s in 6 to 8 hours.
Collecting urine samples for forensic evidence T h e following g u i d e l i n e s will help t h e a c c u r a c y of t h e test: • Collect t h e u r i n e s a m p l e i m m e d i a t e l y to i n c r e a s e t h e likelihood t h a t t h e d r u g will b e d e t e c t e d b y a s s a y s . Collect at l e a s t 10 ml of urine, b u t ideally'30 ml. In t h e c a s e of Rohypnol, d o s e s of a s i n g l e 1 m g t a b l e t h a v e b e e n d e t e c t a b l e in t h e u r i n e for 72 h o u r s or m o r e after ingestion. • Store t h e s a m p l e in a clean, sealable, l i q u i d - t i g h t c o n t a i n e r a n d p l a c e a s e c u r i t y seal c o n t a i n i n g t h e a u t h o r i z a t i o n n u m b e r a c r o s s t h e lid. P u t t h e cont a i n e r in a leakproof b a g in a p r o t e c t i v e c a r d b o a r d b o x t h a t is s t r o n g e n o u g h to w i t h s t a n d s h i p m e n t b y F e d e r a l Express. A l t h o u g h t h e s a m p l e m a y b e u s a b l e for u p to 7 d a y s w h e n s t o r e d at r o o m t e m p e r a t u r e , it s h o u l d b e s t o r e d in a refrigerator or freezer to m i n i m i z e d e g r a d a t i o n . T h e t i m i n g of t h e
Armstrong/JOURNALOF EMERGENCYNURSING
Call the testing service at (800) 608-6540. Directions will be provided for s e n d i n g the sample by Federal Express, free of charge, to the toxicology laboratory. actual testing of the sample is less critical. If the sample is frozen, the test can be administered effectively even months later. • Call the testing service at (800) 608-6540. Directions will be provided for sending the sample by Federal Express, free of charge, to the toxicology laboratory. Once the sample is received, test results are sent to the submitting agency in about 10 days.
Controlling illegal use of medications Although many of the drugs that are reportedly misused in sexual assault are legitimate prescription drugs in this country, others are manufactured or
imported illegally. Rohypnol, for example, is a frequently prescribed drug in 80 countries worldwide, but is not marketed in the United States; it is smuggled into the United States through illicit channels. Hoffmann-La Roche has taken aggressive steps to halt diversion of Rohypnol to the United States from other countries, control its misuse, and educate law enforcement professionals, rape crisis centers, hospital emergency departments, and consumers. The company is working closely with law enforcement agencies, universities, and rape crisis centers to support their efforts to stop substance abuse and misuse. For more information about this issue, health professionals and consumers may call Hoffmann-La Roche at (800) 720-1076.
Contributions to this column should be sent to L i n d a E. L e d r a y , RN, PhD, FAAN, Sexual Assault Resource Service, 525 Portland Avenue South, Minneapolis, MN 55415; phone (612)347-5832; E-mail: [email protected].
August 1997 381
T
Availability of drug testing Hospital ED p e r s o n n e l should collect e v i d e n c e , including urine samples that Wfli[~be~s u b m i t t e d for testing, a c c o r d i n g to strict c h a i n - o f [,, c ~~f , o d y procedures, which will be critical if the case is prosecuted. Even if the rape survivor chooses not to report the incident to law enforcement authorities, drug t e s t i n g can be important to identify s u b s t a n c e s used. A free drug t e s t i n g service has b e e n m a d e available to hospital e m e r g e n c y departments, rape crisis centers, a n d law enforcement a g e n c i e s by HoffmannLa Roche (Figure 1). Roche initiated the program bec a u s e of c o n c e r n a b o u t reports t h a t one of its Robert Armstrong, is vice president, Medical Affairs, Roche Laboratories,Nutley,New Jersey. J Emerg Nurs 1997;23:378-81. Copyright © 1997 by the Emergency Nurses Association. 0099-1767/97 $5.00 + 0 18/1/83721
378 Volume 23, Number 4
Legal a n d illegal d r u g s c a n b e m i s u s e d to s e d a t e p e o p l e involuntarily. B e c a u s e t h e s e d r u g s c a n b e covertly a d d e d to b e v e r a g e s in a social setting, s u b s t a n c e - i n d u c e d rape p o s e s u n i q u e difficulties.
m e d i c a t i o n s , flunitrazepam (Rohypnol), h a d b e e n m i s u s e d in this way. Rohypnol is a prescription medication available in 80 countries worldwide for the t r e a t m e n t of severe and debilitating sleep disorders. This t e s t i n g program, a c c e s s e d by calling (800) 608-6540, uses an i n d e p e n d e n t forensic toxicology laboratory certified by the U.S. D e p a r t m e n t of Health and H u m a n Services that follows strict chain-of-custody procedures. The laboratory has highly sophistic a t e d e q u i p m e n t capable of identifying a w i d e range of a m p h e t a m i n e s , barbiturates, b e n z o d i a z e p i n e s (including flunitrazepam), cocaine, marijuana, codeine, heroin, and morphine through a t h r e e - s t a g e assay. Results are returned in about a w e e k to the hospital e m e r g e n c y department, rape crisis center, or law enforcement a g e n c y that s u b m i t t e d the sample. Although m e d i a reports have focused on just a few s u b s t a n c e s , including Rohypnol, g a m m a hydroxybutyrate (GHB), a central nervous s y s t e m d e p r e s s a n t that is m a n u f a c t u r e d illegally in the United States, and ketamine, a veterinary anesthetic, t e s t results show t h a t a m u c h wider range of s u b s t a n c e s is b e i n g used. From June 1996 through May 1997, 266 t e s t s were performed on urine samples of rape survivors who app e a r e d to have s y m p t o m s of drug-related sexual assault. Ninety p e r c e n t of the samples s u b m i t t e d for analysis were o b t a i n e d within 72 hours of ingestion of the s u s p e c t e d substance, and the a v e r a g e time for
Armstrong/JOURNAL OF EMERGENCYNURSING
The incidence of substances being misused to facilitate sexual assault is increasingly reported in some parts of the country. Numerous substances may cause symptoms of drowsiness, lack of muscle coordination and confusion, especially if combined with alcohol. A new urine test is available, free of charge to law enforcement agencies, rape crisis centers and hospital emergency rooms, that may help determine which substancewas used and document the evidence for legal purposes.
The test is a series of three assaysdesignedto detect certain drugs in the urine, including alcohol, amphetamines, barbiturates, benzodiazepines, cocaine, GHe, marijuana and opiates. • The first assay,Abuscreen ONTRAK°, screens for benzodiazepines, it is a self-containedurinalysis test that provides easily inlerpreted results in less than three minuteswithout the use of instrumentation,and is designedto be used on site. • The second assay,Abuscreen ONLINE®, is a series of automatedinstrument-baseddiagnostic tests designed specifically to detect benzodiazepines in urine. It also can delect amphetamines, barbiturates, cocaine, marijuana and opiates. • The third and final assay,gas chromatography/massspectrometry(GC/MS), is a more specific chemical analysis that confirms the results of the ONTRAKand ONLINE tests. If a benzodiazepineis detected,the assay will determinewhich one it is. If flunitrazepam (Rohypnol), GHB (gammahydroxybutyrate)or alcohol is present in the sample, the assaywill confirm this.
This service is available free of chargeto law enforcement, rape crisis centers and emergency rooms investigating cases of sexual assault.
The urine sample should be collected from the victim immediately to increasethe likelihood that the drug wig be detected by the assays. In the case of Rohypnol, doses of a single 1 mg tablet have been detectable in the urine for 60 to 72 hours after ingestion. The amount of drug in the victim's urine at any particular time depends on the person's metabolism, the amount of drug consumed, and the length ol time that elapsed since the drug was ingested. You should refer to your local laws and proceduresregarding collection of samples and chain of custodyrequirements.
Although the sample may be usable for up to seven days when stored at room temperature, it should be stored in a refrigerator or freezer to minimize degradation. The timing of the actual testing of the sample is less criticaI. If the sample is frozen, the test can be administered effectivelyeven months later.
To access the testing capability, call 1-800-608-6540. You will be given an authorization number and a Federal Express account number. You also wgl be provided with instructions to ship the specimen to ElSohly Laboratories, ]nc (ELI), the independent, DHHS-certified forensic toxicology laboratorythat conducts the analyses. This laboratoryfollows strict chain-of-custodyprocedures in handling samples.
Follow your normal chain-of-custodyprocedures in collecting and handling the urine sample. Place a security seal containing the authorization number across the cap of the bottle. Using the FedExaccount number you were given when you called the 800-number, send Ihe urine sample in a liquid-tight container in a leak-proof bag in a protective cardboard box with a copy of the authorization and chain-of-custodyforms via FedExPriori[y Overnight delivery to ElSohiy Laboratories. Oncethe sample is received,test results will be reported in about ten days to the person completing the authorization form. FOR TESTING, CALL:
1-800-608-6540 For general information about drugs and assault, call: 1-800-720-1076
EISohly Laboratories, Inc. 5 Industrial Park Drive, Oxford, MS 38655 Tel: 601-236-2609 Fax: 601-234-0253 Testing is provided as a service from Heffmann-La Roche Inc. Nutley, New Jersey 07110-1199
Figure 1 Poster shows details of drug testing for sexual assault victims.
August 1997 3 7 9
JOURNAL OF EMERGENCY NURSING/Armstrong
Other Drugs 5 Barbiturates 1 Amphetamines 17 deine 2 *None Found 155
Cannabinoids 39 Morphine/Opiates 2 Cocaine 23
Flunitrazepam 3
Other Benzodiazepines 46
Figure 2 Drug test results of urine samples from 266 reported rape cases in which drug use was suspected. The chart shows amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, and opiates. It does not show alcohol, gamma hydroxybutyrate (GHB), or other substances; tests for these began in March 1997. More than one substance was present in some samples.
A free d r u g t e s t i n g s e r v i c e h a s b e e n m a d e available to hospital emergency d e p a r t m e n t s , rape crisis centers, and law enforcement agencies by H o f f m a n n - L a Roche.
i n g e s t i o n to u r i n e s a m p l e w a s at 27 hours. Only t h r e e c o n t a i n e d R o h y p n o l - - o n e of t h e s e w a s a s p e c i m e n c o l l e c t e d 10 to 13 hours after i n g e s t i o n in Texas; t h e s e c o n d 18 h o u r s after i n g e s t i o n in M i n n e s o t a ; a n d t h e t h i r d 13 h o u r s ' later in A r k a n s a s . O n e h u n d r e d t e n s a m p l e s c o n t a i n e d e v i d e n c e of oJ;her controlled s u b s t a n c e s - - m a r i j u a n a , cocaine, a m p h e t a m i n e s , codeine, morphine, and other benzodiazepines. Testing for GHB a n d alcohol b e g a n in M a r c h 1997 a n d r e s u l t s a r e n o t i n c l u d e d h e r e (Figure 2).
Signs and symptoms of drug ingestion A l t h o u g h t h e effects of s e d a t i n g s u b s t a n c e s m a y vary a c c o r d i n g to t h e a m o u n t i n g e s t e d a n d t h e a m o u n t of alcohol or o t h e r d r u g s c o n s u m e d w i t h t h e s e d a t i n g s u b s t a n c e , t h e m o s t frequently o b s e r v e d s y m p t o m s i n c l u d e t h e following: • A p p e a r a n c e of i n t o x i c a t i o n d i s p r o p o r t i o n a t e to t h e a m o u n t of alcohol c o n s u m e d , or d e s p i t e l a c k of alcohol c o n s u m p t i o n
380
Volume 23, Number 4
• Unexplained drowsiness and impaired motor coordination • Dizziness, confusion, i m p a i r e d j u d g m e n t , a n d loss of i n h i b i t i o n • I m p a i r e d ability to r e m e m b e r details. B e c a u s e Rohypnol, like s o m e o t h e r d r u g s of its class, is p r e s c r i b e d to t r e a t s e v e r e s l e e p d i s o r d e r s , its e x p e c t e d a c t i o n s i n c l u d e anxiolytic, a n t i c o n v u l s a n t , a n d s e d a t i v e effects, a s well a s s l o w i n g of p s y c h o m o tor p e r f o r m a n c e a n d m u s c l e relaxation. N u m e r o u s o t h e r s u b s t a n c e s m a y c a u s e similar s y m p t o m s . W h e n u s e d properlyl R e h y p n o l p r o d u c e s s e d a t i v e effects w i t h i n 20 to 30 m i n u t e s , r e a c h e s p e a k effect in 2 hours, a n d s u b s i d e s in 6 to 8 hours.
Collecting urine samples for forensic evidence T h e following g u i d e l i n e s will help t h e a c c u r a c y of t h e test: • Collect t h e u r i n e s a m p l e i m m e d i a t e l y to i n c r e a s e t h e likelihood t h a t t h e d r u g will b e d e t e c t e d b y a s s a y s . Collect at l e a s t 10 ml of urine, b u t ideally'30 ml. In t h e c a s e of Rohypnol, d o s e s of a s i n g l e 1 m g t a b l e t h a v e b e e n d e t e c t a b l e in t h e u r i n e for 72 h o u r s or m o r e after ingestion. • Store t h e s a m p l e in a clean, sealable, l i q u i d - t i g h t c o n t a i n e r a n d p l a c e a s e c u r i t y seal c o n t a i n i n g t h e a u t h o r i z a t i o n n u m b e r a c r o s s t h e lid. P u t t h e cont a i n e r in a leakproof b a g in a p r o t e c t i v e c a r d b o a r d b o x t h a t is s t r o n g e n o u g h to w i t h s t a n d s h i p m e n t b y F e d e r a l Express. A l t h o u g h t h e s a m p l e m a y b e u s a b l e for u p to 7 d a y s w h e n s t o r e d at r o o m t e m p e r a t u r e , it s h o u l d b e s t o r e d in a refrigerator or freezer to m i n i m i z e d e g r a d a t i o n . T h e t i m i n g of t h e
Armstrong/JOURNALOF EMERGENCYNURSING
Call the testing service at (800) 608-6540. Directions will be provided for s e n d i n g the sample by Federal Express, free of charge, to the toxicology laboratory. actual testing of the sample is less critical. If the sample is frozen, the test can be administered effectively even months later. • Call the testing service at (800) 608-6540. Directions will be provided for sending the sample by Federal Express, free of charge, to the toxicology laboratory. Once the sample is received, test results are sent to the submitting agency in about 10 days.
Controlling illegal use of medications Although many of the drugs that are reportedly misused in sexual assault are legitimate prescription drugs in this country, others are manufactured or
imported illegally. Rohypnol, for example, is a frequently prescribed drug in 80 countries worldwide, but is not marketed in the United States; it is smuggled into the United States through illicit channels. Hoffmann-La Roche has taken aggressive steps to halt diversion of Rohypnol to the United States from other countries, control its misuse, and educate law enforcement professionals, rape crisis centers, hospital emergency departments, and consumers. The company is working closely with law enforcement agencies, universities, and rape crisis centers to support their efforts to stop substance abuse and misuse. For more information about this issue, health professionals and consumers may call Hoffmann-La Roche at (800) 720-1076.
Contributions to this column should be sent to L i n d a E. L e d r a y , RN, PhD, FAAN, Sexual Assault Resource Service, 525 Portland Avenue South, Minneapolis, MN 55415; phone (612)347-5832; E-mail: [email protected].
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