DRUG FACILTATED SEXUAL ASSAULT and SEXTING: IMPACT ON THE COMMUNITY

1. DRUG FACILTATED SEXUAL ASSAULTandSEXTING:IMPACT ON THE COMMUNITY Eileen Allen,RN,MSN,FN-CSA, SANE-A, DABFN Coordinator, Monmouth County SANE/SART Program

2. SEXUAL ASSAULT • NEW JERSEY DEFINITION : • Any act of sexual contact or penetration performed on one person by another without mutual consent, or with an inability of the victim to give consent due to age or mental defect or physical incapacity

3. SEXUAL CONTACT • Intentional touching of intimate body parts; can be direct contact or through clothes. • inner thigh • buttock • breast • sexual organs • genital area • anal area

4. SEXUAL PENETRATION • INCLUDES: • Vaginal Intercourse • Oral-genital Contact • Anal Intercourse • Insertion of a Hand, Finger or Foreign Object into the anus or vagina

5. Lack of Consent = Sexual Assault • No MEANS No • Age related issues • < 13 = no consent • 13-15 = limited ability to consent • < 4 years difference in age • 16 and older = full ability to consent • Mental defect = limited consent • Physically Incapacitated = No consent

6. Sexual Assault Statistics • 1 in 4 college aged Women and 1 in 7 Men report an incident of sexual assault • Average age of victims is 18.5 years • 84% of victims report knowing the assailant • 57% of rapes occur on dates • 75% of males and 55% of females involved in date rape have been using alcohol or drugs

7. Know your personal limits and boundaries Let someone know your plans First dates in a group or at least a public place Clear and firm communication Re-affirm consent Discuss, de-escalate, escape RISK REDUCTION STRATEGIES

8. DRUG-FACILITATED SEXUAL ASSAULT • “Sexual assault facilitated by the offender’s use of an “anesthesia-type” drug which when administered to the victim (stealthily or not) rendered the victim “physically incapacitated or helpless” and thus incapable of giving or not giving consent.” American Prosecutor’s Research Institute -1999

9. What are the “Date Rape” Drugs ? • GHB & GBL • ROHYPNOL • KETAMINE • In reality ANY sedating, tranquilizing or mind altering substance

10. Benzodiazepines Xanax Valium Versed Klonipin PLUS Restoril Soma Percocet, etc Benadryl and dyphenhydramine containing compounds Tylenol PM Allergy medications Burundanga/Datura (Jimsonweed) Embalming Fluid “dipping, dips” Visine SOME OF THE DRUGS USED

11. CNS Depressant Symptoms • Horizontal gaze nystagmus • Vertical nystagmus-possibly • Lack of convergence • Reaction to light slowed • Pulse rate below normal • Blood pressure below normal • Body temp within normal range

12. ALCOHOL • substance most frequently identified in specimens taken from rape victims • more than 80% of all Monmouth County rape cases involve alcohol • CNS depressant, enhances effects of other drugs • decreases inhibitions, decreases sensory perception and motor coordination • associated with increased risk behaviors • ? Pre-gaming?

13. GHB • Gamma hydroxybutyrate • Street Names: G, easy-lay, liquid X, grievous bodily harm, blue verve, Goop, liquid E, gamma-oh • Federal schedule I drug as of 3/00 • synthetic central nervous system depressant

14. GHB • Home-made in clandestine labs • recipe ingredients include industrial degreaser and lye • end product is a colorless, odorless liquid

15. GHB • actions greatly enhanced by alcohol • effects may include dissociative state (awake but diminished muscle control; complete or partial memory loss) • nausea and vomiting common effects • overdose may cause respiratory depression or arrest • DEA reports 60 confirmed GHB related deaths over 5 years

16. DISSOCIATIVE STATE • Chemicals block transmission of impulses at nerve synapses resulting in: • Diminished muscle control • Limited sensory perception • Partial or complete memory loss • “strobe” memory • “out of body” sensations

17. “My feet felt like cement. It was like pins and needles without tingling. I could slap myself and there would be no response, no feeling at all. Then I don’t remember anything.” • Recollection of a date rape drugging victim-APP 9/3/00

18. GBL • Gamma butyrolactone • industrial degreaser (see GHB) • converted into GHB by the body • causes nausea and vomiting followed by dizziness and dissociative state • overdose can cause respiratory depression or arrest • at least 1 death reported;19 incidents of coma requiring intubation confirmed

19. GBL EFFECTS • “Serving of 6 capsules will induce deep sleep within 30 minutes... Use ONLY when sleep is safe and desired. Ensure those around you are aware that you may be unarousable and that this is normal. Excessive doses may result in muscle spasms, vomiting, bedwetting and diarrhea. ...Emergency support measures are not necessary.” • Product information from RENIEWTRIENT label

20. ROHYPNOL • Street Names: Roofies, Rope, Snooze, Forget Pill, La Rocha, R 2, Mind Eraser • Benzodiazapine drug class- CNS depressant • Chemical name: Flunitrazepam • Sleeping pill legally manufactured by Roche Pharmaceuticals in Europe and South America (but not in the U.S.) • 5-10x stronger than valium, halcion

21. ROHYPNOL • Historically available in 1 and 2 mg tablets • Effects include sedation, muscle relaxation, slurred speech, memory impairment • Not legal for possession or sale in the U.S. • Original formula rapidly dissolved in liquid • new formulation 1 mg only, contains blue dye and has been approved for distribution in 20 countries

22. KETAMINE • Street Names: Special K, kit kat, cat valium • animal anesthetic; also sometimes used in pediatric anesthesia • described as “dissociative anesthetic” • mind altering hallucinogen;chemically similar to PCP • short duration of action; sometimes known as “the businessman’s LSD” • liquid boiled down to powder form then smoked or snorted

23. ECSTACY • Chemical Name: (MDMA) methelenedioxymethamphetamine • Street Names: X, XTC, candy, love drug, light show, smurfs, hug drug, love dove • Sold in tablet form; pressed with well-known product symbols • Central Nervous System stimulant • ^ BP, ^ HR • Dehydration; may cause dramatically increased body temperature (temp > 105)

24. ECSTACY • increases perceptions of sensory stimuli: • lights are brighter, trails are seen • skin surfaces are more sensitive • effects include jaw clenching, teeth grinding hyperactivity and dehydration • long term use sometimes associated with depression and decreased serotonin output • overdose causes sweats, chills, tremors, seizures,paranoia and hallucinations

25. LSD • Powerful Hallucinogen • Usage reportedly increasing after a marked decline in the 80’s and 90’s • Onset 30-60 minutes, may last 12 hours • distorted perceptions of space and time • Impaired judgement • seizures and stroke seen with overdose • long term effects may include paranoia or psychosis

26. RECENT DEA ALERT • “Fries” or “dips” • Marijuana or cigarettes dipped in embalming fluid and then smoked • Fluid is highly carcinogenic – HANDLE WITH CAUTION • Coma or cardiac arrest possible • If suspected, transport victim for treatment immediately

27. Signs of Date Rape Drugging • Victim reports: • Recalls having a drink but doesn’t remember what happened afterward • Feeling very drunk after only one or two drinks • suddenly feeling nauseous and dizzy after one or two drinks • Wakes up to missing or disheveled clothing • Wakes up feeling like someone had sex with them, but doesn’t remember who, where or when

28. Typical “Date Rape Drug” Scenario • Female,15-25, at a bar, club or private party • Given a beverage she didn’t see poured, or left her drink unattended while dancing • Sudden onset nausea; goes to bathroom • Male waiting outside bathroom, expresses concern, offers to accompany female outside for air or offers a ride home

29. Typical Scenario (continued) • Victim “wakes up” 1-12 hours later: • in her car • on the beach, in a park or other isolated location • next to a stranger; in unfamiliar surroundings, or • in her own home • Complains of confusion , headache, may report genital “soreness” • clothing disheveled; articles missing

30. Typical Scenario (continued) • Victim has no memory, or • victim remembers only “flashes” • sometimes recalls being awake but unable to move arms or legs • if assailant is still present, he often tells victim she consented • victim often too confused or too embarrassed to tell friends or to report to police because she can’t remember and fears not being believed

31. TIPS TO REDUCE RISK • Never accept a drink you did not see poured • Never leave your drink unattended • Don’t drink anything (including water or soda) from a can or bottle you didn’t see opened • Limit alcohol consumption-even if you’re not the designated driver

32. GET MEDICAL ATTENTION IMMEDIATELY !!!

33. SART SERVICES • Rape Care Advocate • No time limit for support services • Forensic Nurse • In some counties limited to victims 13 or older • Exams only performed within 5 days • Law Enforcement (optional) • No statute of limitations • Time sensitive for some evidence

34. Victim Options • County Rape Care Hotline • 24 hour service • Confidential • All choices reviewed • Local Hospital • SART will be notified • Treatment options vary • Police Notification • NOT MANDATORY IN MOST SITUATIONS • Quicker reporting=better investigations

35. QUESTIONS ??????

36. SexuallyEXplicitTextMessagING

37. SEXTING • The act of sending, receiving, or forwarding sexually explicit messages, photos or images via cell phone, computer or other digital device.

38. Scope of the Problem • 49% of individuals age 13-26 report having sent a sexually explicit message • 56% report having received at least one • Why??? • It’s fun • It’s flirting • It was a present for my boyfriend • It might help me hook up with someone I like • National Campaign to Prevent Teen and unplanned Pregnancy and Cosmogirl.com “sex and tech” survey

39. Scope of the Problem • 22% of teen girls have electronically sent or posted nude or semi-nude images of themselves • 11% are between 13 and 16 years old !! • 51% reported they did this because of pressure from a boy • 18% of teen boys admit having sent images • 33% of young adults ages 20-26 say they have posted images of themselves

40. Recent New Headlines • Teen put on sex offender registry for “sexting” nude photo • 18 year old mad at his girlfriend so he sent naked photos of the 16 year old to dozens of friendsCNN • Teen arrested after posting nude pics of herself on MySpace • 14 year old girl from Passaic County NJ apparently posted x-rated pictures because she wanted her boyfriend to see themAP • Teen sex video sent to students’ cell phone • An Indiana teen secretly videotaped two other teens having sex while at a party then sent the footage out to other kids. WISH TV News

41. Recent New Headlines • Teen commits suicide after nude photo scandal • Jessie Logan ended the relationship with her boyfriend, who then sent the x-rated picture she had sent to him on to friends who forwarded it to hundreds of other students. Harassment soon followed. “They called her slut, whore, skank. They said she was trying to be a porn star,” reported one friend. • In July 2008, Jessie hanged herself in her bedroom.

42. Legal Concerns In many states: • It is illegal for anyone to encourage, cause, coerce, or solicit a child (person under 18) to pose or be shown in a state of nudity for purposes of photographing them • It is illegal for anyone to disseminate a picture of a person under 18 in a state of nudity or engaged in a sexual act • It is illegal to knowingly possess photos of a person under 18 posed in a lewd manner

43. Psycho-social Concerns • Sexualization of children in our society has become commonplace. • “The lines that separate the lifestyles of children from adults have blurred…children dress like mini adults • creative play is being replaced by media entertainment saturated with sex, violence and gender stereotyping • pornographic images of women and girls have been glamorized and mainstreamed through dolls, videogames and comic books • Internet porn is easily accessible and routinely viewed by preteen boys

44. Psycho-social Concerns • Sexual experimentation is a normal part of development, but this electronic communications behavior creates a false sense of safety and distance • While it may seem fun to some teens to get or to send an erotic message, it can create emotional confusion • What is the “message” behind the message?

45. High Risk / High Cost • Guilt • Senders often report lasting regret even if the message or images reaches only the intended recipient • Anxiety • The “what ifs” are endless • Shame • Those with low self-esteem may use sexting as a desperate means of gaining attention or fitting in with the “in” crowd • Cruelty and torment from peers can be devastating to anyone but teens are extremely vulnerable

46. Tips for Parents • Learn about the technology • Monitor what your children are doing on the internet and with the phone • Talk to your children about appropriate behavior and set specific limits with consequences • Talk to them about relationships and the importance of their reputation • Make them aware of the lack of privacy or anonymity associated with e-mail and text messaging

47. Tips For Teens • Once a message or photo is sent you can not take it back • The intended recipient may not react the way you expect. • A person who truly cares about you would not pressure you to do something that makes you feel uncomfortable or is illegal • Privacy may vanish if you send a naked photo. It may end up being viewed by: • Other teens • Teachers • Parents • Police • College admissions staff • Sex offenders

48. Tips For Teens • Think about how classmates will perceive and respond to you…and what will be said behind you back • Nothing is anonymous; the photos can be traced back to you • If you receive a suggestive photo DO NOT forward it; this could be a crime • You could be charged with crimes like distributing pornography even if it’s a picture of yourself

49. QUESTIONS ??????

50. Thank you for your time and attentionCheck out the internet for additional information and resourceswww.medscape.comwww.minortrouble.comwww.wikipedia.com