Community Intervention Centre | Trauma Psychology in Cape Town, Western Cape, South Africa

Spiking the punch or slipping her a Mickey may sound old fashioned, but there is evidence that the drugs referred to are used as silent, invisible, tasteless and scentless weapons to overpower victims. The effects are destructive and deadly. Mickey is a term to describe chloral hydrate and a general word for any substance added to a drink to knock an unsuspecting person out. Substances related with sexual assaults include Gamma-hydroxybutyrate (GHB), Ketamine and Flunitrazipam (Rohypnol). It has been linked to cases of sexual assault or date rape where the victim is assaulted after being rendered unconscious or immobilised by the drug. The guy was on top of me. I tried to push him off, but I couldn't lift my arms. They felt like they were full of sand - victim's testimony.

These drugs have been involved in poison control cases and suspected in unnatural deaths. It was commonly used as synthetic steroids, and later became part of the club scene. Rohypnol has been reported in several date rape incidents (Epidemiology of Youth Drug Abuse Treatment Research Findings 2/98 (NIDA)). In California in 1997 a man was sentenced to 77 years in prison for date rapes involving GHB. Police found almost 2000 photos showing naked women in sexually explicit positions.

SANAB Port Elizabeth seized thousands of Rohypnol tablets that had been stolen from a pharmaceutical company in the area in the second half of 1998. In Cape Town a number of emergency room visits were associated with the use of Gamma-hydroxybutyrate (GHB, Liquid Ecstasy). Twenty percent of patients attending specialist treatment centres in Port Elizabeth listed over the counter medicine (OCM) and prescription drugs as their primary drugs of abuse (Parry, CDH, Pluddeman, April 1999, Highlights of SACENDU, Medical Research Council, hereafter referred to as the Medical Research Council technical report, April 1999). According to Supt Das Neves (SANAB Unit Commander: West Rand), more than half of the stock of drugs at Baragwanath Hospital is stolen. In November 1998 SANAB Pretoria seized more than 20 bottles of GHB (Liquid Ecstasy) at a club scene. It was sold for R100 per bottle. Supt GP J Grobbelaar (SANAB Unit Commander: Durban ) said there was a decrease in reported cases of Rohypnol abuse in this area. Capt S F Meyer of SANAB Port Elizabeth reported that there was an increase of abuse of F2 (generic equivalent of Rohypnol), especially among school children.

GHB is mainly abused as an intoxicant and euphoriant; bodybuilders use it for its alleged utility as an anabolic agent or as a sleep aid, and some individuals use GHB to commit rape or indecent assault. According to the Violence, Child Protection and Sexually Offences Unit two girls were kidnapped in March this year, forced to drink half a can of a cider, and a few minutes afterwards they were too, dizzy to even remember precisely how they had been raped. In April a lady was unexpectedly injected when she walked along the pavement, forced into a car and pushed around by four men in a room until she lost consciousness. She woke up nine hours later in her own bed. She had been raped but couldn't recall what had happened. According to Supt Lobo das Neves, a 15-year-old was raped after a drug had been put in her drink.

It is estimated that at the most 45% of rape incidents are reported and at least 70% of those cases are withdrawn. There are critical delays in reporting cases of rape and indecent assault. Biological samples are useless when taken at a time when the effects of the drug have already worn off and only residual amounts remain in the body fluids. According to Dr Steyn it is not routine procedure for a district surgeon to take a urine or blood sample. Most of the time the victims are underage girls and the generation or perhaps communication gap between parents and teenagers is not a new phenomenon. Then there is one of the side effects of these drugs, antegograde amnesia, which means memory loss for the events immediately following ingestion. The last thing I remember about the party was this guy giving me a drink. I woke up seven hours later in his bed. I can't remember anything. Without physical evidence the case will not stand in court. For the victim it is the self-blame and the shame and the fear of facing a suspect in court. There is difficulty in establishing that a drink has been spiked, and investigating units are understaffed. This is ironic considering that SA has the highest rape incidence in the world.

Gamma-hydroxybutyrate(GHB) - Perfect agent for a date rape
Street names : Liquid Ecstasy, Cherry Meth, Gook, Soap, Grievous Bodily Harm(GBH), Liquid E, Liquid X, Georgia Home Bay, Bedtime Scoop, Easy Lay, Salty Water, G-Riffick, Organic Quaalude, G-juice, Vita-G.

GHB's story
GHB was first synthesised about 30 years ago by a French researcher, Or H Laborit, who was interested in exploring the effects of GABA (gamma amino butyric acid) in the brain. Because little or no GABA crosses the blood brain barrier (BBB) he synthesised GHB (which substitutes a hydroxy group for an amino group). GHB crosses the BBB and some of it is then metabolised into GABA. GHB processes neuromodulatory properties in the brain. The highest concentrates in the brain are in the hypothalamus and basal ganglia. It is also found naturally in every cell in the human body and administered GHB stimulates pituitary growth hormone (GH) release and causes transient elevations of prolactin and cortisol in the blood. It inhibits dopamine release and facilitates REM and non-REM sleep (sleep is deeper and more restful but the person awakes after about three hours).

GHB has been used in Europe as a general aneasthetic, an aid during childbirth (improves cervical dilation and uterine contractions), treatment for insomnia (sleeping disturbances), to treat alcohol withdrawal and narcolepsy, treatment of sexual inhibition and as a psychotherapeutic adjunct (encourages verbalisation and relaxes patient). During the 1980s it was widely available over the counter in health food stores and was mainly used by body builders. In the last few years it has become popular as a recreational drug, offering a pleasant, alcohol like hangover-free high with potent prosexual effects. GHB appeared on the UK club scene in 1994. In South Africa it is currently used as a smart drug, the preferred sedative of the cyber punk culture and used as an alternative for Ecstasy or amphetamine sulphate (Speed). GHB is controlled in 20 states of the US and banned as an over the counter drug by FDA. It is not a scheduled or controlled substance by the DEA or in South Africa .

Appearance and availability
GHB is a colourless, odourless white powder with a slightly salty taste. It also comes as a capsule or in liquid form. It is usually kept in a coloured bottle (brown or green) because it is believed to be light sensitive. GHB is also available in small plastic bottles, about the size and shape of a hotel shampoo bottle.

GHB is not Ecstasy (MDMA) in a liquid form, although some of the effects are similar to Ecstasy. MDMA is an amphetamine/stimulant, while GHB is considered to be a hypnotic/sedative.

GHB is illicitly produced in clandestine laboratories and quality and purity are the main concerns. Normally it contains two non-regulated chemicals: gammabutyrolactone (GBL) a metabolite of GHB, and sodium hydroxide. Its effects are extremely similar to GHB though the required dosage is lower than that of GHB. This drug is widely available in the drug underworld. In the West Rand GHB has been found containing an amphetamine basis which is used as a prescription drug for horses.

GHB is frequently found in bars, night clubs, rave parties and gyms and is primarily used by young adults. It is marketed as a substitute for Ecstasy or Speed or disguised in energy drinks or a sweet liqueur.

Doses, effects/risks
Strength varies greatly from bottle to bottle. A hit can be a drop, a teaspoon or cupful. Potency and content differ from bottle to bottle. The trickiest part of GHB is finding the right dose for the desired effect. The amount required for a given level of effect will vary from person to person. Small increases in the amount ingested lead to significant intensification of the effect. Normally 0.75 -1.5 g is suitable for prosexual purposes and 2.5 g are sufficient to induce sleep. Eye droppers are one method used to administer GHB in liquid form.

The dose required to knock someone out isn't much lower than the one that kills. GHB was put into her soft drink and within 24 hours the 17-year-old varsity volleyball player was dead. (Time, Sept 30, 1996).

Effects are within 20 min after ingestion and usually last one to three hours. It can be prolonged through repeated dosing. GHB produces a relaxed and euphoric state similar in some aspects to MDMA and in some aspects to alcohol. Some effects: uninhibited behaviour, increased libido, temporary amnesia, heightened sense of touch, confusion, remarkable hypotonia (muscle relaxation), clonus (rapid, rhythmic, contraction and relaxation of muscles), uncoordinated movements, intense drowsiness, disorientation, tendency to verbalise, lack of bladder control, orthostatic hypotention, headaches, diarrhoea, nausea, vomiting, sleepiness, muscle stiffness, can cause a sudden sedation and loss of concentration, deep sleep, coma, moderate bradycardia, and cardiac and respiratory depression can occur. Morning after effects: GHB lacks the unpleasant characteristics associated with alcohol and other relaxation-orientated drugs. GHB has a protein sparing effect. Chronic use might lower potassium levels. Users become psychologically dependent.

Interacting effects with other drugs are unpredictable and possibly dangerous especially when used with other depressants like alcohol. The first case of fatal intoxication due to ingestion of GHB and intravenous use of heroin was reported in the Journal of Forensic Science, May 1995. On the rave scene GHB is used as substitute for Speed or Ecstasy. According to the DEA Congressional Testimony, March 11, 1999 , abuse of GHB has increased. It is used frequently in combination with other drugs that heighten its effects.

GHB is especially hazardous when taken with tranquillizers (Valium and Xanax), phenothiazines (Therazine, Stellazine), painkillers (barbiturates and opiates), alcohol, anticonvulsants (Dilatin and Phenobarbital), and over the counter allergy and sleep remedies.

Ketamine / Anaket-V (generic equivalent) - "The forget drug"
Street names: Special K, vitamin K, K, Ket, KitKat, Green K, Super K

History
Ketamine Hydrochloride is an anaesthetic commonly used for people but especially for veterinary purposes. The pharmacological profile is essentially the same as that of Phencyclidine (PCP). Ketamine is controlled in 18 states in the US. In 1992 it appeared on the rave scene in the UK . K has a high potential for abuse and under the Medicine Act unauthorised supply is illegal.

After 25 years of underground recreational drug use by big-city club goers and New of Age types, K exploded onto the suburban drug scene. K is packaged to look like gum. The surest sign of its popularity is seen in the pop culture, for example: The Chemical Brothers recorded a song called Lost in the K - Hole which went gold. K-hole is the jargon for a bad trip. Ketamine was used in several rapes in the 1980s (Time, October 20, 1997).

Availability and packaging
Supt Casper Venter (SAPS Forensic Science Laboratory (FSL) Kuils River ) said that in South Africa it appears in a powder, liquid or tablet form. Most of the time it is stolen from a vet.

Ketamine is distributed as a powder in small bottles, paper, or aluminium "folds" and as a liquid in small vials or bottles. Alcohol, cocaine and marijuana are the most frequently reported substances used in combination with K (DEA Congressional Testimony, March, 1999).

Administration and effects
K is used as an anaesthetic intravenously (IV) 2 mg per kg and a half mg per kg for maintenance. When injected intramuscularly (IM) 6.5 -10 mg per kg are needed. Anaesthesia is produced within 30 seconds IV with a duration of 5-10 minutes and 3-4 minutes IM with a duration of 12-25 minutes.

Ketamine induces dissociative anaesthesia the patient may appear awake and reactive but does not respond to sensory stimuli.

On the street the powder is normally snorted or taken orally and the liquid orally or rather by IM or IV injection. Ketamine is to a lesser extent smoked on tobacco or marijuana. It is difficult to know how strong the dose is.

If snorted, a dose of 20 mg in each nostril is repeated at 5 to 10 minute intervals usually three to four times, until the desired effect is achieved. Effects start after 5 -10 min: a rushing energetic effect (almost immediately when injected) or about 20 minutes to an hour when taken orally. Thereafter there is a soft trip which will linger for approximately 2-3 hours. Side effects include a numbness, strange muscle movements and possible nausea and vomiting. Like most anaesthetics, eating and drinking before taking Ketamine may induce vomiting. Other effects are delirium, an increase in blood pressure, tachycardia, increased salivary and bronchial secretions, bradycardia (lowers the heart rate) which can lead to oxygen starvation to the brain an muscles (an overdose causes the heart to stop), respiratory depression, vomiting, involuntary muscle movements, disorientation, impaired motor skills and out-of-body experiences. The users may feel as if they have entered another reality. In effect it blocks most sensory input, normal thinking and memory recall. Ketamine is highly dose dependent. An overdose will result in unconsciousness (it depresses circulatory and respiratory systems to dangerous levels) and sometimes death. Because it is an anaesthetic it has analgesic effects: one may fall and hurt oneself, and not notice the injury.

Ketamine is popular in multi-drug use. Users that cannot sleep after using Ecstasy use K to sleep. An alternative used is Nubain, a narcotic analgesic which has very much the same effects as K.

It is particularly dangerous to mix Ketamine with respiratory depressants such as alcohol, barbiturates, heroin or tranquillizers.

Flunitrazepam: Rohypnol / Insom & Rolab flunitrazepam (generic equivalents) - The drug of choice for date rape
Street names: Roaches, La Rochas, Rope, Rip, Forget pill, Poor Man's Quaalude, R-2s, Roach-2s, Circles, Dulcitas, Whiteys, Trip-and-Fall, Mind-Erasers, Mexican Valium, Lunch Money (referring to the drug's low street price), Pappas or Potatoes (describing the mental capacity of someone under the influence of the drug), Negative or Minuses (referring to the markings of the 1 mg tablet), Pluses or Roches Dos (referring to the marketing on the 2 mg tablets) Roofies, Trophies, Ruffles, Ropies, Roche, Mexican Valium, Rib, Love Potion, F-2s (generic equivalent Insom).

What is Flunitrazepam?
Flunitrazepam is the brand name and it belongs to the benzodiazepine class of drugs (like Diazepam (Valium), Librium, Xanax and Halcoin) but is several times more potent. These are minor tranquillizers, which are synthetic drugs manufactured as a medicine mainly for the short term treatment of sleep disorders and anxiety.

Rohypnol has been abused in Europe for more than ten years. It is an approved drug in Europe and other countries, but not in the US. In South Florida it is the fastest growing drug problem (Epidemiology of Youth Drug Abuse Treatment Research Findings 2/98 (NIDA)). Germany has removed 2 mg dosage from retail distribution, restricting it to hospital use only. The law in South Africa controlled Flunitrazipan under Act 101 of 65 (Schedule 5). Since 11 June 1999 it is also controlled under the Drug Act 140 of 92. According to Supt Lobo das Neves (he has served 17 years in the SAPS and is currently busy with a doctoral in Criminal Justice at Hawthorne University, US ) tranquillizers are still the most commonly prescribed mood-altering drugs in the UK, South Africa and US.

Manufacture and distribution
The pills are typically sold in its original form in plastic "blister packs" or bubble packs, conveying a sense of security and legibility in its use. Sometimes the packages are opened and the pills are put into vitamin jars or other medicine bottles, or the pills may be ground into a powder.

Mode of ingestion and effects
Flunitrazepam is usually swallowed as a pill or dropped whole or crushed into punch, beer, soft drinks or other alcoholic beverages. When it is dissolved one cannot see, smell or taste it. It is a potent and fast acting sedative. Effects start after 20-30 minutes (2 mg tablets) and can last up to 8-12 hours without repeating the dose.

Physical and psychological dependence increase with dose and duration of use. Rohypnol as a short term medicine, continual use of Rohypnol may result in sleeping pills becoming ineffective after two weeks, and medication to combat anxiety might become ineffective after four months. With regular use tolerance can develop quickly, so increasing amounts are needed to get the same effect. Effects include drowsiness, memory impairment, dizziness, nightmares, headaches and psychomotoric impairment. Paradoxically, depressants can induce excitability or aggressive behaviour in some users. Dependence can develop quickly with regular use and withdrawal can lead to intense anxiety, muscle pain, nausea, insomnia, irritability and headaches. Sudden withdrawal from very high doses can result in confusion and serious convulsions and hallucinations, impaired motor skills, skin reactions, dizziness, uninhibited behaviour, impaired judgement, reduced levels of consciousness, visual disturbances and gastrointestinal disturbances.

As a street drug Rohypnol is also used in combination with alcohol to enhance the feeling of drunkenness. It has been reported that it is used in combination with cannabis/marijuana or tobacco to boost the high of heroin and to ease the comedown from a cocaine or crack binge. (Users parachute to remedy the depression that follows a stimulant-induced high). Flunitrazepam is also used as a substitute for Wellconal (Pinks).

Using Flunitrazepam with alcohol may produce extremely low blood pressure, respiratory depression, difficulty in breathing, coma or even death.

Similarities between GHB, Ketamine and Rohypnol
It is difficult to predict the exact effects of any dug on a particular individual. Effects will vary depending upon the drug, the dose ingested, whether it is mixed with alcohol or other drugs, weight, gender and metabolism but in Mickeys specifically the price can be death. There are many parallels between GHB, Ketamine and Rohypnol. None of them was manufactured to be abused. Synergism (the effects of individual drugs are more intense when used in combination than when used on their own) plays an important part. Other similarities include: availability and appearance, the venues and the age of people that use them, the significant abuse potential and the destructiveness. All of these drugs are used in combination with other drugs, especially alcohol. According to the Medical Research Council technical report, April, 1999, alcohol is the most common substance of abuse among patients seen at specialist treatment centres in Cape Town, Durban, Port Elizabeth and Gauteng, accounting for up to 68% of admissions.

Special considerations for police investigators
Antegograde amnesia (memory impairment) and drowsiness in victim.

These drugs are the PERFECT AGENTS FOR DATE RAPE and indecent assault; when hidden in a drink it may be completely undetectable.

Don't use it.
Don't take drugs from strangers.
Avoid beverages you didn't open yourself.
Drink from tamper-proof bottles/cans.
Don't fall for that new drink.
Watch for signs of intoxication.
Don't go anywhere with anyone you don't trust.
Do not ask someone to watch your drink.
Personally observe any beverage being mixed or prepared.

If you feel a lot more intoxicated than you should, considering your usual response to the amount of alcohol that you have consumed.
If you wake up feeling weird or crazy, experience a memory lapse and cannot account for what has happened over a period of time.
If you remember taking a drink but cannot recall what happened for a period of time after you consumed the drink.
If you feel as though someone has had sex with you, but you cannot remember any of or all the detail of the incident.

Move to a safe place, not out on the street!
Call the police, who will refer you for medical care.
Request that the district surgeon take a urine and blood sample for drug toxicology testing.
Reserve as much physical evidence as possible. Do not urinate, shower or bathe, don't throwaway or wash the clothing you were wearing during the incident. If possible save any other materials that might provide evidence, such as the glass that contained your drink.

The information in this article has been transcribed verbatim from the following publication:
Servamus – Community edition – Drugs and Occult Related Crime – The Facts – The Answer.

We express our heartfelt gratitude for permission to replicate these articles on this website.

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