Sexual assault and substance abuse are frequently intertwined for a number of reasons. First, drugs and alcohol may be used to facilitate sexual assault. Second, the trauma of being a victim of sexual abuse or assault may lead to the use of drugs or alcohol to cope. Finally, suffering from addiction may place an individual at a greater risk of becoming a victim of an assault.

If you’ve been the victim of a sexual assault while intoxicated or have developed an addiction stemming from the trauma of assault, there are avenues for you to access the support you need to find healing.

What Is Drug-Facilitated Sexual Assault?

drink getting spiked with drugs Drug-facilitated sexual assault (DFSA) is any act of sexual assault that occurs while a victim is under the influence of drugs or alcohol.¹ This can involve a perpetrator giving a victim drugs with the intention to assault the person or a perpetrator taking advantage of an already intoxicated victim.¹ While the majority of sexual assaults involve male perpetrators and female victims, this is not always the case.²

The majority of sexual assault victims know their offenders.¹ Approximately 4 out of every 5 sexual assaults are committed by someone close to the victim, such as a spouse, family member, friend, or acquaintance.³

Alcohol is involved in a large number of drug-facilitated sexual assaults. Other drugs commonly involved in these assaults include:

Gamma-hydroxybutyric acid (GHB).
Ketamine.
Rohypnol (flunitrazepam, aka “roofies“).
Ecstasy.

Unfortunately, a significant number of sexual assaults go unreported. Victims may choose not to report to sexual assaults for a variety of reasons, including:^2,3

Feelings of shame or embarrassment.
Fear of the perpetrator causing further harm to the victim or the victim’s family.
Fear of being blamed for the assault.
Lack of certainty on what constitutes sexual assault.
Lack of knowledge on how to report an assault.
Pressure from loved ones to not report the assault.

Victims of DFSA may falsely assume that they did not experience a sexual assault because they were under the influence of drugs or alcohol. To be clear: having been under the influence of drugs or alcohol during an assault does not mean you are not a victim of a crime. A person who is intoxicated and does not give consent to participate in sexual activity is a victim of assault.

While sexual assault may involve intercourse, assault is not limited to this one act. Other sexual advances and acts that fall under the umbrella of sexual assault include:³

Touching or grabbing that is not wanted/invited.
Sexual penetration with objects.
Oral sex.
Anal sex.

Experiencing DFSA can lead to a range of emotional reactions. While people will certainly differ in how they respond to and cope with a sexual assault, common initial reactions may include:³

Shock.
Denial of the event.
Anxiety.
Anger.
Shame.
Guilt.
Confusion.
Numbness.
Intrusive memories.
Flashbacks.
Nightmares.

Some DFSA victims may go on to develop mental health conditions and other difficulties, such as:³

Major depressive disorder, a condition characterized by significantly depressed mood, decreased energy, and difficulty finding pleasure in life. Other symptoms can include changes in sleeping and eating patterns, difficulty concentrating, and suicidal thoughts.
Post-traumatic stress disorder (PTSD), a condition that can develop after exposure to a traumatic event. Symptoms may include intrusive thoughts, memories, and nightmares of the event, avoidance of reminders of the event, negative thoughts and feelings, and increased arousal.
Relationship problems, such as isolation from family and friends, difficulty trusting others, and conflict.
School- and work-related problems.
Sexual problems. These may include low libido, fear of sexual activity, and avoidance.
Drug or alcohol use disorders. Sexual assault victims may turn to drugs and alcohol to cope with the emotional aftermath of the event. Sexual assault victims are up to 10 times more likely than people who have not experienced sexual assault to use drugs.³

Drug-facilitated sexual assault victims may benefit from professional help in order to process the event and learn tools for coping with emotional reactions that can result from the trauma.

Alcohol and DFSA: An All-Too-Common Link

While ‘date rape drugs’ like ketamine, GHB, and Rohypnol are typically what come to mind when thinking about DFSA, alcohol frequently plays a significant role in sexual victimization.² In fact, alcohol is the most common drug involved in sexual assaults.⁴ Almost half of all sexual assaults involve alcohol use by the perpetrator and/or victim.²

shots of alcohol

Drinking alcohol can lead to:

Impaired thinking and judgment.
Difficulty determining whether a situation is risky.
Difficulty setting boundaries.
Inability to fight back during a sexual assault.
Blackouts.
Memory loss.

Alcohol can alter both the victim’s and perpetrator’s perceptions and behaviors in a situation. Perpetrators may specifically target victims who are intoxicated because they believe it will be easier to commit a sexual assault. Other perpetrators may not initially intend to commit a sexual assault but may misperceive a victim’s cues while under the influence of alcohol. Drinking alcohol can also lead perpetrators to behave more aggressively, since their ability to control their behavior and cope with rejection is impaired. Victims may have a harder time fighting back because alcohol can hinder their motor movements.
Almost half of all sexual assaults involve alcohol use by the perpetrator and/or victim.
Alcohol-related sexual assaults are a major concern on college campuses. Approximately 1 in 20 college women experience sexual assault each year, and alcohol consumption is a major risk factor for rape in this population.⁵College students may be at increased risk of DFSA because of the culture of college campuses, where binge drinking is common and encouraged at parties, such as Greek events.²

Though alcohol is involved in a significant number of sexual assaults, a significant portion of drug-facilitated sexual assaults involve other drugs either mixed with alcohol or used alone.

Other Drugs of Concern

Other substances commonly used for the purposes of incapacitating and assaulting a victim are referred to as “date rape drugs.” These drugs typically lack color, smell, and taste, allowing for them to be easily slipped into a victim’s drink.⁴ In general, these drugs can cause weakness, confusion, and altered or lost consciousness, which can impair or remove a person’s ability to consent to sexual activity.

Rohypnol

Rohypnol is a benzodiazepine that is 7 to 10 times stronger than Valium.¹ It is also known by the generic name flunitrazepam and by the following street names:^4,6

Roofies
Forget-me pill
Mexican Valium

The drug may be swallowed, snorted, or injected, but it is most notorious for perpetrators dissolving it in a victim’s drink without their knowledge. Rohypnol pills appear small, round, and white or oval and greenish-gray. Consuming Rohypnol can lead to confusion, dizziness, poor coordination, muscle relaxation, loss of consciousness, impaired vision, and memory loss.⁴

Victims who are drugged with Rohypnol may fall into a sleepy state before or during the sexual assault and have difficulty remembering the details of the event. The effects of the drug typically set in within 30 minutes of ingestion and can last for a few hours.⁴

GHB

GHB, or gamma-hydroxybutyric acid, is a powerful drug with a high risk for overdose.⁴ Street names for GHB include:⁶

Georgia home boy.
Liquid ecstasy.
Liquid X.
Cherry meth.

ghb colorless liquid The drug is available as a colorless and odorless liquid, white powder, or pill. When GHB is mixed in liquid, it may give the drink a salty taste, but this can be hard to detect in fruity drinks. The effects of GHB can include nausea, drowsiness, dizziness, loss of consciousness, memory loss, and difficulty breathing. In some cases, GHB can also cause seizures, coma, and death.^4,6 The drug’s effects typically occur within 15 minutes of ingestion and may last for 3 to 4 hours.⁴

Ketamine

Ketamine is a dissociative sedative used medically for the induction of anesthesia, as well as for a variety of veterinary purposes. It is also sometimes involved in date rape. It may be referred to as:^1,4,6

K.
Special K.
Vitamin K.
Cat Valium.
K-Hole.
Kit-Kat.

The drug may be sold as a liquid or white powder. Ketamine can cause users to enter a dream-like state that involves a distorted sense of sight and sound and difficulty perceiving time. Some users also describe having an “out of body experience,” where they may feel detached from their own bodies. Other effects can include slurred speech, poor coordination and motor functioning, confusion, impaired memory, difficulty breathing, nausea and vomiting, and possibly death.^4,6

Ecstasy

Methylenedioxymethamphetamine (MDMA), or ecstasy, is a club drug that may be swallowed, snorted, or injected.⁶ Ecstasy can cause hallucinogenic effects, as well as a heightened sense of empathy and touch, lowered inhibitions, anxiety, sweating, chills, teeth clenching, muscle cramps, depressed mood, hyperthermia, and memory loss.⁶

Ecstasy may make people feel more affectionate toward others, impair their ability to sense danger, and diminish their ability to provide reasoned consent to sexual activity.⁴

Signs You Have Been a Victim of DFSA

Determining if you have been the victim of a drug-facilitated sexual assault may be difficult, since many of the drugs used by perpetrators can cause loss of consciousness, memory loss, and blackouts. You may be unable to remember details of the assault but notice physical signs or feel strongly that something traumatic has occurred.

bruised leg Victims of DFSA may experience:

Bruising and/or soreness of the body and genitals.
Bleeding of the genitals or anus.
Broken, sprained, or fractured bones.
Pain.
Difficulty walking.
Sexually transmitted infections.
Pregnancy.

Assault victims who have been drugged may also experience physical and emotional discomfort as they recover from the effects of drugs and alcohol on their bodies. Victims may feel “hung over” the next day as they recover from their intoxicated episode.⁴

Family and friends of sexual assault victims may notice physical and emotional changes after an assault. Victims may have a difficult time disclosing the abuse for a number of reasons, such as fear, embarrassment, or shame. Possible signs that your loved one has been the victim of sexual assault may include:^9,10

Symptoms of depression, such as sad mood, loss of interest in activities, low energy, changes in sleep and appetite, difficulty concentrating, and suicidal thoughts.
Symptoms of anxiety, such as excessive worry, restlessness, irritability, muscle tension, and sleeping problems.
Fear and distrust of others.
Person is easily startled.
Increased or decreased interest in sexual activity.
Changes in appetite and/or weight.
Self-harming.
Low self-esteem.
Feelings of numbness.
Isolation/avoidance of others or of loving communication or touch.
Initiation of or increase in drug, alcohol, and/or nicotine use.

If you or someone you care about has been the victim of sexual assault, help is available. Treatment programs and support groups can help victims cope with the trauma of sexual assault.

Tips to Protect Yourself from DFSA

When it comes to sexual assault, victim-blaming is an unfortunately common occurrence. Often, the victim is blamed for being in the wrong place at the wrong time, dressing too provocatively, drinking too much—the list goes on and on. However, perpetrators of sexual assault are the only ones to blame. If you’ve been a victim, you may blame yourself for having been intoxicated, but understand that perpetrators often secretly intoxicate their victims or take advantage of a victim who is already under the influence. You cannot consent when you are incapacitated. You are not to blame if you’ve been assaulted under the influence.

Understanding that assault is never the victim’s fault, there are some precautions you can take to reduce your risk of experiencing a sexual assault. A significant number of sexual assaults happen in social settings, such as bars, nightclubs, and parties. Even if you choose to use alcohol or drugs in these settings, there are steps you can take to protect yourself:

Avoid excessive use of alcohol and drugs.
Do not leave a drink or any other substance unmonitored. Observers can slip a toxic substance into your drug or drink without your knowledge.
If possible, only drink alcohol that comes from a sealed bottle. Party drinks like “jungle juice” can easily be mixed with dangerous drugs without your knowledge.
Avoid mixing drugs and alcohol with one another, as this may enhance the level of intoxication and possibly lead to a blackout.
Notice any changes to the color or taste of your drink. Do not consume the drink if you detect any strange tastes, odors, or colors. This may indicate that someone has tampered with it.
Monitor how you are feeling and your level of intoxication. If you start to feel sick, confused, or too intoxicated, consider slowing down, telling a friend, and getting to a safe place.
Research mobile apps that let you signal for help if you feel unsafe.
Do not drink or use drugs alone or in unfamiliar environments. Instead, stay with one or more trusted friends. If possible, develop a plan for arriving, leaving, and checking in with one another throughout the event.

Other helpful tips for staying safe include:

Taking note of exit points (doors and windows) when entering a new setting.
Creating a code word when going out with friends to signal that you are uncomfortable or concerned about your safety.
Carrying a list of phone numbers of family, friends, and local transportation, such as taxis.
Developing a safe plan for traveling domestically or abroad. If traveling alone, be sure to tell trusted friends and family where you are traveling and develop a plan for getting safely to and from your destination. Contact the nearest U.S. Embassy or Consulate if you have any safety concerns during your trip.
Trusting your gut. If you feel uncomfortable with a certain person or situation, listen to your instincts and remove yourself from the situation or seek help.

Addiction, Drug-Seeking, and Sexual Victimization

People who abuse or are addicted to drugs or alcohol are at risk for sexual abuse and assault.⁷ Substance users may find themselves in risky situations that may increase the likelihood of becoming victims:

Men and women who are addicted to drugs may turn to prostitution to fund their addictions, exchanging sex for drugs or money to buy drugs. Sex workers may be at higher risk of sexual assaults and rapes from both ‘pimps’ and ‘johns.’ Pimps and johns may use aggression and violence as a way of controlling sex workers.
Substance users may be in relationships where they depend on their partners for drugs and alcohol and may be repeatedly bribed or coerced into sexual activity they don’t want to participate in.
Substance users may be at risk for sexual assault and rape while under the influence. Drugs and alcohol can impair a user’s thinking, judgment, and motor movements, which may make it difficult to identify a perpetrator and to fight back during an assault.

devastated woman Substance users who are victimized may be at risk for physical injuries, sexually transmitted diseases, unintended pregnancies, and emotional health issues. While substance users are at higher risk of sexual assault, no one deserves to be victimized, regardless of whether they suffer from addiction. Unfortunately, addicted victims may be further victimized by a fear of approaching law enforcement and reporting the incident (if they feel at risk of being jailed for unlawful activity and/or blamed for the incident). Some addicted individuals have expressed that they find a partner, or someone to protect them while they seek out drugs, only to be assaulted or coerced into sex by their “partner.”

If you’re suffering from an addiction, you are not a bad person and you do not deserve to be a victim of assault. You can get treatment for substance abuse and move forward toward the life you deserve.

What to Do if You’ve Been Victimized

Dealing with the aftermath of a sexual assault can be challenging. Survivors may have a hard time sharing what happened with family, friends, medical and mental health professionals, and authorities. Knowing your options after a sexual assault can help you make an informed decision about what to do.

Some rape survivors may choose to complete a sexual assault forensic exam (SAFE) and collection, also known as a rape kit. A SAFE exam involves collecting evidence from a survivor’s body and clothes. This information can be helpful if a survivor decides to report the assault.

Prior to completing a rape kit, it is helpful to avoid bathing, showering, brushing your teeth, washing your hands, and going to the bathroom so as to preserve as much evidence as possible.⁴Carefully remove any clothes you were wearing during the assault and place them in a paper bag.¹¹ For best evidence collection, it is recommended that a SAFE exam be completed as soon as possible; certain drugs leave the body faster than others. For example, Rohypnol stays in the urine up to 72 hours, but GHB is eliminated in approximately 12 hours.⁴ In most scenarios, for DNA evidence to be collected, the kit must be completed within 72 hours.¹¹ SAFE exams typically take a few hours to complete and involve a series of steps:¹¹

Treatment of any acute injuries.
Questions about health and sexual history.
Full body exam, including the genitals.
Urine, blood, and hair samples.
Pictures of injuries and various body parts.
Follow-up care, such as to prevent or treat sexually transmitted infections.

SAFE exams are free to survivors and covered by the Violence Against Women Act. While SAFE exams can help collect evidence in the event that a survivor wants to report the assault, there is no pressure to make a report. However, some states have mandatory reporting laws for child victims of sexual assault. The amount of time that the evidence will be stored after a SAFE exam depends upon the specific state and jurisdiction.

Reporting a sexual assault to authorities allows for survivors to seek justice and may also give survivors a voice, which can help on the road to recovery. To report a sexual assault you may:

Call 911 if you are in immediate danger.
Contact your local police department.
Contact your college campus’s law enforcement.
Call or go to a local sexual assault service provider.

For a list of local sexual assault service providers, see the Rape, Abuse, & Incest National Network’s directory. You can also call the National Sexual Assault Telephone Hotline at 1-800-656-HOPE (4673). The hotline provides free and confidential support, assistance with finding local health facilities and treatment programs, and information on medical concerns and local reporting laws.

The window of time to report a sexual assault is restricted by the statute of limitations, which requires that a crime be reported within a specific timeframe. The statute of limitations varies from state to state depending upon the crime and age of the victim.

Finding Help

Sexual assault survivors may experience emotional reactions to the abuse, such as depression, anxiety, and post-traumatic stress. Some people may also develop addictions after turning to drugs and alcohol to cope with the emotional pain. Treatment programs can help sexual assault survivors recover by learning to cope with the trauma.

victim going through therapy session Mental health treatment programs offer therapy for people struggling with mental illness and emotional health issues. These programs aim to help a person process their trauma in a safe environment and learn coping skills to manage their emotional reactions. Therapy for trauma may take place in a mental health treatment facility, which typically offers intensive group and individual therapy sessions, or with a therapist who specializes in treating sexual assault survivors.

Drug and alcohol abuse treatment programs can help survivors who are abusing or are addicted to drugs or alcohol. The goals of these programs include safely quitting drugs and alcohol, understanding the reasons for using drugs and alcohol, and developing healthier coping strategies. Addicted sexual assault survivors may benefit from one or more of the following types of addiction treatment programs:

Detoxification programs. The abuse of certain drugs, such as alcohol, opioids, and benzodiazepines, can result in serious and potentially dangerous withdrawal symptoms.⁸ These and certain other drugs may also cause or exacerbate psychological symptoms, such as anxiety and depression. Detox programs can help monitor and treat withdrawal symptoms to improve safety and provide emotional support during withdrawal.
Inpatient treatment programs provide intensive addiction treatment and temporary housing. Participants may attend daily therapy sessions and support groups and also participate in other wellness-promoting activities, such as yoga, meditation, and equine therapy. These programs may take place in a hospital or a residential treatment facility.
Outpatient treatment programs offer weekly therapy sessions without temporary housing. Participants may attend outpatient treatment once or more per week, depending upon the particular program.

Sexual assault survivors who are experiencing both mental health and addiction problems may benefit from treatment that simultaneously addresses both concerns. Dual diagnosis programs offer help for people suffering from both addiction and one or more mental health conditions, such as anxiety, depression, bipolar disorder, eating disorders, and post-traumatic stress disorder, as well as addiction. The goals of these programs are to help people understand the relationship between their drug use and emotions and to develop healthier ways of dealing with emotional issues and trauma. These programs may offer group, individual, and family therapy sessions and support groups in an inpatient or outpatient setting.

Support groups may also be an important part of recovery for a sexual assault survivor who is struggling with addiction:

Twelve-step groups like Alcoholics Anonymous and Narcotics Anonymous help people with addictions to alcohol and drugs recover by encouraging members to form connections with other sober people as they work through the 12 steps. The 12 steps include admitting that you are powerless over drugs and alcohol, making amends for past mistakes, and helping others in the program.
SMART Recovery is an addiction self-help group that teaches relapse prevention tools based on the latest scientific research. The goals of SMART Recovery include developing motivation for sobriety, coping with urges, gaining control over thoughts, feelings, and behaviors, and living a balanced life.
Women for Sobriety (WFS) is a support group for women struggling with addictions to alcohol and drugs. WFS encourages women to grow emotionally and spiritually and develop self-esteem and a healthy lifestyle.
National Alliance on Mental Illness (NAMI) offers support for people living with mental illness and their families, including information about mental health, treatment, and local community resources.

Sexual assault survivors may experience difficulty coping with the trauma that they have experienced. Survivors may turn to unhealthy ways of coping, such as drug and alcohol use, in hopes of finding some relief. Mental health, addiction, and dual diagnosis treatment programs can help people successfully learn to cope with sexual abuse and go on to live healthy, drug- and alcohol-free lives. If you need help, don’t wait. Reach out today.

Effects of Drug- and Alcohol-Related Sexual Assault