Implication of GHB in proactive drug facilitated crime in Paris, France

To assess the proportion of suspected pro-active drug facilitated crime (DFC) cases involving GHB through an appropriate toxicological assessment for any adult presenting as a victim of proactive DFC within 10 h at the Department of Forensic Medicine (DFM) of Hôtel-Dieu hospital or the emergency departments of Hôtel-Dieu and Cochin hospitals, Paris, France.

Adults presenting at the DFM of Hôtel-Dieu hospital or the emergency departments of Hôtel-Dieu and Cochin for suspected proactive DFC were included. Blood and urine samples were sent to the toxicology laboratory of Lariboisière for a toxicological assessment, including GHB measurement and screening using high-performance liquid chromatography coupled with high-resolution mass spectrometry (LC-ESI-HRMS/MS). Cannabinoid's plasma concentration and urine confirmation were performed using LC-ESI-HRMS/MS. Other compounds were quantified by liquid chromatography-tandem mass spectrometry. This study was approved by the AP-HP Centre Research Ethics Committee, registered under IRB #00011928, and listed in the AP-HP general treatment registry RESULTS: A total of 49 individuals were included in the study. The mean sampling time was 6.0 h. The sex ratio was 0.33, and the median age was 24.11 years. Voluntary consumption of psychoactive substances in the hours before the event were frequently reported by the patients (91.8 % for ethanol, 20.4 % for illicit substances and 12.2 % for medication with potential psychoactive effects). Six patients tested positive for GHB in urine (mean: 576.3 mg/L), and three were also positive in blood (mean: 46 mg/L). Among them, none reported voluntary GHB consumption. Additionally, undeclared PAS were detected in five other patients, including benzodiazepines and non-therapeutic PAS, suggesting cases of proactive DFC. Overall, proactive DFC was probable in 11 cases and opportunistic DFC in 17 cases.

Our results show a significant proportion of probable GHB-related proactive DFC cases, often within a chemsex context. Further studies, in collaboration with emergency services are necessary to better understand this rising phenomenon and GHB might be under detected in DFC cases due to its pharmacokinetic properties.