Is drug facilitated sexual assault changing? About a case involving 4-bromomethcathinone

Drug-facilitating sexual assault (DFSA) corresponds to sexual activity occurring whereas the victim is unable to express consent due to the action of drugs. Although the use of sedative and amnesic drug in DFSA, such as benzodiazepines and gamma-hydroxybutyrate, is widely described in the medical literature, there is a lack of information regarding the involvement of amphetamine derivatives in this context, particularly synthetic cathinones. Herein, we report a case of a 19-year-old woman who presents herself to the emergency department following an acute alcoholic intoxication and a suspected DFSA after going to a nightclub. The emergency toxicological screening on the plasma and urine of the patient, performed through liquid chromatography coupled to high resolution tandem mass spectrometry in target and non-target mode and with gas chromatography coupled to high resolution mass spectrometry, enabled the detection of 4-bromomethcathinone, a new psychoactive substance (NPS) of the cathinone family. The demethylated and reduced metabolites of the drug were also found in both plasma and urine. No other substance was identified except ethanol, which was quantified in gas chromatography-flame ionization detection, and diazepam with its metabolites, this last one having been administrated in the emergency department. As far as we know, this report described the first case of DFSA involving this halogenated derivative of cathinone and consequently, highlights the need for toxicologists to systematically investigate with specific analytical methods the potential presence of NPS in cases of DFSA.