Entactogen chemicals and drug facilitating sexual assault: A case report in a clinical toxicology context

Drug facilitating sexual assault involve the use of a broad array of chemicals, including new psychoactive substances (NPS). In this context, entactogen cathinone administration is rarely reported, as these chemicals do not induce anterograde amnesia. In this study, we reported the case of a man which presented himself spontaneously at the emergency department in a potential context of drug facilitating sexual assault. The urinary toxicological screening, performed through immuno-enzymatic, gas chromatography coupled to mass spectrometry analyses and liquid chromatography coupled to high resolution tandem mass spectrometry, enabled the identification of cocaine, methamphetamine, amphetamine, sildenafil and a NPS known as alpha-pyrrolidinohexiophenone (a-PHP) which belongs to the cathinone family. We were also able to detect 10 metabolites of a-PHP in the urine and/or plasma samples of the patient. The detection of methamphetamine and a-PHP was in accordance with the clinical signs of the patient including logorrhea and unreactive mydriasis. To the best of our knowledge, this study is the first to highlight the identification of a-PHP, an entactogenic cathinone, in the context of chemical submission and highlights the need for methods allowing the detection of NPS in cases of drug facilitating sexual assault. (c) 2023 Societe Franc,aise de Toxicologie Analytique. Published by Elsevier Masson SAS. All rights reserved.