GCS Survey: "GHB IN CHEMICAL SUBMISSION: MYTH OR REALITY?"

Overview

According to the media, GHB is the main substance used for chemical submission. The national survey conducted by the Addictovigilance centre of Paris on drug-facilitated assaults shows that GHB is used, but only in a very small proportion of cases. However, the short detection times for this substance point to its possible under-detection (06-09h in blood, 10-12h in urine). A pilot research protocol in Ile de France focusing on capillary analysis is therefore being proposed to volunteer victims to overcome this bias and answer this question: is the massive use of GHB in chemical submission a myth or a reality?

The Addictovigilance center of Paris (CEIP-A) has been responsible for the national chemical submission survey under the supervision of the French National Agency for the Safety of Medicines and Health Products (ANSM) since 2003, using data from expert toxicology laboratories, forensic police and forensic medicine departments. With 20 years' experience in the criminal use of substances, the center draws up an annual report on substance-facilitated assaults in order to put in place appropriate, up-to-date prevention measures. In 2021, the #balancetonbar movement emerged in Brussels and spread like a shockwave across Belgian cities and Europe. On Instagram, women spoke out about the extent of drug-facilitated sexual assault (DFSA) in nightclubs and denounced the " laissez faire " attitude of the political authorities. The movement is resonating in France and getting louder : #balancetonbar has now been joined by #MetooGHB, which puts the so-called "rape drug" in the spotlight. But what's really going on? A retrospective study of the national survey data from 2010 to 2019 reports only 26 chemical submissions (CS) attributable to GHB/GBL out of 617 CS identified (4.2%) among 4349 suspected cases. However, this study highlights all the limits to the disclosure of GHB (low proportion of complaints filed, speed of elimination of this substance from the usual matrices, insufficient number of court orders for hair analysis). With the aim to eliminate the limitations identified as far as possible and answer the question "Is the massive use of GHB in chemical submission a myth or a reality?", a pilot research protocol, centred on capillary analysis, is being proposed to 200 victims in the Ile de France region. This is a non-interventional, multi-centre, category 3 study, the only acts (hair sampling) or procedures (chemical submission declaration form) are risk-free and do not affect the management of participants. Victims are included whether or not they have lodged a complaint, in collaboration with forensic medicine departments, HIV and STI screening Center and Victim Support Associations. Referred to the parisien CEIP-A, 3 strands of hair are sampled after an interview in which the victim's history and voluntary drug use data were taken. A pre-analytical treatment of the hair (washing, fragmentation), followed by detection by high-resolution mass spectrometry is carried out by an expert laboratory in search of GHB and other known chemical submission agents (illicit drugs and psychoactive medicines). To meet our objective, a comparative study of the results of the GCS protocol and the survey history was carried out using an exact binomial test. This study will also provide an opportunity for a more general discussion of the value of hair analysis in the detection of chemical submission agents.