Unusual attempted drug-facilitated sexual assault involving MDMA

Background. - Cases of sexual assault involving MDMA are rare probably because MDMA does not induce sedation. The authors present a case of attempted date rape sexual assault with particularly high concentrations of MDMA in blood and hair. Description. - A 34-years old woman was invited by her former husband to have a drink. Alerted by the unusual taste of the drink, she left the apartment and rapidly experienced hallucinations, tachycardia, and excessive sweating. She was transferred to hospital. Blood and urine samples were taken on admission. On site urine immunological screening showed the presence of MDMA. Five weeks later, two 30-cm hair strands were collected. Methods. - Blood screening was done by LC-MS/MS and confirmed by LC-HRMS. NPS were tested by LC-MS/MS. GHB was measured by GC-MS and alcohols by HS-GC/FID. Amphetamines were analyzed in hair by LC-MS/MS after segmentation. Results. - MDMA and MDA were quantified in blood at 189 and 13 ng/mL. GHB determination showed a physiological concentration. In hair, MDMA and MDA concentrations are 936 and 38 ng/mg in the proximal segment, those of MDMA at 20 and 3 ng/mg, respectively, in the adjacent segments, and those of MDA are below the limit of detection. Discussion/conclusion. - MDMA and MDA blood concentrations confirm a recent intake of ecstasy. Hair concentrations of MDMA and MDA are very high in the segment of interest, confirming that the absorbed dose is very high. The presence of MDMA in consecutive segments is likely due to sweat contamination. From a clinical viewpoint, the massive absorption of MDMA explains the severity of the symptoms. (C) 2022 Societe Francaise de Toxicologie Analytique. Published by Elsevier Masson SAS. All rights reserved.