Letter to the Editor
Bufotenine use in drug facilitated sexual assault
Bufotenina como droga facilitadora de agresión sexual
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The most commonly involved are those with central nervous system depressant effects, such as alcohol, GHB or benzodiazepines. Recently, however, other less common substances, such as bufotenine, have also been used.</p><p id="par0010" class="elsevierStylePara elsevierViewall">We would like to report 2 cases studied at the Institute of Legal Medicine and Forensic Sciences of Alicante in which bufotenine was used. The chemical-toxicological analyses were carried out at the National Institute of Toxicology and Forensic Sciences in Barcelona.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Bufotenine is a hallucinogenic tryptamine with effects similar to those of LSD. It is a natural alkaloid found in the skin glands of the toad <span class="elsevierStyleItalic">Bufo alvarius</span>, in plants and in the seeds of certain South American legumes. It has also been found naturally and in small concentrations, secreted by the pineal gland, in the human body and in other mammals. It causes visual disturbances, alterations in the perception of time and space, as well as nausea, nystagmus and mydriasis. It also stimulates the heart rate and causes hypertension.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">It is consumed orally, sublingually and smoked, as well as by atomizing bufotenine and inhaling it as a fine powder, as "snuff".<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The first victim was a 20-year-old male who attended a private party at a private home. He had voluntarily consumed alcohol and cocaine. At one point, when he refused to have sex with one of the party participants and suspected that he had put some substance in his glass without his consent, he went to the police.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The second victim was an 18-year-old female who reported having been sexually assaulted by 3 men in a house where a party was being held. She had voluntarily consumed alcohol at the party.</p><p id="par0035" class="elsevierStylePara elsevierViewall">The toxicological result of the contents of victim No. 1’s glass, which was not ingested by the victim, was positive for ethanol and bufotenine and the analysis of victim No. 2’s urine was positive for benzodiazepines (nordazepam, oxazepam and temazepam), ethanol (1.70<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.20<span class="elsevierStyleHsp" style=""></span>g/l) and bufotenine.</p><p id="par0040" class="elsevierStylePara elsevierViewall">In case No. 1, the vulnerable state of the victim, who was at the time of the events under the influence of alcohol and drugs of abuse (the result of the toxicological analysis of his urine was positive for cocaine and metabolites), made it easier for the assailant to slip bufotenine into his drink at a given moment. If he had consumed the contents of the glass, he would have probably been the victim of a DFSA.</p><p id="par0045" class="elsevierStylePara elsevierViewall">Ethanol was found in the urinalysis of victim No. 2, which the victim admitted having taken voluntarily before the events. However, she denied having consumed bufotenine and benzodiazepines. Ethanol is the substance most commonly associated with DFSA,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> which is considered to be a major factor in victim vulnerability, as it influences the victim's critical judgement in giving consent to sexual intercourse. The use of alcohol with benzodiazepines produces a potentiation of their CNS depressant effects.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Bufotenine has so far not been linked to sexual assault and is rarely mentioned in the toxicology literature. It has been linked to a death following ingestion of ayahuasca, which either contained, or was mixed by the deceased, with 5-Meo-DMT (bufotenine precursor).<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> It has also been mentioned in a case of robbery with chemical submission of a male,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> in which the victim consumed a concoction containing bufotenine (he reported having taken ayahuasca and 24<span class="elsevierStyleHsp" style=""></span>h later a drink with "no smell or taste").</p><p id="par0055" class="elsevierStylePara elsevierViewall">In recent years, the use of plant preparations containing tryptamines has become fashionable in mystical shamanic ceremonies. Other synthetic derivatives of tryptamine have been used for recreational purposes. Vegetable preparations may be mixed with synthetic tryptamines or other active ingredients that increase their potency and that may be unknown to the consumer.</p><p id="par0060" class="elsevierStylePara elsevierViewall">In the 2 cases reported, the victims did not admit to having voluntarily consumed bufotenine. This illustrates a possible emerging use of bufotenine in drug-facilitated sexual assault (DFSA) in a leisure setting that need not be related to rituals or specific cultural groups.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interests</span><p id="par0065" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interests" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nuevas drogas psicoactivas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "H. 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Fowler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/jat/29.8.838" "Revista" => array:6 [ "tituloSerie" => "J Anal Toxicol" "fecha" => "2005" "volumen" => "29" "paginaInicial" => "838" "paginaFinal" => "841" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16356341" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Sumisión química por ayahuasca" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Fernández Alonso" 1 => "C. Megía Morales" 2 => "A.E. 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