“The whole world is watching this trial which, I believe, carries a societal message”declared Béatrice Zavarro, Dominique Pelicot’s lawyer, interviewed by France Inter on October 2. If the Mazan rape affair has hit the headlines and fascinated foreign media for several weeks, it is first and foremost because of its scale. For almost a decade, Dominique Pelicot had his wife Gisèle raped by men recruited on the internet. Thus, there are currently fifty-one of them to find themselves in the dock before the Vaucluse criminal court in Avignon.
But this affair is also fascinating because it sheds a harsh light on what chemical submission is. In fact, the husband drugged his wife with lorazepam (Temesta brand) which he put in her food before throwing her out to strangers. Dominique Pelicot would thus have been able to obtain more than 780 tablets over several years from his attending physician. How is this possible? What is the extent of the phenomenon of chemical submission in France, of which Gisèle Pelicot has become the emblematic figure?
97 cases of chemical submissions likely in 2022
In its annual reports, the National Agency for the Safety of Medicines and Health Products (ANSM) documents the phenomenon of chemical submission since 2003, when toxicological analyzes permitted it.
The agency first notes a very significant increase in the number of reports for “substance-facilitated aggression”: 1,229 cases reported in 2022an increase of 69% compared to the previous year, in connection with the #MeToo free speech movement.
The ANSM defines chemical submission as “the administration for criminal purposes (rape, acts of pedophilia) or misdemeanor (intentional violence, theft) of psychoactive substances without knowledge or under threat”. When one or more substances not declared by the victim are identified, we speak of probable chemical submissions.
The latter represent 97 cases for the year 2022, of which 23 involve minors, a figure increasing compared to those of previous years. It is most often women who are victims (82.5%, or 80 cases). For both men and women, sexual assault represents the majority of cases (62.9%, or 61 cases). Finally, the perpetrators are often known to the victims (43.3%, or 42 cases) and to the children’s relatives. What molecules do attackers use?
Mostly used medications
Contrary to popular belief about chemical substances, it is sedative medications that are used more than drugs. In 56.7% of cases, drugs are found in the analyses. Leading the way are benzodiazepines and related drugs (25.2%), antihistamines (12.6%), opioids (11%) and other sedatives (7.9%), including neuroleptics. This is a constant that we find throughout the various ANSM reports.
“As every year, sedative drugs are mainly incriminated (56.7%). Non-medicinal substances remain at the highest level (43.3% compared to 43.6% in 2021 and 27.8% in 2020) with stimulants in the lead and in particular MDMA”informs the ANSM in its latest report on the subject, based on figures for the year 2022. | Report “Chemical Submission – Survey Results 2022 (06/09/2024)” via ANSM
In the Mazan rape case, Dominique Pelicot used Temesta (lorazepam) and sometimes also Stilnox (zolpidem) to drug his wife. Two drugs that belong to the class of benzodiazepines and related drugs.
For their part, drugs are used in 43.3% of cases of chemical submission. MDMA and cocaine come first with twelve cases recorded in 2022 (21.8%). GHB/GBL – often referred to as the “rapist drug” – accounts for six cases (10.9%). Thus, as is the case in the Pelicot affair, chemical submissions are carried out mainly through sedative medications diverted from their intended use and easily accessible from a doctor.
Limit benzodiazepine prescriptions
Dominique Pelicot crushed several Temesta tablets into his wife’s food without her knowledge. Over several years, the septuagenarian would have been prescribed a total of 780 tablets of this sedative anxiolytic, in particular from his general practitioner, or twenty-six boxes over ten years, therefore around two and a half boxes per year. How is this possible? Are there means of control?
First of all, we must situate the extent of the consumption of anxiolytics and hypnotics in France. In 2017 (figures from 2015), the ANSM indicated what “France ranks second behind Spain in the consumption of benzodiazepines in Europe. (…) In 2015, 64.6 million boxes of anxiolytic benzodiazepines (compared to 64.9 in 2010) and 46.1 million boxes of hypnotics (compared to 48.2 in 2010) were sold in France.” If the trend was downward in recent years, Covid-19 has caused this consumption to restart on the rise.
In 2016, the Ministry of Health estimated that more than one in four French people had consumed it during the year. According to the press release, this massive consumption is explained by the rapid effectiveness of these molecules on anxiety symptoms, but also by the addiction they cause. “The patient is then “trapped” in his treatment”wrote the ministry. However, prescription rules have been put in place to limit these sedative and addictive drugs.
As Health Insurance reminds usthe maximum duration of a prescription for a hypnotic is four weeks and twelve weeks for an anxiolytic. Beyond that, the patient must see a doctor who reassesses the prescription and judges whether or not it is necessary to renew it. However, far too many patients are prescribed benzodiazepines for long periods. The fact that Dominique Pelicot was able to have access, for years, to these molecules is unfortunately far too banal.
If it is rarer, the criminal use he made of these treatments is not an exception either. Also at this level, certain measures have been taken to limit diversions, but they too are not very effective.
The case of clonazepam (or Rivotril)
Clonazepam, marketed under the brand name Rivotril, is a textbook case. In the 2000s, this benzodiazepine was widely prescribed by doctors, particularly general practitioners, as an anxiolytic and hypnotic. But, because of its ease of access and its oral solution form, it is identified as the main molecule used in cases of chemical submission.
It is then planned to add a coloring so that it takes on a blue color when mixed with a drink. Finally, in 2011, its initial prescription was limited to pediatricians and neurologists only, with the exception of a break during the Covid-19 health crisis to support the end of life.
Previously, other drugs had been withdrawn from the market because they were too frequently used for chemical submissions: these are Halcion (triazolam). in 1991 or Rohypnol (flunitrazepam) in 2013. Are these measures effective in limiting cases of chemical submission? Not sure.
Logically, the restriction of access to Rivotril had led to a drop in its use in cases of chemical submission: the ANSM noted three cases in 2020, then none in 2021 nor in 2022. But through a communicating vessel effect, other molecules in the same category have taken over.
The difficult identification of chemical submission
The Mazan rape case raises another challenge for caregivers: the difficult identification of cases of chemical submission. After the weekend where she had been drugged with several Temesta tablets, Gisèle Pelicot presented severe drowsiness, memory problems, and even confusion. She then saw two neurologists for consultation. “Amnesic Ictus” had assumed the first, while the second suggested an anxiety disorder.
When and how to discuss a case of chemical submission when you are a caregiver? The College of General Medicine has started to take up the subject within the framework of working groups on the prevention of risks linked to psychotropic drugs and intra-family violence.
In his reportthe ANSM recalls a few points which may attract attention. Nearly one in two people affected report amnesia of the facts (60 cases). Victims also present with vigilance, neurological or behavioral disorders. The administration of the substance mainly takes place in a festive context for adult victims, unlike child victims for whom the private context remains in primary position.
The Pelicot affair fascinates with its extraordinary side and challenges society as a whole on the problem of chemical submission. She questions the ease with which, in France, we can obtain benzodiazepines, these sedative and addictive medications. And it poses a challenge to caregivers: to better identify cases of chemical submission.
Source: www.slate.fr
