A Review of the Associations between Drugs (including Alcohol) and Sexual Violence

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A Review of the Associations

between Drugs (including Alcohol)

and Sexual Violence

Literature Review Report

Prepared for the Ministry of Justice

September 2008

NOT GOVENRMENT POLICY

Prepared by Nina Russell

Russell Research

nina@russellresearch.co.nz

This document was prepared as part of the work programme of the Taskforce for Action on Sexual Violence. The document does not reflect the views of the Taskforce, the government or

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Executive Summary

Overall Aim

The overall aim of this literature review is to report the associations between alcohol and drugs and sexual violence, including how incidents of sexual violence that involve alcohol and/or drugs are treated within the justice system and by the media.

Drinking and Drug Taking in New Zealand

Most New Zealand adults drink occasionally, and whilst many drink in moderation, New Zealand is recognised as having a drinking culture which supports and condones the excessive consumption of alcohol (Alcohol Advisory Council of New Zealand, 2005 in Cagney and Palmer 2007).

After alcohol and tobacco, marijuana is the most commonly used recreational drug in New Zealand. Most illicit drugs (with the exception of marijuana) are only used regularly by a very small percentage of the New Zealand population (Alcohol Drug Association New Zealand, 2005). Young males are more likely to take drugs, drink more often and in greater amounts than other groups in New Zealand.

Associations between Drugs (including Alcohol) and Sexual Violence

It is estimated that half of the rapes committed are associated with alcohol use (this estimate is based on the average of a range of figures from the United States, Spain, Canada and New Zealand (Abbey et al, 1994). Approximately one half of all sexual assaults are committed by men who have been drinking alcohol and approximately half of all sexual assault victims also report having consumed alcohol pre-assault (Abbey et al, 2001). The association between alcohol/drugs and sexual violence has prompted suggestions that providers working in each field need to be equipped to deal with both issues, and that a combined approach to these issues may present the best outcomes for prevention (Stephens, 1992, Abbey, 1995, Ullman, 2003).

Alcohol and Drugs - a Risk Factor for Sexual Violence

Alcohol and drug consumption is a known risk factor for sexual violence (WHO, 2007, Abbey et al, 1996). However, intoxication in itself is not enough to increase the risk of sexual assault (e.g. a female can drink heavily at home alone with virtually no risk of victimisation as long as she is not at a bar or party or in the presence of potential male offenders) (Testa and Parks, 1996, Testa, 2004).

The role of alcohol and drugs as a risk factor for sexual violence typically co-occurs with other risks for sexual violence (e.g. being young, female, and exposure to potentially dangerous settings/situations [e.g. bars where potential offenders may be]) (Kilpatrick, et al, 1997, Parks and Miller, 1997 in Combs-Lane and Smith, 2002).

Alcohol and drug abuse contributes to perpetrator aggression and also to victim vulnerability (Martin and Hummer in Bart 1993, Koss 1988, Curtis, 1997, Muehlenhard and Linton 1987, all in McPhillips et al 2002). Alcohol consumption (voluntary or involuntary) can have the following effects:

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• Cognitive impairment (e.g. make it difficult to communicate, or assess risks)

• Reduction of inhibitions (e.g. engage in behaviours that would normally be considered repugnant)

• Physical impairment (e.g. reduce motor skills, make it difficult to fend off an assault)

• Increased aggression.

It is recognised that the relationship between intoxication and sexual violence is not a straightforward one, as well as the association with other risk factors there may be a ‘bi-directional’ relationship between drinking and sexual violence. For example, childhood/early sexual victimisation increases the likelihood a person will be a problem drinker, and problem drinking (i.e. binge drinking) increases the likelihood of sexual violence (Ullman, 2003). Also, it has been hypothesised that the desire to commit sexual violence may actually result in alcohol consumption (e.g. as a justification for unacceptable behaviour) (Abbey et al, 2001).

Mediating Factors Linking Alcohol and Sexual Violence

The link between alcohol and sexual aggression is likely to be mediated by factors such as pre-existing hostility towards women, having rape supportive attitudes and beliefs (e.g. that alcohol consumption indicates sexual availability), and alcohol-related expectancies (e.g. people’s expectations of what drinking alcohol will do greatly influences the effect alcohol has on them).

Drug and Alcohol Assisted Sexual Violence (DASV)

Drug-facilitated sexual violence refers to sexual activity with a person following their intoxication resulting from the forced, covert, or voluntary consumption of illicit/licit drugs (including alcohol) that interferes with that person’s ability to consent.

The most commonly used drug to facilitate sexual assault is alcohol (voluntarily or involuntarily ingested); this is far more significant than the use of other drugs to facilitate rape (Kelly, 2005, Papadodima et al, 2007, Kilpatrick et al, 2007). Victims of DASV are nearly always women (Neame, 2003). A proportionally very small number of people are victims of what the media conceives and portrays as “drink spiking” (i.e. victims of sexual assault that follows the covert administration of a sedative or hypnotic drug other than alcohol) (Neame, 2003).

DASV is more likely than other sexual assaults to occur between people who do not know each other very well (e.g. strangers, acquaintances, casual dates) (Abbey et al 2001, Horvath and Brown, 2006). Perpetrators of DASV typically target vulnerable females (e.g. drug addicts or drunk women) (Ullman et al, 1999, Homel et al, 1992 in Testa and Parks, 1996, Foote et al, 2004).

Perceptions of Alcohol and Sexual Violence on Attribution of Blame

The presence or absence of alcohol in incidents of sexual violence effects attributions of blame. Typically, male offenders who were drunk pre-assault are seen as less culpable, whereas females who were drunk pre-assault are seen as more blame worthy, less credible, and are assigned more responsibility for the assault (Richardson and Campbell, 1982; Scronce and Corcoran, 1995; Aramburu and Leigh, 1991 and Stormo et al, 1997 both in Wild et al, 1998; Shuller and Stewart, 2000 in Davis and Loftus; 2003; Sims et al 2007). The

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exception to this is if a male offender is sober and the female victim is drunk, in this instance the male is seen as more culpable (e.g. “taking advantage”).

Media Treatment of DASV

Media representations of DASV tend to focus on drink spiking with drugs (other than alcohol), as opposed to the more frequently occurring DASV resulting from voluntarily consumption of alcohol (Neame, 2003, Lawson, 2005, Horvath and Brown, 2006). Neame (2003) states the fact that DASV occurs in situations of voluntary consumption of alcohol is difficult for the media to accept as it does not constitute stereotypical views of “real rape”. Research suggests the media is more likely to publish stories about cases which fit the ‘real rape’ scenario (e.g. a stranger, unsuspecting women, violent attack by deviant/abnormal offender etc) (Anderson and Beattie, 2001, Thakker and Durrant, 2006, Marhia, 2008 in Ball, 2008 unpublished report).

Accurate reporting in the media can have positive consequences by helping raise awareness of DASV in the community, and raised awareness may result in increased reporting of DASV (e.g. if it enables victims to recognise what happened to them was a crime) and more support for victims (Foote et al, 2004).

Inaccurate (or ill-informed) reporting can reinforce victim-blaming, rape myths and attitudes (e.g. about drinking implying willingness to engage in sexual activities, about ‘real rape’ victims and ‘real rapists’) (Neame, 2003, Foote et al, 2004). Further, detailed reporting of DASV may serve to provide information that may result in ‘copycat’ crime (Foote et al, 2004).

Reporting of DASV

Victims of sexual assault are the least likely of all victims of crime to report the event to the police (Morris et al, 2003), and when drugs and/or alcohol is present this compounds the issue (Stormo, et al, 1997, Fisher et al, 2003 in Finney, 2004). There are a number of reasons for victim’s non-reporting including fear at how they will be treated by the justice system (in particular the trial process1_{), or by the police; not recognising or naming what}

occurred was sexual assault; fear of being partially blamed or self blame, and feeling unable to report sexual assaults because of voluntarily taking illegal drugs (Densen-Gerber, 1981 in Stephens, 1992, Griffiths 2001, Kilpatrick et al, 2007, Ministry of Justice, 20082_).

Evidential Issues in DASV Cases

There are issues relating to evidence collection raised by DASV, including data collection difficulties at the initial interview (if the person is still intoxicated at the time of interview or is unable to recall events as a result of being intoxicated when the assault took place). Typically forensic evidence of DASV is difficult to establish (e.g. because of time delays in reporting, inadequate data collection at initial interview, or negative toxicology test3).

Prosecution of DASV Cases

1_{Previous research has stated that involvement in the criminal justice system for a sexual assault}

victim can feel like a “second assault” (Kelly, 2005).

2_{http://www.justice.govt.nz/discussion/sexual-violence-legislation/introduction.html}

3_{A test may show as being negative even if drugs were ingested; some drugs are processed by the} body quickly and are only required in very small amounts.

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DASV cases are often difficult to prosecute because of evidential difficulties meaning that the basis of the case ends up being the word of the victim against that of the defendant (Lievore, 2004; ODPP and AFP, 2005 in Taylor, 2007). The decision to proceed with the prosecution often comes down to the perceived credibility of the victim. There are a number of factors which are seen as undermining a victims credibility including delay in rape reporting, the incident not fitting the stereotypical ‘real rape’ scenario, discrepancies in accounts of the incident, and risk-taking behaviour (Kelly, 2005; Frohmann 1991, HMCPSI 2002, Spohn et al, 2002 all in Lievore, 2004). These factors are commonly all present in DASV cases.

Courtroom Experiences for Women

Courtroom experiences for women in sexual violence cases can be harrowing because of the tactics of the defence lawyers and/or the presence of the defendant in the court (Foote et al, 2004).

Issues around Consent in DASV Cases

Issues surrounding consent in sexual violence cases are complicated, and made even more complex by the association of drugs and alcohol. Eastwick-Field (2007) notes a number of things that add to the complexity of determining ‘consent’ or ‘reasonable belief in consent’ in DASV cases including the inability of the law to deal with the range of effects of intoxication. For example, in some cases an intoxicated victim’s ability to make free choices about the acts they engage in may be compromised (e.g. if the victim is physically unable to consent because they are unconscious) and in other cases an intoxicated victim may appear consenting (but their actual ability to give true consent is impaired4_{(Eastwick-Field, 2007).}

Another issue with consent is a lack of clarity about what it means; jurors uncertainty around the legal definition of consent can result in them making judgements based on their own stereotypes to do with drinking, drugs and sexual violence (Taylor, 2007, Eastwick-Field, 2007). As noted earlier, individuals’ views about intoxication and sexual activity inform their attribution of blame and beliefs about the consent.

Outcomes of DASV Cases

DASV cases have high attrition rates and low conviction rates relative to other crimes (Foote et al, 2004, Kelly, 2005, Taylor, 2007). The conviction rates for sexual violence in New Zealand, Australia and North America, have remained static (or decreased) for at least a decade, this fact combined with the lack of reporting of sexual violence has resulted in a virtual impunity for offenders (Kelly et al, 2005).

4_{Some drugs (e.g. Rohypnol and GHB) can have a sexually disinhibiting or stimulant effect resulting} ‘compliant behaviour’, the effect of these drugs is problematic when issues of consent fall to be considered (Griffiths 2001, Eastwick-Field, 2007).

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1.0 Background, Aims, and Methodology

The Ministry of Justice commissioned this literature review to further understand the associations between alcohol and drug consumption and sexual violence, including how incidents of sexual violence that involve alcohol and/or drugs are treated within the justice system and by the media.

1.1 Aims

The specific aims of this review are listed below.

• To explore the link between alcohol and drug consumption and sexual violence.

• To identify issues and themes arising in cases where alcohol and/or drugs were consumed by offenders or victims of sexual violence.

• To explore how incidences of sexual violence that involve alcohol and drug consumption are dealt with by the justice system.

• To explore how incidences of sexual violence that involve alcohol and drug consumption are reported in the media.

This report also looks at the implications of the relationship between alcohol/drugs and sexual violence for:

• Substance abuse and sexual violence prevention programmes

• Public Health prevention of alcohol abuse

• Crime prevention (including environmental design)

• Improving evidence collection and courtroom experiences.

1.2 Methodology

The literature presented in this report is based on a review of national and international literature provided by the Ministry of Justice to the contractor. Literature was sourced via Librarians from the Ministry of Justice, Ministry of Women’s Affairs, the Alcohol Advisory Council of New Zealand, Accident Compensation Corporation and the Department of Corrections’ conducting searches on the major bibliographic databases using key words such as ‘alcohol’, ‘drugs’, ‘sexual violence’, ‘rape’, ‘consent’ and ‘aggression’. An internet search was also undertaken of relevant government websites in New Zealand and overseas (in order to obtain alcohol, drug and crime statistics). The review also draws on media reporting of sexual violence and relevant case law. This review reflects a comprehensive, but not exhaustive, overview of the relevant literature.

1.3 Notes on Terms Used

This report uses the term ‘victim’ to refer to those who have experienced sexual violence. The use of this term is in no way intended to undermine individual’s status as survivors of sexual violence (Women’s Health Strategy Unit, 2004). Further, in the discussion of alcohol and drug consumption as ‘risk factors’ for sexual violence there is no intended blame for

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victims who had consumed alcohol or drugs pre-assault. Responsibility for sexual violence rests with those who perpetrate such violence. In some instances in this literature the victim will be referred to as a complainant (e.g. during a trial).

The offender is sometimes referred to as a perpetrator or as a ‘defendant’ (e.g. when referring to courtroom trials). Some of the literature referenced in this review refers to victims as female and perpetrators as male, this is because (whilst acknowledging both males and females can be victims) females are predominantly the victims of DASV. The literature review focuses on sexual violence against people aged 16 years and over and almost all of the literature refers to female victimisation.

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2.0 Context

Setting

To provide context for this report, in this section the following topics will be canvassed:

• Alcohol and drug consumption in New Zealand

• Definitions of sexual violence and drug assisted sexual violence

• Occurrence of sexual violence in New Zealand, including drug assisted sexual violence (DASV).

• DASV internationally.

2.1 Alcohol

Consumption in New Zealand

Alcohol is the most typically used recreational drug in New Zealand5_{. Most New Zealand}

adults drink occasionally, and whilst many drink in moderation research has shown New Zealand “has a drinking culture which supports and condones the excessive use of alcohol, including harmful patterns of intoxication and binge drinking” (Alcohol Advisory Council of

New Zealand, 2005 in Cagney and Palmer, 2007).

The following statistics illustrate drinking patterns in New Zealand:

• The majority of New Zealanders (81%) aged 12-65 years consume alcohol (this figure is stable from age 18 years onwards) (Ministry of Health, 2008).

• A fifth (21%) of all youth aged 12-17 years (or two fifths [39%] of all youth drinkers) can be classed as heavy or “binge” drinkers. Binge drinkers are equally likely to be female as male6_.

• The Youth2000 survey of secondary school students found that around a quarter of secondary school students who are current drinkers consume alcohol at least once a week, and more than half report binge drinking (having 5 or more drinks in one drinking session) on at least one occasion in the previous month (Adolescent Health Research Group, University of Auckland, 2004). Binge drinking by young people is of concern in New Zealand, however it is not the exclusive domain of the young (Cagney and Palmer, 2007).

• Around a quarter of New Zealand drinkers aged 12-65 years consume large amounts of alcohol on a typical drinking occasion (i.e. quantities defined as potentially hazardous and harmful by the Ministry of Health) (Ministry of Health, 2008).

• For both males and females in New Zealand the proportion of adult drinkers with a potentially hazardous drinking pattern is higher in areas regarded as being the most deprived as compared to the least deprived areas (2006/07 New Zealand Health Survey)7.

New Zealand Males and Females – General Population

5_{http://www.moh.govt.nz/moh.nsf/pagesmh/7601/$File/alcohol-ch2.pdf}

6_{http://www.justice.govt.nz/pubs/reports/2007/sale-supply-alcohol/chapter-6.html} 7_{http://www.moh.govt.nz/moh.nsf/pagesmh/7601/$File/alcohol-ch2.pdf}

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• The 2004 New Zealand Health Behaviours Survey reported that among New Zealanders aged 12-65 years who had consumed alcohol in the 12 months prior that 15 percent drank large amounts of alcohol8_{at least weekly; males were significantly}

more likely to have consumed large amounts of alcohol at least once a week (20%) compared to females (11%)9_{. Male and female drinkers had similar rates of drinking}

large amounts of alcohol on a typical drinking occasion but males drink more per

occasion10_.

• The 2004 New Zealand Health Behaviours Survey also found that males were significantly more likely to:

o have drunk alcohol in the previous 12 months as compared to females

o consume alcohol four (or more) times a week on average, compared to

females

o consume a large quantity of alcohol, and to drink enough ‘to feel drunk’ at

least weekly, compared to females11_.

Māori

• Fewer Māori drink than the general population; however within the group of Māori that do drink there is evidence of hazardous (e.g. binge) drinking (Dacey, 1997). A 1995 survey undertaken by the Alcohol and Public Health Research Unit found two-fifths (43%) of Māori male drinkers and one fifth (22%) of Māori female drinkers drank ‘enough to feel drunk’ at least once per month (Dacey, 1997). Around a fifth of Māori drinkers (18%) reported they were drinking more than they were happy with (Dacey, 1997). A third of Māori male drinkers (32%) and around a fifth (22%) of Māori female drinkers reported having at least once in the previous year woken the day after drinking unable to remember events or their actions while drinking (Dacey, 1997).

New ZealandPacific Peoples

• Proportionally fewer Pacific peoples drink alcohol relative to the general New Zealand population (Huakau, 2005). However, Pacific drinkers consume larger amounts of alcohol per annum and have larger typical amounts of absolute alcohol per occasion than drinkers in the general New Zealand population (Huakau, 2005). The University of Auckland Youth2000 report found that a considerable proportion of Pacific students reported never having drunk alcohol at all: 33% of pacific female students and 26% of pacific male students. More Pacific students (29%) than NZ European students (21%) reported they had never drunk alcohol. Of students who reported drinking alcohol there was no difference between Pacific and NZ European students in the frequency of binge drinking (Adolescent Health Research Group, University of Auckland, 2004).

8 For males this means more than six standard drinks on one drinking occasion and for females this means more than four standard drinks on one drinking occasion.

9_{http://www.alac.org.nz/NZStatistic.aspx?PostingID=16709}

10_{http://www.alac.org.nz/NZStatistic.aspx?PostingID=16709} 11_{http://www.alac.org.nz/NZStatistic.aspx?PostingID=16709}

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The New Zealand Pacific Drugs and Alcohol Consumption Survey (2002-03) found that just over half (57%) of Pacific peoples were drinkers (61% of pacific males and 51% of pacific females), compared with 85 percent of the general New Zealand population (88% of males and 83% of females as per the National Alcohol Survey) (Huakau, 2005).

The average amount consumed by Pacific drinkers on any one occasion was nine drinks for males and five drinks for females compared with five drinks for males in the general New Zealand population and around four drinks for females in the general New Zealand population (Huakau, 2005). A third (33%) of Pacific drinkers consumed enough ‘to feel drunk’ at least weekly (41% of pacific males and 25% of pacific females) compared with nine percent of drinkers in the general New Zealand population (13% of males and 6% of females as per the National Alcohol Survey) (Huakau, 2005).

New Zealand Asian

• Asian men and women are significantly less likely to have a hazardous drinking pattern than other ethnic groups in New Zealand (2006/07 New Zealand Health Survey)12_.

2.2 Drug

Consumption in New Zealand

The most common recreational drug in New Zealand (after alcohol and tobacco) is Marijuana13_{. According to figures from the 2002 ‘Drug Use in New Zealand’ survey, half of}

those surveyed had tried cannabis, of those who had tried cannabis around a third (30%) had done so before the age of 15 years (Alcohol and Public Health Research Unit, 2002 in Alcohol Drug Association New Zealand, 2005).

Statistics about illicit drug use are difficult to obtain and verify. Other than cannabis, most illicit drugs are used regularly by only a very small percentage of the New Zealand population (Alcohol Drug Association New Zealand, 2005).

Hallucinogens

In the 1998 National Drugs Survey14_{the most commonly used hallucinogens were LSD,}

hallucinogenic mushrooms and ecstasy (Field and Casswell, 1998 in Alcohol Drug Association New Zealand, 2005). Around 13 percent of respondents had tried at least one of these drugs (4% were current users) (Field and Casswell, 1998 in Alcohol Drug Association New Zealand, 2005). Young males (aged 18-24 years) had the highest level of ecstasy use (around 9% of those surveyed) (Field and Casswell, 1998 in Alcohol Drug Association New Zealand, 2005).

12_{http://www.moh.govt.nz/moh.nsf/pagesmh/7601/$File/alcohol-ch2.pdf}

13_{http://www.nzhis.govt.nz/moh.nsf/pagesns/130}

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Stimulants (e.g. Amphetamines and Cocaine)

In the 1998 National Drugs Survey around nine percent of respondents had tried at least one stimulant (2% were current users) (Field and Casswell, 1998 in Alcohol Drug Association New Zealand, 2005). As with other drugs, young males (18-19 years) were the highest users of stimulants (12% of those surveyed) (Field and Casswell, 1998 in Alcohol Drug Association New Zealand, 2005). Research undertaken by the Centre for Social and Health Outcomes, Research, and Evaluation (SHORE) also found that Amphetamine type stimulants drug users were disproportionately males aged 18-29 years, with the heaviest use being among those males aged 20-24 years (SHORE, 2004 in Alcohol Drug Association New Zealand, 2005).

Methamphetamine (P)

Around three percent of New Zealanders were users of Methamphetamine in 2001, second only to Thailand (United Nations Survey, 2001 in Alcohol Drug Association New Zealand, 2005).

Opiates (e.g. Heroin, Home-bake, Morphine and Poppies)

In the 1998 National Drugs Survey around four percent of respondents reported they had tried at least one of the drugs in the opiates category (0.6% were current users) (Field and Casswell, 1998 in Alcohol Drug Association New Zealand, 2005).

Prescription drugs and Over-the-counter Medications

As with illicit drugs there is little data about the non-medical use of prescription drugs and over-the-counter medications (Field and Casswell, 1998 in Alcohol Drug Association New Zealand, 2005). The major drugs in this category include: steroids, Benzodiazepines (tranquilisers including diazepam and rohypnol), Ritalin, analgesics, morphine and codeine products (Field and Casswell, 1998 in Alcohol Drug Association New Zealand, 2005).

In the 1998 National Drugs Survey around two percent of respondents reported they had used Benzodiazepines (tranquilisers) for recreational purposes (males were more likely to do this than females) and less than one percent (0.6%) of the respondents said they were current users (Field and Casswell, 1998 in Alcohol Drug Association New Zealand, 2005). Information from substance abuse service providers in New Zealand suggest that over half the drugs abused are from legal prescriptions (Alcohol Drug Association New Zealand, 2005).

The next part of this context setting section defines sexual violence (including drug assisted sexual violence) and presents sexual violence statistics from New Zealand and internationally (including statistics of sexual violence associated with alcohol and drug consumption).

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2.3 Sexual Violence Defined

The World Health Organization (WHO, 2002 pg 149 in Adair, 2006 pg 88) defines sexual violence as: “Any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic, or otherwise directed, against a person’s sexuality using coercion, by any person, regardless of their relationship to the victim, in any setting, including but not limited to home and work”. Sexual violence can include the following;

threat of rape, attempted rape, rape, sexual harassment, sexual coercion, and sexual contact with force (WHO, 2002 in Adair, 2006). Rape differs from other unlawful sexual connection in that it refers to the act of penetration of one person’s genitalia by the other person’s penis.

2.3.1 Limitations of Definition of Sexual Violence

Not all people are aware of the definition of sexual violence. Some victims of sexual violence do not classify what they have experienced as sexual violence if there is no violent coercion (e.g. if the assault occurs by someone they know in their own homes (Urbis Key Young, 2004). When surveyed, self reports of ‘unwanted sexual behaviour’ far exceed reports of sexual assault, this suggests that language which reflects a continuum of unwanted behaviour may be more useful for prevention efforts than the term sexual violence (Urbis Key Young, 2004).

It is worth noting that ‘unwanted sexual behaviour’ especially as it relates to unwanted sexual activity when a victim is intoxicated (by their own volition) and unable to give or withhold consent may constitute sexual assaultunder the law (Neame, 2003).

2.4 Defining Drug and Alcohol Assisted Sexual Violence

There are a number of terms used when discussing drug and alcohol assisted sexual violence (DASV) including:

• drug assisted sexual assault (Sturman, 2000 in Foote et al, 2004)

• drugs used as a weapon in sexual assault (Griffiths, 2000 in Foote et al, 2004) • drug rape (Cannon, 1999 in Foote et al, 2004)

• date-rape drugs (Cannon, 1999 in Foote et al, 2004)

• spiked drinks (Australian Defence Force Fact Sheet in Neame, 2003)

• drug facilitated sexual assault (European Monitoring Centre for Drugs and Drug Addiction, 2008)

• drug and alcohol assisted sexual assault (Foote et al, 2004)

For this report ‘drug and alcohol assisted sexual violence’ (DASV) is used, this label was chosen because it clearly includes alcohol (not everyone recognises that alcohol is a drug) and because it uses the term sexual violence (which covers a range of unwanted sexual behaviour not only completed rapes). Foote et al (2004) notes there are issues with some of the terms used, for example terms such as ‘rape drugs’, ‘drug rape’ and ‘spiked drinks’ make the offender invisible and make the drugs/drink the focus (and may also be seen to place the burden of responsibility on the potential victim to stay safe and avoid the drug rape).

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DASV is relatively new in terms of being recognised (European Monitoring Centre for Drugs and Drug Addiction, 2008). However, DASV is not a new practice but has received greater recognition in recent years as a result of new drugs, an increasing intolerance for sexual violence and increased reporting of DASV incidents15_{(Scott-Hamer and Burton, 2005). This}

increase in reporting has been in part attributed to heightened public awareness and condemnation following media interest (Scott-Hamer and Burton, 2005).

Confusion about DASV

There is some confusion about what constitutes drug and alcohol facilitated sexual assault (European Monitoring Centre for Drugs and Drug Addiction, 2008). Specifically there are issues around a victim’s capacity to give consent, and about their voluntary or involuntarily consumption of alcohol and/or drugs (illegal or legal) that are unresolved (European Monitoring Centre for Drugs and Drug Addiction, 2008). Briefly, certain substances that have an inhibitory effect can result in individuals behaving in ways that they would not if they had not ingested those substances, thus whilst a person may not be unconscious their capacity to give consent is impaired. There are also arguments that voluntary ingestion of substances (including alcohol) could be construed as consenting behaviour. These issues are discussed in detail in 4.5.1 ‘Issues Surrounding Consent in DASV Cases’ in this report.

Two Conceptually Different Types of DASV

There are two conceptually different types of DASV that are discussed within the literature – proactive DASV and opportunistic DASV (European Monitoring Centre for Drugs and Drug Addiction, 2008).

• Proactive DASV – is the surreptitious or forcible administration of an incapacitating or disinhibiting substance by an assailant for the purposes of committing sexual assault (European Monitoring Centre for Drugs and Drug Addiction, 2008).

For example, drink spiking is defined as “The covert placement of drugs (including alcohol) into a person’s drink with the aim of sedating them, usually for the purposes of sexual assault or robbery . . . Alcohol is the most commonly used drug to facilitate sexual assault. This occurs when alcohol is added to a non-alcoholic drink or when an alcoholic drink has shots of spirits added to it without request” (Australian Defence

Force Drink Spiking Fact Sheet in Neame, 2003).

• Opportunistic DASV – is sexual activity with someone who is profoundly intoxicated by his or her own actions to the point of near or actual unconsciousness (Horvath and Brown, 2005 in European Monitoring Centre for Drugs and Drug Addiction, 2008).

Kilpatrick (et al, 2007) notes that for DASV “the highest risk factor for females is not being rendered intoxicated and incapacitated by others it is being taken advantage of from a sexual predator after she has become intoxicated voluntarily”.

Arguing the case for DASV definitions to include voluntary ingestion of intoxicants, Foote (et al, 2004) notes that while different types of DASV (e.g. proactive and opportunistic) may present different issues for police investigation, victim support and prosecution, if a sexual assault follows then it is still sexual assault.

15 _{Reporting of DASV is discussed in detail in Section 4.0. Sexual violence (including DASV) is a}

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The recent definition by the United Kingdom Advisory Council on the Misuse of Drugs (ACMD) brings both types of DASV together and makes no distinction between how the intoxication occurred (i.e. forced, covert, or self-administered) and no distinction between the type of substance used (i.e. the use of illicit/licit drugs or alcohol) (ACMD 2007, in European Monitoring Centre for Drugs and Drug Addiction, 2008).

ACMD (2007 in European Monitoring Centre for Drugs and Drug Addiction, 2008) definition of drug facilitated sexual assault (DFSA) includes “all forms of non-consensual penetrative sexual activity whether it involves the forcible or covert administration of an incapacitating or disinhibiting substance by an assailant, for the purposes of sexual assault: as well as sexual activity by an assailant with a victim who is profoundly intoxicated by his or her own actions to the point of near or actual unconsciousness.” (ACMD 2007, in European Monitoring

Centre for Drugs and Drug Addiction, 2008). This definition may still be construed as problematic in that it does not cover opportunistic sexual assault by an assailant when the victim is under the influence of disinhibiting substances by his or her own actions but not “to the point of near or actual unconsciousness” (i.e. conscious but with an impaired ability to

consent).

Sturman (a well known researcher of DASV) presents a broader view of DASV describing it as “a situation where a person’s ability to consent or refuse consent is impaired as a result of drugs” (Sturman, 2000 in Finch and Munro, 2004). Sturman defines drug-facilitated sexual

assault as being “where a person has sexual intercourse with a person after administering, being a party to the administration or being aware of the administration of a drug or noxious substance, (including alcohol), to that person, thereby interfering with that person’s ability to consent” (Sturman, 2000 in Kasteel, 2004).

Sturman’s view differs from some definitions (including the ACMD definition) in that Sturman’s focus is on the victim’s state of mind and ability to give or withhold consent (Finch and Munro, 2004). Some concern has been expressed by research participants about Sturman’s description of DASV (as outlined above), in that participants were worried this viewpoint could be ‘dangerous’ for a defendant in that voluntary intoxication could “negate an apparent consent when the person is sober and reconsiders” (Finch and Munro, 2004).

The definition of drug-facilitated sexual assault used by the Australian Women’s Health Strategy Unit (2004) is more inclusive of potential variations of DASV, as follows “This term [drug-facilitated sexual assault] is used to describe a person who has sexual intercourse with another person or touches that person in a sexual way after administering, being a party to the administration or being aware of the administration of a drug or noxious substance, including alcohol, to that person, thereby interfering with that person’s ability to consent. The ingestion of drug/s and/or alcohol in this case may be voluntary or involuntary.” (NB DASV

cases discussed in this report refer to all incidents as per this definition.)

2.4.1 Alcohol – Most Common Substance in DASV

The most commonly used drug to facilitate sexual assault is alcohol (voluntarily or involuntarily ingested); this is far more significant than the use of other drugs to facilitate rape (Kasteel, 2004, Kelly, 2005, Papadodima et al 2007, Kilpatrick et al, 2007). Victims of DASV are nearly always women (Neame, 2003).

A proportionally very small number of people are victims of what the media conceives and portrays as “drink spiking” (i.e. victims of sexual assault that follows the covert administration of a sedative or hypnotic drug other than alcohol) (Neame, 2003).

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Increasing numbers of sexual assaults are occurring after victims’ drinks are spiked with alcohol (e.g. the perpetrator gives the victim [who is voluntarily consuming alcohol] double or triple the expected measures of spirits) (Neame, 2003). Those who spike drinks with additional alcohol content typically do not view themselves as ‘drink spikers’, because in Western countries using alcohol to lower inhibitions is culturally sanctioned (Neame, 2003). Kasteel (2004) also notes there has been an increase of unconfirmed reports that a wide range of prescription and non-prescription drugs (e.g. benzodiazepines [diazepam, rohypnol], opiates (heroin, morphine, and codeine), tricyclic anti-depressants, ketamine, and cocaine) are being surreptitiously administered by offenders to induce disinhibition and amnesia on the part of their victims in order to facilitate sexual assault.

2.5 Incidence of Sexual Violence in New Zealand

There is no one definitive number in New Zealand which provides the true incidence rate of sexual violence; however the following statistics of sexual violence provide an indication of the size of the issue in New Zealand:

• A cohort study of New Zealand children spanning from birth to age 25 reported sexual abuse occurring for around one in five people before the age of 18 (18.5%) (Fergusson et al, 2000 in Fanslow, 2007). A previous New Zealand community based study found rates of child abuse at 32 percent before the age of 16 (Anderson et al, 1993 in Fanslow 2007).

• Unwanted sexual contact was reported by 24 percent of female students and 14 percent of male students at seventeen years of age. (Youth 2000 Abuse report by the Adolescent Health Research group, University of Auckland, 2001).

• The 2001 New Zealand National Survey of Crime Victims reported an incidence of sexual violence of around 20 percent of females (Ministry of Justice, 2004).

• A random cross-sectional survey of New Zealand woman aged 18 to 64 years old in an urban region (Auckland) and rural region (North Waikato) found (retrospectively) prevalence rates for child sexual abuse of 24 percent for woman from the urban region and 28 percent for those from the rural region (Fanslow 2007). These figures work out to be one in four females overall; of these most victims (86%) were perpetrated by a family member (nearly all of whom were male), and half the victims (50%) had the sexual abuse occur on more than one occasion (Fanslow 2007).

• New Zealand statistics from the National Collective of Rape Crisis for the years 1992 to 1996 show that the majority of survivors (92.6%) knew the perpetrator (this is consistent with overseas findings that the majority of offenders are not total strangers (McPhillips et al, 2002).

• In financial terms, a Treasury Working Paper (06/04) estimated that the cost per incident is $72,130. The next most costly categories of offences were serious traffic offences at $31,210 per crime, and robbery at $23,100 per crime. Overall, sexual violence was estimated to have cost New Zealand 1.2 billion in 2003-04.16

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2.6 Occurrence of Sexual Violence Associated with Alcohol Use

It is estimated that half of the rapes committed are associated with alcohol use (this estimate is based on the average of a range of figures from the United States, Spain, Canada and New Zealand) (Abbey et al, 1994)17_{. Approximately one half of all sexual assaults are}

committed by men who have been drinking alcohol and approximately half of all sexual assault victims also report having consumed alcohol pre-assault (Abbey et al, 2001).

Studies of sexual violence report alcohol and/or drugs are present in between a third to two-thirds of incidences (Abbey 1991, Pernanen, 1991 both in Brecklin and Ullman, 2001). Koss’s study (1988 in Abbey et al, 1996 in McPhillips et al 2002) found even higher rates of alcohol consumption among offenders with around three-quarters (74%) of offenders having ingested drugs or alcohol before sexual violence occurred (Koss’s study also found just over half of date-rape victims [55%] had also consumed drugs or alcohol).

There is a perception (based on anecdotal evidence [e.g. from support services] and unreported cases) that occurrences of DASV are increasing (Foote et al, 2004, Neame, 2003, and Kasteel, 2004, Women’s Health Strategy Unit, 2004). In New Zealand, the police, rape crisis, and health clinics also acknowledge that there is an increasing amount of drug assisted sexual assault cases (Devereux, 2002 in Foote et al, 2004). Whether this is due to increased reporting or increased incidents is unclear (Foote et al, 2004).

There is little data readily available about DASV in New Zealand (or elsewhere). There are a number of reasons why there is limited data on DASV including:

• underreporting of sexual violence

• lack of understanding that unwanted sexual activity is a crime (e.g. the 2001 New Zealand National Survey of Crime Victims (NZNSCV) found that more than two-fifths of victims (43%) of sexual violence saw it ‘as wrong but not a crime’, and eight percent saw it as ‘just something that happened’18_).

• delayed reporting (e.g. due to impaired recall or intoxication) meaning there was limited potential to collect forensic evidence (Ministry of Health, New Zealand, 2003) • New Zealand police data collection system not allowing for the differentiation of

DASV from other occurrences of sexual violence (National Drug Policy, Ministry of Health, New Zealand, 2003)

• different focus of data collection for service providers as compared to those undertaking forensic investigations (with the former having the primary focus of sexual violence and regarding the presence of alcohol/drugs as a secondary concern, and the latter having the principle focus of the presence/absence of intoxicants, and whether they were voluntarily ingested or not) (Neame, 2003).

17_{The data available indicates that the association of alcohol use and sexual violence in New Zealand} is similar to other comparable countries. However, the scarcity of available data and differences in data collection make it difficult to make detailed and definitive comparisons.

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2.6.1 DASV in New Zealand

The statistics below provide some indication of the issue in New Zealand (either of DASV directly or of the association between alcohol and sexual violence in New Zealand).

• The New Zealand National Survey of Crime Victims (NZNSCV) 2001 reported that just under half (46%) of victims of sexual violence thought the offender was affected by alcohol and/or drugs.19

• An online survey of New Zealand University of Otago students found that:

o a third (34%) of females and a quarter (25%) of males had unwanted sexual

advances from someone who had been drinking in the previous month (Cashell-Smith et al 2007)

o thirteen percent of participants as a consequence from their own drinking had

‘sex they were unhappy with at the time’ (Cashell-Smith et al 2007).

• Police records show that n=30 DASV cases were reported in New Zealand in the first four months of 2002 (Ministry of Health, New Zealand, 2003). (Given the lack of differentiation between DASV cases and other sexual offences this number may in fact be greater; note also that only around 10 percent of sexual assaults get reported to police).

• The National Alcohol survey (2000) found that 10 percent of females and three percent of males report being sexually harassed in the previous year by someone who had been drinking (Habgood et al 2001). The survey also found younger women were more likely to experience sexual harassment by someone who had been drinking, with one in five women under the age of 30 reporting this had occurred in the 12 months prior (Habgood et al 2001).

• A 1995 survey undertaken by the Alcohol and Public Health Research Unit found that 14 percent of Māori females and seven percent of Māori males reported they had (in the previous year) been sexually harassed at least once by someone who had been drinking (Dacey 1997).

• The New Zealand Pacific Drugs and Alcohol Consumption Survey (2002-03) found that 10 percent of New Zealand Pacific females and five percent of New Zealand Pacific males report being sexually harassed in the previous year by someone who had been drinking (Huakau, 2005).

• New Zealand females (regardless of ethnicity) were more likely to report sexual harassment as a result of someone else’s drinking than were males (Habgood et al 2001). More Māori females reported this than European or pacific females.

• The 1995 national survey on ‘Drinking in New Zealand’ found that one in four women (27%) had been sexually harassed by someone who had been consuming alcohol (McPhillips et al 2002).

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2.6.1.1 Sexual Violence Cases involving Alcohol and Drugs in New Zealand

This section reports on the findings of a review undertaken by the Ministry of Justice (200820₎

of n=61 New Zealand cases of sexual violence (involving alcohol or drugs) sentencing notes (of n=23 cases involving young people (aged 12-16 years) and n=38 cases of adults (16 years and over)21_.

The review found in most instances the offender and victim knew each other, but there was not a strong relationship (e.g. in 20 cases the offender was a stranger or someone the victim had just met, and in 14 cases the offender was an acquaintance (this finding is consistent with the literature on DASV).

The majority of the offenders (50 cases out of 61) were reported or suspected to be drinking (sometimes in combination with other drugs primarily marijuana but Ritalin and ‘P’ were also mentioned. In 30 cases offenders were reported to have an alcohol abuse problem. Alcohol issues were implied in an additional seven cases where receiving alcohol/drug treatment was recommended in the sentencing notes. Seven offenders were reported to have a drug problem. Alcohol or drug consumption was not accepted as a mitigating factor in any cases. Victims were reported to be voluntarily drinking in 37 cases. There were no reported cases involving involuntary alcohol consumption. In 20 cases the victim and the offender had been drinking together, and in additional five cases, the offender was drinking at the same premises as the victim.

Alcohol was supplied to the victim in seven cases by the offender (in all of these instances, the victims were teenage girls, and the supply of alcohol was treated as an aggravating factor).

Victims were reported to be voluntarily consuming drugs in seven cases (typically marijuana). Two cases involved the involuntary use of drugs.

20_{Unpublished paper “Case Law Summary of New Zealand Sentencing Notes (SVAD)”.}

21_{NB There were originally n=82 cases of sexual violence (including alcohol and drugs) in the review}

however, n=21 were excluded because they involved children under 12 years and in one instance a victim of unspecified age.

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2.7 Occurrence of DASV Internationally

The statistics below provide some indication of the issue (either of DASV directly or of the association between alcohol and sexual violence) in other comparable countries.

Australia DASV (or related) Statistics

• Around one-fifth of people (21%) presenting to a New South Wales Health Service reported the use of drugs in their assault (either voluntarily or involuntarily ingested) (New South Wales Department of Health statistics in Neame, 2004).

• An evaluation of a ‘drink spiking’ project undertaken by Queensland Health (Australia) in 2002, found that a quarter (25% or n=90 out of 360) patrons reported a suspicion of drink spiking (Queensland Health [Unpublished], 2002 in Kasteel, 2004).

• Recent (2007) research undertaken at Melbourne University, Australia found that 25 percent of participants (out of more than n=800 18-35 year olds) report having had their drink spiked.22_{Drinks were mostly spiked by adding alcoholic ‘shots’ to an}

alcoholic drink (16%), followed by adding alcoholic ‘shots’ to a non-alcoholic drink (6%), and in a small proportion of cases adding either legal (valium) or illegal (ecstasy) drugs to a drink (1%).23_{The reasons given for drink spiking included}_“for fun” and “because it was easier to approach someone for sex if they are drink or drug affected”.

• During 2000 to 2001, the Victorian Centre Against Sexual Assault (CASA) House recorded that two-fifths (40% or n=82 out of n=207) of victims who visited the Centre stated that their drinks had been spiked or drugged (Lantz, 2001 in Kasteel, 2004).

United Kingdom (UK) DASV (or related) Statistics

• The 2001 British Crime Survey reported that five percent of victims of sexual violence had been drugged, and an additional 15 percent of victims said they were unable to give consent because of intoxication due to the consumption of alcohol (2001 British Crime Survey in European Monitoring Centre for Drugs and Drug Addiction, 2008).

• A UK study of men incarcerated for rape found that 58 percent of offenders had been drinking pre-assault, and that a further 12 percent were also using drugs (Grubin and Gunn, 1990 in Finney, 2004)24_{. Of those incarcerated, just over two-thirds (37%)}

were alcohol dependent at the time of the study interview (Grubin and Gunn, 1990 in Finney, 2004).

22_{McPherson, 2007 cited in Mancuso, 2007 in} http://www.news.com.au/story/0,23599,22485527-2,00.html

23_{McPherson, 2007 cited in Mancuso, 2007 in} http://www.news.com.au/story/0,23599,22485527-2,00.html

24_{Note that offenders may over report the amount of alcohol consumed pre-assault in order to} minimise personal responsibility (Finney, 2004).

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United States DASV (or related) Statistics

• Alcohol is the most common intoxicant used in DASV in the US; almost two thirds of rape incidents in the US have been reported to involve alcohol use by victims or offenders (Papadodima et al 2007).

• One in ten women is raped when she is unable to consent or resist as a result of being incapacitated due to drug and/or alcohol consumption (Testa, 2003).

• The US ‘National Violence Against Women’ Survey found that two thirds (67%) of offenders were using drugs and/or alcohol pre-assaulting female victims (n=421 out of n=628 offenders). Just over half (59%) of offenders were using drugs and/or alcohol pre-assaulting male victims (n=31 out of n=53 offenders) (Tjaden and Thoennes, 2006). The survey also found that one fifth of female victims (20%) had used drugs and/or alcohol pre-assault (n=145 victims out of n=726), and that around two-fifths (38%) of male victims had used drugs and/or alcohol pre-assault (n=23 out of n=60) (Tjaden and Thoennes, 2006).

• A large forensic study on drink spiking revealed high levels of alcohol, and much lower than expected findings for drugs such as Rohypnol and GHB (Slaughter, 2000 in Neame, 2003). An analysis of 2,003 specimens revealed alcohol was present in around two-thirds (63%) of the samples, marijuana in 30 percent, GHB in 5.4 percent, and the benzodiazepine known as Rohypnol, in 0.5 per cent of specimens (Slaughter, 2000 in Neame, 2003).

• As many as three out of four university aged females reported being too intoxicated to consent at the time of the rape (Mohler-Kuo et al, 2004 in Kilpatrick et al, 2007).

• Results of a study undertaken by Kilpatrick (et al, 2007) designed to estimate the prevalence of DASV in the US indicate that 5 percent of adult females (an estimated 5.6 million women) and around 6 percent of University aged females (an estimated 375,000 women) have been victims of drug and alcohol facilitated rape/incapacitated rape at some point during their lives.

• Research by Wilsneck (1991, in Testa and Parks, 1996) reported that 60 percent of women (across all drinking levels) report having had someone who had been drinking become sexually aggressive towards them.

Canada DASV (or related) Statistics

• Research looking at the number of victims who presented to hospital-based sexual assault referral care between January 1993 to May 2002 in Vancouver, Canada found that 15 percent of sexual assaults were DASV (using the definition of proactive DASV i.e. covert administration of drugs) (McGregor et al, 2004). The incidence of DASV was most common in young females aged 15 to 19 years (McGregor et al, 2004). The actual number of DASV cases in the wider community is likely to be much higher than the amount presenting, as it is estimated that fewer than 10 percent of victims of sexual assault in Canada report to hospital (McGregor et al, 2004).

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3.0 Link between Alcohol and Drugs and Sexual Violence

This section explores the ways in which alcohol and drugs are associated with sexual violence (i.e. a risk factor for sexual violence), including:

• Previous history of alcohol consumption

• Alcohol related expectancies and beliefs

• The physical effects of alcohol and drug intoxication (on offenders and victims)

• The associated risks of alcohol and drug taking (e.g. contextual and situational risk factors, and increased likelihood of engaging in ‘risky behaviours’).

The characteristics of drug and alcohol assisted sexual violence will also be outlined, along with people’s perceptions of sexual violence where alcohol and drugs are involved.

The main focus in this section will be alcohol (as opposed to other drugs); this is because it is the main drug associated with sexual violence.

There is a strong association between alcohol and drug consumption and sexual violence. Alcohol is present in approximately one third to two thirds of rape incidents (Abbey 1991, Pernanen, 1991 both in Brecklin and Ullman, 2001).

Alcohol and drug consumption is a known risk factor for sexual violence (WHO, 2007, Abbey et al, 1996). However, the direction of the relationship is not necessarily a straightforward contributory one, and may be ‘bidirectional’ in some instances. For example, being intoxicated increases an individual’s chance of being sexually assaulted, and previous incidents of sexual assault (e.g. child/early sexual victimisation) may increase the likelihood a person will be a problem drinker, and problem drinking (i.e. binge drinking) increases the likelihood of sexual violence and so on (Ullman, 2003). It has also been suggested that the desire to commit sexual violence may actually result in alcohol consumption (e.g. as a justification for unacceptable behaviour) (Abbey et al, 2001).

Also, the role of alcohol and drugs as a risk factor for sexual violence co-occurs with other risks for sexual violence (e.g. being young, female, at a place where alcohol is available and potential offenders are also present). However, alcohol and drugs are not a prerequisite for sexual violence, not all incidents of sexual violence involve either alcohol or drugs, and not all occasions where alcohol and/or drugs are consumed result in sexual violence.

3.1 Alcohol and Drugs - a Risk Factor for Sexual Violence

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Heavy alcohol and drug use is a recognised risk factor for sexual violence perpetration and victimisation (WHO, 2007, Abbey et al, 1996, Vogel and Himelein, 1995, Koss and Dinero, 1989; Muehlenhard and Linton, 1987 both in Combs-Lane and Smith, 2002, Testa and

25_{There are a number of known risk factors for sexual violence perpetration and victimisation; these}

are listed in detail in the Ministry of Justice “What Works in Sexual Violence Prevention” literature review report (2008, unpublished). The current report focuses primarily on the risks associated with alcohol and drug consumption.

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Parks, 1996). Alcohol and drug abuse contributes to perpetrator aggression and also to victim vulnerability (Martin and Hummer in Bart 1993, Koss 1988, Curtis, 1997, Muehlenhard and Linton 1987, all in McPhillips et al 2002). Alcohol and drugs are a risk factor for sexual violence but not a causal factor (i.e. consuming alcohol and/or drugs does not ‘make’

someone perpetrate sexual violence)26_{. Similar to alcohol being a risk factor, females’ use of}

drugs has been shown to be associated with subsequent physical and sexual abuse (Kilpatrick, et al 1997 in Testa, 2004)

Alcohol use has been found to be predictive of the occurrence of future victimisations (Gidycz, Hanson, and Layman, 1995 in Combs-Lane 2002). The risk of sexual violence is also associated with the frequency and amount of alcohol consumed. A study undertaken by Felson and Burchfield (2004) found that infrequent drinkers (those who drink 1-3 times a month) have no greater risk than those who never drink, yet people who drink once or twice weekly are at a much greater risk27_{. The amount of alcohol consumed on any one occasion}

is also strongly related to the risk of sexual victimisation while drinking, the risk for individuals who drink six or seven drinks per occasion is particularly strong (Felson and Burchfield, 2004).

Combs-Lane and Smith (2002) undertook a study which found that alcohol consumption played a strong role in both the occurrence of new victimisations and frequency of involvement in risky sexual activities. The study also found that females who were victimised reported three times the number of regular binge drinking days as compared to those females who were not victimised (Combs-Lane and Smith, 2002)28_.

Alcohol consumption presents a greater risk for sexual assault than it does for physical attack; this indicates that drinking has an important role in increasing vulnerability to sexual violence specifically (Felson and Burchfield, 2004). It is difficult to assess exactly how alcohol influences sexual victimisation because of the fact there are direct influences of alcohol (e.g. effects of drinking and indirect influences (e.g. the setting in which a person drinks) (Testa and Parks, 1996).

Alcohol consumption by offenders and victims typically co-occurs, seldom is the victim only drinking, this makes sense given that in social situations (e.g. bars) alcohol consumption tends to be a shared social activity (Abbey et al, 2001). Victims who are assaulted by perpetrators who have been drinking are more likely to have been drinking themselves, and victims assaulted in bars are more likely to have been drinking (Felson and Burchfield, 2004).

26_{It is important that policies aimed at prevention are not based on simplistic views that suggest that}

alcohol directly disinhibits or causes violence (Bennett and Williams, 2003 in Chen, 2005).

27_{The relationship between frequency and risk is not entirely straightforward as the study found a} slight decline in risk of sexual violence for those who drink everyday (Felson and Burchfield, 2004). The ‘frequency risk’ is most likely related to additional factors such as location and amount consumed – ‘everyday drinkers’ may consume one to two drinks in one sitting in their own home home whereas regular (2-3 times a week) drinkers may consume more alcohol per occasion at public places (e.g. bars or parties).

28_{Combs-Lane and Smith (2002) note this finding is consistent with other research and suggest that}

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3.1.1 Previous History of Alcohol Consumption

There is evidence of a strong association between alcohol consumption immediately pre-assault and long term drinking patterns and sexual violence (Finney, 2004). There is evidence that both offenders and victims are more likely to be heavy drinkers (or problem drinkers):

• Research on adolescent sexual offenders found that many were diagnosed as abusers of drugs and or alcohol (Boyd et al, 1999), or were from families of alcoholics (Langevin et al 1985 in Boyd et al, 1999, Hsu and Starzynski, 1990 in Boyd et al, 1999).

• Drug and alcohol use and abuse problems (mainly alcohol abuse) appear to be common in rapists (Seto and Barbaree, 1995 in Marshall, 2000). Research with rapists who are in jail has frequently found that indicators of alcoholism or heavy drinking are associated with offending (Seto and Barbaree, 1997 in Abbey et al, 2003).

• Grubin and Gunn’s 1990 study of males incarcerated for rape found that nearly two-fifths were alcohol dependent (Grubin and Gunn, 1990 in Finney, 2004).

• The more frequently offenders drank around the time of the sexual assault (in general, not just pre-assault) the more severe the type of sexual assault they committed was (Abbey et al, 2003).

• Stephens (1992) notes that there is a high incidence of sexual offences against women who are drug dependent.

The relationship between intoxicants and sexual violence (as mentioned previously) is likely to be bidirectional:

• Childhood sexual abuse has been identified as a contributory factor to the development of alcohol problems (Miller and Downs, 1995 in Testa and Parks, 1996), Retrospective studies show heavier levels of alcohol consumption amongst people who had experienced childhood sexual victimisation (McMullin and White, 2006; Bensley et al, 2000; Champion et al, 2004; Koss and Dinero, 1989, Wilsneck, 1997 et al; all in Testa et al, 2007)

• There is evidence that the occurrence of childhood sexual abuse increases an individuals’ vulnerability to a range of behaviours such as the early onset of, and heavier use of, alcohol and drugs (Saphira and Glover, 2004). The early commencement of alcohol use is predictive of higher levels of drinking and alcohol related issues later on in life (Ministry of Health, 1997 in Saphira and Glover, 2004).

• The same independent predictive relationship (between sexual violence and heavy drinking) was not found in a prospective study of adult sexual victimisation – more

research is required to understand the effects of adult sexual violence on subsequent alcohol and/or drug usage (Testa et al, 2007).

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3.1.2 Beliefs and Alcohol Related Expectancies

The link between alcohol and sexual aggression is likely to be mediated by factors such as:

• Hostility towards women – intoxicated males who have anger or hostility towards females (including those males who think it is acceptable to use violence to achieve goals) are more likely to be sexually aggressive towards women (Burt, 1980, Lalumière et al 1995, Walker et al, 1993 all in Seto and Barbaree, 1995).

• Rape supportive attitudes and beliefs - intoxicated males who hold traditional views about gender roles, who believe in stereotypes about gender (e.g. ‘women say ‘no’ when they really mean ‘yes’) and rape myths (e.g. someone wearing a short skirt is ‘asking for it’) are more likely to be sexually aggressive towards females (Burt, 1980, Lalumière et al 1995, Walker et al, 1993 all in Seto and Barbaree, 1995; Mahoney, 1998 in McPhillips 2002; Curtis 1997, Bernard et al, 1985, Muehlenhard and Linton, 1987, Murnen and Bryne, 1991, in Karlof, 2000, all in McPhillips, 2002).

• Beliefs about alcohol consumption - alcohol consumption is viewed as a sexual cue, both males and females believe to some degree that alcohol enhances sexuality29 (George and Stoner, 2000). There are a number of stereotypes about women who drink alcohol including that women who consume alcohol on a date are more sexually available (Abbey 1980; Abbey 1995, George et al, 2000 in Sims et al 2007). A study by Abbey (et al, 2005) found that intoxicated males thought they acted more sexually, were more sexually attracted to the confederate (female actor) in the study, and also saw her as being more sexual than other sober (or placebo – no alcohol) research participants did.

• Alcohol-related expectancies - people’s expectations of what drinking alcohol will do greatly influences the effect alcohol has on them (Marlett and Rohsenhow, 1980 in Abbey et al, 1994). Holding strong beliefs about the effects of alcohol (e.g. that it reduces anxiety) increases the likelihood that alcohol will act as a disinhibitor when consumed (the extent to which this occurs depends on personal and social inhibitions along with the subjective desirability of reducing inhibitions) (Seto and Barbaree, 1995).

Research shows that alcohol-related expectancies for females include expecting to feel ‘more friendly’ and ‘romantic’ (Leigh, 1987 in Abbey, 1994). Males expect to feel sexual, more powerful, aggressive, and less inhibited (Marlett and Rohsenhow, 1980 in Abbey et al, 1994).

Alcohol expectancy beliefs are important and have a powerful effect on male’s behaviour (George and Stoner, 2000). Pre-existing expectancies of the effects of alcohol operate both directly and interactively with alcohol consumption on the reported likelihood of sexual aggression in males (Norris et al, 2002). Research has found males who have high alcohol-related expectancies that alcohol enhances their sexuality and who received alcohol, rated themselves as more likely to commit sexual aggression than males with little or no alcohol (Norris et al, 2002). Further, the study showed it was the expectation (as opposed to the actual consumption of alcohol) that indirectly increased the likelihood of sexual aggression (Norris et al, 2002).

29_{However, George and Stoner (2000) report that alcohol consumption actually decreases both} males and females genital reactions.

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Fenaughty (et al, 2001) notes that males are more likely to link alcohol consumption with a reduced ability to manage anger and increased feelings of superiority (Brown et al, 1997 in Fenaughty et al, 2001) and accordingly may regard intoxication as legitimizing aggressive behaviour.

3.1.3 The Physical Effects of Alcohol and Drug Intoxication

The physical (as in biological) effects of alcohol and drug intoxication have been well documented, as has the role these effects play in sexual violence. The physical effects of alcohol are known as ‘pharmacological effects’ (which means simply the effects that a drug has when taken by somebody).

The types of drugs most often implicated in cases of sexual assault are central nervous system depressants (European Monitoring Centre for Drugs and Drug Addiction, 2008). The effect of these depressants includes altering a victims behaviour (e.g. loss of inhibitions), loss of consciousness (in some instances), and retrospective amnesia (European Monitoring Centre for Drugs and Drug Addiction, 2008). The central nervous system depressant most commonly associated with sexual assault is alcohol (European Monitoring Centre for Drugs and Drug Addiction, 2008).

The effects of alcohol or substance use resulting in intoxication can increase the likelihood of sexual violence, whilst awareness of these effects may assist in understanding the contributory role of intoxication in sexual violence they do not exonerate the offender of their responsibility, nor do they attribute blame to the victim. Felson and Burchfield (2004) raise the point when looking at the relationship between drinking and victimisation, that ‘cause’ and ‘blame’ are two different things (e.g. a person can do something which may have a causal role in their victimisation without being at all blameworthy) (Felson and Burchfield, 2004). The effects, as shown below, are discussed in detail in this section.

Alcohol consumption (voluntary or involuntary) can have the following effects:

• Cognitive impairment

• Reduction of inhibitions

• Physical impairment (e.g. reduced motor skills)

• Increased aggression.

3.1.3.1 Cognitive

Impairment

Alcohol consumption to certain (varying) levels can impair a person’s cognitive ability in a number of ways (European Monitoring Centre for Drugs and Drug Addiction, 2008).

Alcohol effects cognitive functioning in the following ways:

• Impairs judgement, makes people less capable of evaluating risk, and more likely to take risks they normally would not take (e.g. accepting a car ride from someone they do not know) (Papadodima et al, 2007).

• Increases the likelihood of misperceptions occurring (e.g. of a women’s platonic friendliness being misinterpreted by a male companion as a sign of sexual attraction),

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and facilitates miscommunication (Abbey et al, 1994, Abbey 1995, Fenaughty, et al 2001). Intoxication may also cause females to ignore or miss cues that suggest their intent has been misperceived (Abbey et al, 1994).

• Makes it difficult for an individual to easily or quickly correct misperceptions or fend off unwanted sexual advances (Abbey et al, 1994, Abbey, 1995).

• Makes it more difficult to communicate, and reduces peoples’ ability to interpret ambiguous cues (many aspects [verbal and nonverbal] of dating behaviour may be regarded as ambiguous) (Abbey et al, 1994, Abbey et al, 2001). M

A Review of the Associations between Drugs (including Alcohol) and Sexual Violence