Standard operating procedures for the detection of substances of abuse in biological matrices in drug-related violence cases

The “Pink Code” (Codice Rosa) is a protocol established in several Italian healthcare centers designed to offer a multidisciplinary approach to support victims of psychological, physical, sexual, or economic violence, including cases involving coercion and deprivation of freedom, as defined by the Istanbul Convention. This Convention is considered the most comprehensive legal framework for preventing and addressing violence against women and domestic abuse, which are recognized as violations of human rights. Emergency departments serve as the initial point of contact and play a key role in identifying cases that might otherwise remain undisclosed. The national framework is outlined in the Prime Ministerial Decree (DPCM) dated November 24th, 2017, entitled National Guidelines for Emergency and Socio-Health Care and Hospital Organization for Women Victims of Violence. This decree highlights the medico-legal importance of all healthcare personnel’s actions in these circumstances. In situations of recent physical violence, medical care must address both clinical treatment and legal requirements. The careful collection of biological samples and strict adherence to the chain of custody are essential to preserve evidence that can be used in legal proceedings. Nevertheless, early-stage collection and transport may face challenges such as contamination or degradation if protocols are not properly followed. To mitigate these risks, the present procedure is based on fundamental principles: ensuring the highest level of privacy protection for the victim, fostering thorough coordination among all involved staff, providing dedicated spaces for each step of care, and implementing clear protocols that guarantee the integrity and legal validity of medico-legal processes.