Unveiling dynamics of drug-facilitated sexual assault: an observational retrospective study in Barcelona (2018–2022)

The Hospital Clinic of Barcelona, which is the leading centre for sexual assault cases and has developed a care model for the comprehensive treatment of recent sexual violence, reports 400 to 500 sexual assaults annually, with substance use (drug-facilitated sexual assault, DFSA) involved in about one-third of cases. Alcohol and cocaine have been described as the most frequent substances detected, although updated data on victims, aggressors, and substances are needed. This retrospective study analysed 682 DFSA cases seen at the Barcelona reference centre for sexual assault victims over 16 years old (2018–2022). Univariate, bivariate, and multivariate analyses described victim characteristics and identified key associations. Among the DFSA cases assessed, 85% involved women and 73% involved individuals aged 18–35 years. Assaults most occurred in domiciles (42%) and public spaces (23%). Alcohol (55%) and cocaine (28%) were prevalent, with emerging drugs like GHB (15%) and MDMA (23%) increasing. During the pandemic, assault contexts and substance use shifted. Cases involving drugs supplied by the perpetrator rose, constituting 17% of DFSA in 2022, with MDMA and cocaine more prevalent in women, and methamphetamine and GHB in men. Multivariate analysis among female victims showed that cases involving both alcohol and drugs were more frequently associated with public spaces compared to nightlife settings (OR 3.75, 95% CI 1.55–9.05). Cases involving drugs alone were less frequently observed among women aged 18–25 years compared to those aged 25–35 years (OR 0.55, 95% CI 0.32–0.97). Cases occurring in domiciles were more frequently classified in the drug-only category compared to nightlife settings (OR 2.46, 95% CI 1.14–5.45). Among the DFSA cases assessed, most involved women aged 18–35 years, and residential settings were the most frequently reported locations. Alcohol and cocaine remained the most commonly detected substances, while newer substances showed different patterns according to assault setting and victim sex. These findings highlight the importance of surveillance systems capable of monitoring evolving patterns of substance use and assault contexts to support prevention and victim care.