Use of intentional drugging as a weapon in child abuse: A medicolegal perspective

Abstract

Background: Child abuse through intentional substance exposure is an emerging concern that poses significant forensic, psychiatric, and medico-legal challenges. This case series examines four adolescents subjected to deliberate drugging to incapacitate them, facilitating abuse. It highlights such cases' clinical and legal implications, emphasizing the need for early detection, multidisciplinary intervention, and robust preventive strategies to protect vulnerable children. Method: A case series of four adolescents subjected to intentional substance exposure was conducted. Comprehensive evaluations included toxicology screening, forensic examination, and psychiatric assessment. Result: Toxicology screening confirmed barbiturate poisoning in Case 1, accompanied by forensic evidence of sexual assault. In Case 2, methamphetamine intoxication was identified alongside indicators of chronic abuse, depression, and post-traumatic stress disorder. In case 3, the boy was sedated with an unknown drug mixed in the milk, and in Case 4, the boy was given beer and ethanol (Kasippu) to drink on repeated occasions. All cases were addressed through a multidisciplinary intervention approach. Conclusion: This case series underscores the alarming use of intentional drugging as a weapon in child abuse, where barbiturates induced sedation to mask assault, while methamphetamine and alcohol enabled control through addiction. Such tactics delay detection and complicate legal remedies, particularly given victims' developmental vulnerabilities. Forensic examinations and toxicology proved paramount in confirming abuse, with longitudinal medico-legal collaboration critical to justice. These cases emphasize the urgent need for systemic integration of medical, legal, and social strategies to safeguard children and address both immediate and lifelong impacts of substance-facilitated abuse.