The French mass rape trial has brought the expression "chemical submission" into public discourse, along with "medical wandering" (visiting more than one doctor for the same issue). During Gisèle Pelicot's nearly 10-year-long ordeal – raped by her husband and dozens of men after being drugged with anxiolytics – clinical signs and symptoms were identified. These included memory loss, "absences" and gynecological problems, but the "puzzle" leading to the identification of the sexual assaults to which she was the victim could not be assembled.

Beyond the seriousness of the facts and the emotion they arouse, the case is also raising questions about the role of doctors, who are essential watchdogs in the face of this type of violence. But "how do we think about the unthinkable?" This is the question posed by general practitioners: family doctors who are closest to their patients and who make no secret of the fact that they are often unaware of this type of violence.

"Of course, we're concerned by this matter, but it's not an easy task to identify the problem," said Emeline Pasdeloup, co-leader of a working group on the issue set up a year ago by the Collège de Médecine Générale. "We're on the cusp between two delicate subjects to tackle in consultation: sexual health and violence." It's even more complicated, added this young GP practicing in the Loiret region, "when the patient doesn't come for such a reason, or when she comes accompanied by her husband," which occurs frequently.

Total or partial amnesia

The lack of training for professionals is compounded by the complexity of the phenomenon. "Chemical submission" is defined by the French National Drug Safety Agency (ANSM) as "the administration of psychoactive substances for criminal purposes [rape, pedophilia] or criminal offenses [intentional violence, theft] without the victim's knowledge, or under threat," and has the particularity of plunging many victims into total or partial amnesia.

How many are there? The estimate is very difficult to determine. In 2022, according to data from the national network in charge of monitoring addiction problems collected via forensic medicine departments, toxicology laboratories, emergency services, the police and other groups, 1,229 "substance-facilitated assaults" were recorded by ANSM. Of these, 97 refer to cases of "probable" chemical submission, 346 to so-called chemical "vulnerability" cases (induced by "voluntary" consumption of substances) and 786 to "possible" cases of chemical submission. The Paris center in charge of monitoring addiction problems, which has been coordinating this annual national survey for 20 years, spoke of an "exponential" increase, which can be linked with freer speech on social media.

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