Flunitrazepam abuse

The anxiolytic effects of lorazepam and possibly chlordiazepoxide may be opposed by alcohol. Alprazolam and alcohol together may possibly increase behavioural aggression. Similarly, flunitrazepam abuse can cause violent behaviour, impulsive decision-making and anterograde amnesia a report looking at violent crimes committed by abusers of flunitrazepam found that alcohol was almost always also present. Alcoholic drinks also enhance the effects of flunitrazepam when it is used as a date rape drug. ... 

Some abusers mix barbiturates with alcohol or marijuana in order to create a better high. A different kind of abuse occurs when rapists mix another drug, Rohypnol (flunitrazepam), into a woman s drink in order to render her incapable of resisting a sexual assault. The capacity for criminal abuse has led to higher penalties for its possession or use. 

Many people in the United States have heard of Rohypnol (flunitrazepam), otherwise known as the date rape drug, as a result of news reports about its abuse. Rohypnol is neither actually on the market nor approved for medical use in the United States. However, it is legal and available by prescription in other parts of the world, including Mexico, South America, Asia, and Europe, where it is one of the most widely used benzodiazepine drugs. Like other benzodiazepines, it is a downer, meaning it acts as a sedative and has a depressant effect on the body s central nervous system (CNS). Other common benzodiazepine drugs include Valium, Xanax, and Halcyon. 

Although some sedative-hypnotics such as the nonbarbiturates glutethimide (Doriden) and methaqualone (Quaalude) were once legally prescribed drugs, these substances were banned from use in the United States because of their potential for addiction and abuse. Some sedative-hypnotics such as flunitrazepam (Rohypnol) are illegal in the United States but are legal in Europe and Latin America. 

Many benzodiazepines have potent hypnotic activity and are useful in the treatment of insomnia. Examples include flurazepam (Dalmane, A.93), midazolam (Versed, A.94), temazepam (Restoril, A.95), and triazolam (Halcion, A.96) (Figure A.28). Flunitrazepam (Rohypnol, A.97) is a particularly notorious sedative. Often called roofie or the date rape drug, flunitrazepam causes sedation and amnesia. Because of flunitrazepam s tendency to be abused, almost all nations tightly regulate the drug s availability. 

Another compound used in some countries as a hypnotic is lorazepam, which can show some rebound phenomena [18], A similar compound, the chlorinated derivative of temazepam, lormetazepam, shows marked rebound phenomena [19], Flunitrazepam is aparticularly controversial benzodiazepine [20], It has achieved notoriety as the date-rape drug, although documented instances of clandestine use are sparse. It has a high abuse potential, resulting in tight scheduling. However, it does not appear to have a particular propensity to prominent rebound or withdrawal problems. 

Woods JH, Winger G (1997) Abuse liability of flunitrazepam. J Clin Psychopharmacol 17, 3 Suppl 2 1-57... 

Bond A, Seijas D, Dawling S, Lader M. Systemic absorption and abuse liability of snorted flunitrazepam. Addiction 1994 89(7) 821-30. 

A 69-year-old man developed acute benzodiazepine withdrawal delirium following a short course of flunitrazepam after an acute exacerbation of chronic obstructive pulmonary disease. He was not an alcohol-or drug-abuser and he had not previously taken benzodiazepines. Six days after withdrawal of flunitrazepam he became agitated and confused, and had visual hallucinations, disorganized thinking, insomnia, increased psychomotor activity, disorientation in time and place, and memory impairment. Tachycardia and significant anxiety were also noted. He fulfilled the DSM IV criteria for withdrawal syndrome and delirium, and had spontaneous remission of symptoms within 48 hours. 

A 37-year-old man who had abused metamfetamine, paint thinner, psychotomimetic drugs, and alcohol for 20 years was given chlorpromazine, haloperidol, and flunitrazepam just before surgery. After spinal anesthesia he was given propofol 5 mg/kg/hour intravenously. However, euphoria and excitement occurred 10 minutes after the start of the infusion and he had excitement, hallucinations, and delirium. His symptoms were suppressed by intravenous haloperidol 5 mg. 

In 2001, Flunitrazepam has been subjected to the same prescribing restrictions as narcotics in several countries because of its continuing abuse by drug addicts. 

As well as the opioids cocaine and cannabis, polytoxicomane drug abusers also consume bromazepam, diazepam and flunitrazepam in high doses, and fatalities among drug abusers and substitution patients can often be blamed on the consumption of these substances, often in combination with alcohol [48]. Patients who suffer low-dose dependence, in addition to consuming the three above-named substances, also consume therapeutic amounts of dipotassium clorazepate, flurazepam, lorezepam, nitrazepam or oxazepam, sometimes also in combination with amphetamines or antihistamines. 

Cardiovascular Accidental injection of flunitrazepam tablets dissolved in tap water into the left femoral artery by a 22-year-old drug abuser caused acute ischemia of the leg with severe rhabdomyolysis within 5 hours [14 ]. There was acute occlusion... 

Note that the top 25 detected by NFLIS are all among the most commonly abused drags in the United States. The major ones missing (but which are captured in the remaining 10% of samples analyzed by NFLIS) are baibiturates (e.g., seconal and phenobaibital, but whose rate of abuse has been declining), certain benzodiazepines (except flunitrazepam, such as alprazolam, diazepam, and chlordiazepoxide). 

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