Rohypnol abuse

Government trend-watchers say Rohypnol is south Florida s fastest-growing drug problem. High school students who use the drug with alcohol or cocaine make up the greatest proportion of Florida s Rohypnol abusers. 

In some areas of the country, such as Texas, Rohypnol abuse and illegal sales and distribution of the drug has become prevalent among gang members. 

Intentional Rohypnol abuse appears to be most prevalent among teenagers and college students, some of whom use the drug recreationally to intensify the effects of alcohol. When Rohypnol is used in this way, it is often referred to as an alcohol extender. The White House s ONDCP says another common way in which some club-goers use Rohypnol is in combination with methamphet-... 

Reports of abuse on many college campuses include stories of women waking up naked in unfamiliar surroundings with no memory of the preceding hours. They may have been sexually assaulted but have no memory of what took place. It is important to note that both men and women can be victims of sexual assault, although the vast majority of cases are reported by females. Rohypnol can have an equally incapacitating effect on males. Both males and females have the right to seek treatment after sexual assault and/or suspected Rohypnol abuse. 

As reports of Rohypnol abuse continued, the United States moved to make the drug illegal. In 1995, Rohypnol was placed on Schedule III of the 1971 Convention of Psychotropic Substances and was designated a Schedule IV drug. This designation means that it has some medical use. However, it is illegal to import Rohypnol into the... 

Because Rohypnol is banned in the United States, there is an emerging trend for young people to start abusing two other Rohypnol-like drugs that are still legal in the United States clonazepam (Klonopin ) and alprazolam (Xanax). Both Klonopin and Xanax are benzodiazepines that are used for the treatment of anxiety and insomnia. Although they are less potent than Rohypnol, they can produce similar effects when mixed with alcohol and also have been reported to enhance the effects of heroin. 

A Website targeted toward teenagers, part of the National Institute on Drug Abuse. Focuses on club drugs such as Ecstasy, GHB, Rohypnol, ketamine, methamphetamine, and LSD. 

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. 

Rohypnol, developed by the pharmaceutical firm of Hoffmann-La Roche, is first sold in Switzerland as a sleeping aid for the treatment of insomnia. Reports begin surfacing that Rohypnol is abused as a recreational or party drug, often in combination with alcohol and/or other drugs. 

Racially, white patients account for 61% of all drug-related hospital visits in the United States, followed by black (26%) and Hispanics (11%). With the exception of rohypnol, the 69-80% of all club drug incidents recorded by Drug Abuse Warning Network (DAWN) involve white, non-Hispanic patients—a fairly typical reflection of the U.S. population. A far larger share (56%) of rohypnol mentions are attributed to Hispanic patients, but this may have to do with the small sample size available to researchers. 

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. 

While swallowing the pills or dissolving them in liquid are the most common ways to take Rohypnol, reports suggest some abusers crush the pills and snort the powder much as they would cocaine. The White House s Office of National Drug Control Policy (ONDCP) also indicates there is evidence that some abusers are injecting powdered Rohypnol with hypodermic needles, possibly as a cheap substitute for heroin. 

Some heroin addicts use Rohypnol to intensify the heroin high. Officials say this may be particularly true of users of low-quality heroin. Cocaine addicts may use Rohypnol to mellow cocaine s high and to ease themselves down from a crack or cocaine binge. Some drug abusers call Rohypnol landing gear, when it is used in this manner. 

Since many abusers of Rohypnol take the drug with alcohol, there may be two addictions present, and therefore, the addicted person should be referred for treatment for both the drug and alcohol dependence. In these patients, additional drugs must be given to alleviate alcohol withdrawal, which can include rising pulse and blood pressure, tremors, and profuse sweating. 

Approximately 50% of all people entering treatment for cocaine abuse or addiction to painkillers also report abusing a benzodiazepine. As with Rohypnol users with a simultaneous alcohol addiction, those with an addiction to other drugs in addition to Rohypnol must undergo a more complex withdrawal treatment than those who are addicted to Rohypnol alone. 

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. 

Even though Hoffmann-LaRoche has reformulated Rohypnol tablets to be more easily identified when placed into someone s drink, Rohypnol is still a very potent benzodiazepine and is subject to abuse. Chronic or daily Rohypnol use causes dependence in humans. Once dependence has developed, abstention induces withdrawal symptoms, including headache, muscle pain, extreme anxiety, tension, restlessness, confusion, and irritability. Numbness, tingling of the extremities, loss of identity, hallucinations, delirium, convulsions, shock, and cardiovascular collapse also may occur. Withdrawal seizures can occur in chronic abusers with abrupt cessation of Rohypnol use. 

According to Pulse Check Trends in Drug Abuse, published by the Office of National Drug Control Policy, the availability of Rohypnol appears to be stable at low levels, and the drug is the least available of the club drugs and date rape drugs. The... 

Rohypnol was found to have entered Texas by two methods (1) simple smuggling across the United States-Mexico border, and (2) the abuse of provisions of the Controlled Substances Act of 1970, which permits travelers to carry small amounts of a controlled substance for personal medical use. 

Figure 2.3 This table explains the formal scheduling of drugs according to the Controlled Substances Act of 1970. Drugs are classified based upon their medical uses and potential for abuse. Although some states list Rohypnol in Schedule I, the federal government currently places the drug in Schedule IV.

Respiratory support with oxygen may be required for respiratory depression associated with Rohypnol ingestion. A benzodiazepine antagonist can reverse respiratory depression and coma caused by overdose but is not routinely recommended because it can precipitate withdrawal symptoms and seizures. There is no antidote to GHB overdose. Ventilator respiratory support, seizure control, and supportive care may be required. Symptoms often resolve within 3-4 h. Abuse of both rohypnol and GHB can cause withdrawal symptoms. Long-term use of Rohypnol can cause seizures, tremors, and anxiety. Long-term abuse of GHB withdrawal can last from days to weeks. GHB withdrawal includes anxiety, tremors, disorientation, hallucinations, and insomnia. 

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