ROHYPNOL (flunitrazepam) Fact Sheet*

What is Rohypnol? Rohypnol is a sedative which belongs to the class of drugs called benzodiazepines. This group of substances includes such familiar drugs as diazepam (Valium), alprazolam (Xanax), chlordiazepoxide (Librium) and lorazepam (Ativan).

Is Rohypnol a Common Drug in the United States? Flunitrazepam is marketed in more than 70 countries worldwide including countries in Europe, South America, Asia and Africa. It is sold under various trade names and as generic preparations. The most common trade name is Rohypnol by the Hoffmann-La Roche Company. Rohypnol is formulated as 0.5, 1.0 and 2.0 mg tablets and as a 2.0 mg/ml injectable solution. Rohypnol has never been submitted to the Food and Drug Administration for marketing approval in the United States. As a result it has never been marketed in this country, but is a common drug of abuse in countries where it is legally available. Since 1992, the federal Drug Enforcement Administration has identified approximately 4,000 cases where Rohypnol was involved in cases involving law enforcement agencies. About 85% of the cases were in either Florida or Texas. The remaining cases were in 34 other states, primarily located in the southern and central parts of the country.

What are some of the street names for Rohypnol? "Roofies", "la rocha", "rib", "rope."

What are the primary effects of Rohypnol? The primary effects of Rohypnol include central nervous system depression, sedation, hypnosis, muscle relaxation, relief of anxiety, elevation in seizure threshold (anticonvulsant effect) and anterograde amnesia. In terms of potency, Rohypnol is approximately 10 times more potent than diazepam (Valium). Some of the adverse effects associated with the use of Rohypnol include drowsiness, hangover, dizziness, gastrointestinal upset, slurred speech, muscle weakness, disorientation, sweating, tremor, motor incoordination, unsteadiness, impaired judgment, confusion and headaches. Like all other drugs, the effects of Rohypnol are dose dependent in that the higher the dose the more likely one is to experience one or more of these effects. At very high doses Rohypnol may cause respiratory depression, coma and, in rare cases, death. Since the combination produces a synergistic action, these latter effects are much more likely to occur when sedatives such as Rohypnol are mixed with alcohol.

What does it mean when it is said that Rohypnol is a "date rape" drug? A date rape drug is one which is used to render a person unconscious, unaware of his/her surroundings, and/or unable to resist physical assault. Such drugs also impair judgment, leading in some cases to inappropriate and regrettable decisions regarding sexual activity. The most common date rape drug is alcohol. Rohypnol has also emerged as a date rape drug primarily because the tablets have little or no taste, thus allowing them to be added surreptitiously to food or drink. Except for this characteristic, Rohypnol does not differ in its actions from the dozens of other sedating drugs found commonly in the United States.

Is Rohypnol Addicting? The misuse and abuse of sedative drugs, including Rohypnol, is very common. With prolonged use of high doses, a serious physical dependency can develop as well. The withdrawal signs associated with Rohypnol dependence may include nervousness, anxiety, drug hunger (craving), headache, muscle pain, restlessness, irritability, confusion, delirium, hallucinations, convulsions (seizures) and dangerously high body temperature. Treatment of physical dependence on Rohypnol involves the substitution of another sedative drug followed by a gradual reduction in the dose. Such treatment should be managed by a physician because of the distinct possibility of death as the result of the more serious withdrawal symptoms.

Can Rohypnol be detected in the human body? Exposure to Rohypnol can be detected thorough urinalysis. To have the best chances of detecting exposure to Rohypnol, urine samples need to be collected within the first 72 hours following exposure. Very little Rohypnol is excreted into the urine. Instead, once in the body, the Rohypnol is converted to other substances, called metabolites, which are found in the user’s urine. Thus, urinalysis is directed towards detection of Rohypnol metabolites, not Rohypnol itself.

The most important metabolite to look for in urine is 7-amino-Rohypnol. Detection of this substance in urine indicates prior exposure to Rohypnol.

ASAM Statement on Rohypnol

Because of the proliferation of inaccurate information concerning Rohynol, the American Society of Addiction Medicine issued a statement on the misuse and abuse of this drug** :

Fluintrazepam (Rohypnol):

1. is perceived as particularly effective in inducing sedation, submissive behavior, and amnesia, and is therefore linked to cases of "date rape"
2. has synergistic effects with ethanol that can produce significant sedation, including coma and death
3. is no more or less than a benzodiazepine, with drug interactions with ethanol and other sedative hypnotics like those seen with any other sedative hypnotic drugs.
4. benzodiazepines, including Rohypnol, have specific clinical indications and are safe and effective for many medical conditions, but are nonetheless substances that are misused by significant numbers of Americans
5. the Rohypnol problem is especially prevalent in states along the southern border of the United States
6. The AMA (should) contribute to public education and public health initiatives regarding the inappropriate Rohypnol use, especially when it is mixed with ethanol
7. The AMA (should) target its own members for education about this matter
8. The AMA (should) educate physicians that even though the popular press and some public health officials see Rohypnol as being a uniquely dangerous product, that it is, in fact, a benzodiazepine, and that other sedative-hypnotics can carry the risks of misuse, morbidity and mortality that are inaccurately solely attributed to Rohypnol.

Antegrade amnesia:

Notes: * Portions of this fact sheet were taken from: U.S. Department of Justice, Drug Enforcement Administration, "Special Issues" series, Flunitrazepam (Rohypnol) ("Roofies"), Arlington, Va., July 1998.