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Rohypnol

Also known as

roofies, forget-me-pill, R-2, rophies, roach, rope, forget me drug, roches, ruffles, date rape drug, la roche, rib, roofenol, the forget pill, getting roached, lunch money drug, mexican valium, pingus, reynolds, robutal, wolfies, circles, forget pill, forget-me-pill, la rocha, roach 2, roaches, roachies, roapies, rochas dos, ropies, roples, row-shay, ruffies

Classification

Sedative

Overview

Rohypnol is the common and brand name for Flunitrazepam, a benzodiazepine sometimes used in the treatment of sleep disorders [1].

Medical usage

It is used in the short-term treatment of insomnia, as a pre-medication in surgical procedures and for inducing anaesthesia [2]. For short-term treatment of severe insomnias, that are not responsive to other hypnotics [3].

What does it look like?

Usually come in tablet form. 1 mg in the UK being green, film coated marked '542' oval and centrally scored (previously scored purple rhomboids). Non-water soluble. Some non-UK sources can be 2 mg, white and medium-small, quartered and more soluble in water. This was the probably the derivation of the 'date-rape' reputation [1].

Prior to 1997, Rohypnol ® was manufactured as a white tablet (0.5 - 2 milligrams per tablet), and when mixed in drinks, was colourless, tasteless, and odourless. In 1997, the manufacturer responded to concerns about the drug's role in sexual assaults by reformulating the drug.

Rohypnol ® is now manufactured as an oblong olive green tablet with a speckled blue core that when dissolved in light-coloured drinks will dye the liquid blue. However, generic versions of the drug may not contain the blue dye [4].

A benzodiazepine with pharmacologic actions similar to those of diazepam that can cause anterograde amnesia. Some reports indicate that it is used as a date rape drug and suggest that it may precipitate violent behaviour. The United States Government has banned the importation of this drug [3].

Why take it?

Sought after effects

  • relaxing,
  • sleepy,
  • reduced anxiety [1].

Undesired effects

  • aggressive behaviour,
  • deep and intense memory loss,
  • complete loss of movement and lack of coordination potentially leaving users very vulnerable [1].

Dosage

Abuse

  • light - 0.5 - 1 mg,
  • common - 1 - 2 mg,
  • heavy - 2 - 4 mg + [5].

What are the different forms?

Rohypnol, previously available as a white tablet that dissolved without colour or taste, is now formulated as a caplet that is light green with a blue core. The manufacturer instituted this change to help identify tampered drinks at clubs. When dissolved in clear liquids the blue core will turn the clear liquid to blue. However, when dissolved in darker-coloured liquids, the blue dye may not be noticeable. Generic versions of Rohypnol may not contain the blue dye [2].

How long do its effects last?

Onset of effects

  • all ROA's - 15 - 30 minutes [5].

Duration of effects

After-effects

  • all ROA's - 2 - 24 hours [5].

Pharmacology

The pharmacological actions of flunitrazepam are shared with other benzodiazepine drugs in that they enhance the effect of the body's main inhibitory neurotransmitter GABA [1].

Pharmacodynamics

Flunitrazepam is a powerful hypnotic drug that is a benzodiazepine derivative. It has powerful hypnotic, sedative, anxiolytic, and skeletal muscle relaxant properties. The drug is sometimes used as a date rape drug. In the United States, the drug has not been approved by the FDA for medical use, and is considered to be an illegal drug. It has however been approved in the United Kingdom and other countries [3].

Absorption

50% (suppository) and 64% - 77% (oral) [3].

Metabolism

Hepatic [3].

Half-life

18 - 26 hours [3].

Lethal dosage

In rats the LD50 is 2.8125 mol/kg [3].

Mechanism of action

Benzodiazepines bind nonspecifically to benzodiazepine receptors BNZ1, which mediates sleep, and BNZ2, which affects affects muscle relaxation, anticonvulsant activity, motor coordination, and memory. As benzodiazepine receptors are thought to be coupled to gamma-aminobutyric acid-A (GABAA) receptors, this enhances the effects of GABA by increasing GABA affinity for the GABA receptor. Binding of the inhibitory neurotransmitter GABA to the site opens the chloride channel, resulting in a hyperpolarized cell membrane that prevents further excitation of the cell [3].

How is it taken?

Tablets are swallowed, in 'spiking' they are crushed and added to drink, usually alcohol [1]. It can also be crushed and snorted [6], or by dissolving prior to injection [2], or sprinkle it on marijuana and smoke it [7].

Signs of usage

  • blackout with complete loss of memory,
  • dizziness,
  • slowed breathing,
  • disorientation,
  • nausea,
  • difficulty with motor movements and speaking [8].

Effects

Positive

Neutral

  • slurred speech,
  • dizziness,
  • nausea [9].

Negative

  • blacking out,
  • lashing out,
  • stealing things,
  • amnesia [9].

Interactions

Food

  • avoid alcohol,
  • avoid excessive quantities of coffee or tea (caffeine),
  • avoid taking with grapefruit juice,
  • take with food [3].

Dangerous

  • Alcohol - Ethanol ingestion may potentiate the CNS effects of many benzodiazepines. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blacking out and memory loss is almost certain.
  • GBL / GHB - The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position.
  • Opioids - Central nervous system and/or respiratory-depressant effects may be additively or synergistically present. The two substances potentiate each other strongly and unpredictably, very rapidly leading to unconsciousness. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Blackouts/memory loss likely.
  • Tramadol - Central nervous system- and/or respiratory-depressant effects may be additively or synergistically present. Vomit aspiration is a risk when passed out, lay down in recovery position if ingested [5].

Unsafe

  • PCP - Both substances potentiate the ataxia and sedation caused by the other and can lead to unexpected loss of consciousness at high doses. While unconscious, vomit aspiration is a risk if not placed in the recovery position. Memory blackouts are likely [5].

Withdrawal

  • anxiety,
  • insomnia,
  • nausea,
  • dizziness,
  • depression,
  • convulsions,
  • psychosis [10].

Harm reduction

Rohypnol is an extremely powerful prescription only medicine, and should only safely be used under the direction of a doctor [1].

  • If you do take it recreationally, use only very small doses,
  • Never use it with people you don't know and trust completely,
  • Make sure there is at least one reliable person with you who isn't using, and that they're aware that you are,
  • Never give it to anyone else,
  • If you think you or someone you're with may have had their drink spiked, call 999 immediately [1].

History

Rohypnol was developed by the Swiss company Hoffman- La Roche, who had been working with benzodiazepines since the 1950's, in 1975. Its potential for misuse was quickly recognised, but it was not until 1995 that the UN reclassified it from a Schedule IV to a Schedule III drug (meaning greater restrictions on its prescription were required). It was known to be used on the gay scene in the 1980's/1990's.

Despite the negative associations with the drug, Rohypnol continues to be a popular sedative due to its fast and long acting effects, although doctors are now far more cautious in prescribing it. There remains a small but significant black market for the drug [1].


References