Rohypnol

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ROHYPNOL

OFFICIAL NAMES: Flunitrazepam, Rohypnol

STREET NAMES: Circles, forget-me pill, la rocha, lunch money, Mexican Valium, mind erasers, R-2, rib, ro, roofies, roche, roaches, roachies, roapies, rophies, rophy, rope, ruffies, ruffles, shays, stupefi, wolfies

DRUG CLASSIFICATIONS: Schedule IV, hypnotic, sedative

OVERVIEW

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.

Benzodiazepines were first developed and marketed in the 1960s and touted as safer alternatives to barbiturates. They also were thought to be less addictive than barbiturates. Of all controlled substances for which prescriptions are written, benzodiazepines account for about 30%. One of the main uses of prescription Rohypnol is to reduce anxiety and insomnia and induce sleep. As a sedative, Rohypnol is reportedly about 10 times more powerful than Valium.

History

Rohypnol was first developed in the 1970s by the pharmaceutical firm of Hoffmann-La Roche. It was first sold in Switzerland in 1975 as a sleeping aid for the treatment of insomnia. It is also given as a sedative prior to administering anesthesia for certain surgeries, including heart surgery performed on infants. Over time, the drug has come to be used by doctors in a total of 64 countries.

Not long after it was introduced in Europe in the 1970s, reports began surfacing that Rohypnol was being abused as a recreational or "party" drug, often in combination with alcohol and/or other drugs.

Although benzodiazepines were originally believed to have fewer harmful side effects than barbiturates, scientists and others who study these drugs now say benzodiazepines actually share many of the same undesirable side effects of barbiturates and are every bit as dangerous in certain circumstances.

Despite being legally unavailable in the United States, Rohypnol distribution and abuse began to rise sharply in the early to mid-1990s, particularly among young people in high school and college. It became a well-known drug of abuse at dance clubs, fraternity parties and large all-night dance parties called "raves." In fact, some DEA officials compared the popularity of Rohypnol among teenagers in the 1990s to the popularity of Quaaludes among young people in the 1970s and 1980s. Data from the Drug Abuse Warning Network (DAWN) indicates that at least 80% of hospital emergency department admissions involving Rohypnol and other so-called "club drugs" involve people ages 25 and under.

In 1997, Rohypnol was banned in the United States. It is illegal to import it from other countries, and individuals who are found to be in possession of it are subject to significant prison sentences. Prior to the ban, one study found that Rohypnol was second only to Valium as the most common drug declared at U.S. border crossings in Texas. According to the study, an average of 11,000 Valium pills and about 4,000 Rohypnol pills were being declared each day by people—many of them returning Americans—crossing into the United States from Mexico. At that time, it was legal for travelers to bring a three-month supply of Rohypnol into the country for personal use. Since then—even with the ban—the drug has become more widespread throughout the United States.

While the ban on importing Rohypnol prevented people from simply traveling across the border to Mexico—where it is available in pharmacies—and bringing the drug back, it resulted in increased smuggling of Rohypnol. The U.S. Drug Enforcement Administration (DEA) routinely stops shipments of the drug and has prevented large quantities of it from being smuggled over the border in cars and other vehicles. Law enforcement officials in Florida routinely seize packages of Rohypnol that are shipped via overnight mail from Mexico and Central America. Often, the pills may be disguised to look like vitamins or cold medicine.

In addition to rophies or roofies, Rohypnol is known by a multitude of other street names, including roach or roche, a direct reference to Hoffmann-La Roche, the pharmaceutical company that manufactures the drug. In some circles, being under the influence of Rohypnol is referred to as being "roached out." Another street name that is sometimes used is R-2, a reference to the pills themselves, which are imprinted with a "1" or "2" inside a circle to identify whether they are a 1-milligram or 2-milligram dose. Other names may include roachies, La Rocha, rope, rib, and ruffies.

Like other club drugs—including ecstasy (MDMA), ketamine, GHB (gamma-hydroxy butyrate), methamphetamine, and LSD (d-lysergic acid diethylamide)—Rohypnol is easily accessible and relatively inexpensive. Often, users who intentionally take the drugs to get high at rave parties or elsewhere may not even know what they have taken or been given, which can make it difficult for medical professionals to treat them if they overdose or have a reaction.

Wrongly, many young people apparently believe Rohypnol is harmless because it is legal in other countries and has a confirmed medical use. Many also apparently believe that it is not addictive. In fact, the drug can become physically addictive within about 10 days of continuous use. Once someone has started using it regularly, it is often difficult to stop without experiencing withdrawal symptoms, including headaches, muscle pain, restlessness, and confusion. Even worse, stopping the drug suddenly after taking it for a long period of time can have severe health consequences, including seizures, coma, and even death. As a result, experts say regular users must taper off the drug slowly, as they would from any drug on which they have become dependent.

Another misconception about Rohypnol that some young people have is that it cannot be detected on routine urinalysis. The National Clearinghouse for Alcohol and Drug Information says while many young people think they can take Rohypnol and drive home from a club or rave and avoid being arrested for driving under the influence (DUI), the truth is that drug tests for Rohypnol are available and are in use in some states. In Florida, for example, Rohypnol testing is used as part of DUI checks when a driver appears impaired but the breath test indicates relatively low levels of alcohol. Rohypnol stays within detectable levels in urine for up to 72 hours. Researchers are working on newer tests that may be able to detect Rohypnol as long as one week after ingestion.

At some rave parties where Rohypnol and other club drugs are commonly found, people selling the drug try to convince potential buyers that the drugs are no more harmful than vitamins or energy drinks. They also may suggest that the effects of the drugs can be "danced off" or "sweated off" during the night-long party. None of these statements are true.

One consequence of the recreational use of Rohypnol has been an increase in the number of date or acquaintance rapes reported to have involved the drug. This has earned Rohypnol its most common nickname: the date rape drug. On college campuses, women are warned not to leave their drinks unattended or accept a drink from someone they do not know. Because Rohypnol is colorless and odorless, it can be used to "spike" just about any beverage. When placed in an alcohlic beverage, Rohypnol increases the effects of the alcohol and the rate at which the person will start to feel "drunk."

While not every person who consumes Rohypnol will have the same reaction, most will seem drunk and may even appear to be having a good time. This situation, unfortunately, makes it difficult for others to realize what is happening and to intervene in situations where Rohypnol has been used on an unsuspecting person. Experts say one warning sign that Rohypnol may have been used is when someone appears extremely drunk after consuming only a small amount of alcohol.

Although date rape involving Rohypnol or other drugs can happen to just about anyone, efforts have been targeted at educating young women because statistics show they are at highest risk. According to the U.S. Department of Justice, more than half of all rape and sexual assault victims in 1998 were females younger than age 25. In addition, alcohol or drug use immediately before a sexual assault has been reported by more than 40% of adolescent victims and their attackers.

Hoffmann-La Roche, Inc., the manufacturer of Rohypnol, has taken steps to stop individuals from using it to drug victims. The most significant of these has been changing the pills so that a bright blue color is released when Rohypnol is dissolved in beverages. The newer tablets also dissolve more slowly—taking an average of 40 minutes to dissolve completely—making it more difficult to "spike" a drink quickly. It is important to remember, however, that illegally manufactured Rohypnol is colorless and does not produce any strong taste or odor when dissolved in a drink. These counterfeit pills also do not release the bright blue dye. Therefore, people should not assume that they will automatically be able to detect Rohypnol.

In addition to adding the blue coloring to their legally manufactured pills, Hoffmann-La Roche also created an ad campaign to increase public awareness about Rohypnol among high school and college students, who are among the most vulnerable to voluntary or involuntary Rohypnol use.

Another serious concern is that young drug users may not be able to distinguish Rohypnol from other potentially harmful drugs. The DEA has received reports of benzodiazepines other than Rohypnol being passed off by drug dealers as Rohypnol pills. One such substitute Rivotril, a benzodiazepine sold in Mexico for the treatment of epilepsy. In the United States, this drug is known as Klonopin (clonazepam).

CHEMICAL/ORGANIC COMPOSITION

Rohypnol is a benzodiazepine with properties similar to those of Valium and Xanax. Its main function is to depress the central nervous system. It is manufactured in 1 mg doses. The 2 mg dose that was once available has been discontinued by the manufacturer. However, law enforcement officials in the United States and other countries say counterfeit 2-mg pills are being discovered.

INGESTION METHODS

Rohypnol is available in pills that are slightly smaller than an aspirin and may or may not be sealed in the manufacturer's plastic bubble pack, making them look like any over-the-counter medication.

The pills are easily crushed and are sometimes both odorless and colorless—although, again, legally manufactured Rohypnol now turns blue when dissolved in beverages. Although the powder does have a slightly bitter taste, illegally manufactured Rohypnol is often easily disguised when dissolved in alcohol or flavored beverages. The drug's effects typically begin within 30 minutes and peak at two hours after ingestion. A single dose can produce effects on the user that last for eight hours or more.

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.

THERAPEUTIC USE

Originally, Rohypnol was developed as a sleeping pill. It has been used successfully for that purpose in many countries outside the United States (It is the most frequently prescribed sleeping pill in Europe.) When used as prescribed, it is an effective short-term therapy for severe sleep disorders. Studies show that Rohypnol increases the total amount of time spent sleeping and lessens the difference between the amount of time spent in bed and the amount of time asleep. Both factors are significant to people who suffer from severe sleep problems that leave them sleep-deprived and anxious. Therapeutic doses of Rohypnol vary from 0.5 mg to 1 mg.

Because it lowers blood pressure, thus reducing bleeding, Rohypnol also is given prior to some surgeries. In addition, it is useful as a muscle relaxant and to control painful muscle spasms.

In typical use, a 2-mg dose of Rohypnol induces sleep within about 15 minutes and allows the user to sleep uninterrupted for at least six to eight hours. Taking higher doses is not recommended. A 4-mg dose, for example, can cause a coma in the same short period of time.

Japanese researchers have reported that adding Rohypnol to an existing drug therapy regimen helps correct severe sleep disturbances in children with epilepsy. Also, fewer seizures were reported when Rohypnol was used along with epilepsy therapy. The study appeared in the medical journal Brain Development in 1995.

USAGE TRENDS

Scope and severity

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.

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.

Young people who attend rave parties often take amphetamines ("uppers") to keep themselves awake throughout the night. Similarly, some also will take Rohypnol to ease the effects of the amphetamine use. Others reportedly down Rohypnol as a cure for hangovers.

Compared with other club drugs such as methamphetamine, LSD, GHB, MDMA, and ketamine, the use of Rohypnol is relatively low. Still, U.S. officials say the Rohypnol trend does not show signs of decreasing. In addition, women who have been given Rohypnol in a date-rape setting often do not report the rape or the drug use, so it is impossible to estimate the true extent of Rohypnol use. Even if the rape is reported, they may not have knowledge of the drug that was used on them.

Age, ethnic, and gender trends

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 methamphetamine. In some areas of the country, the combination is known as a "club mix."

Disturbingly, there are reports of schoolchildren as young as eight to 10 years old abusing Rohypnol, primarily because it is cheap and relatively easy to obtain. Children who use the drug most often dissolve it in soft drinks for a faster effect. Many of them are obtaining the drug from peers their own age. According to the ONDCP, some established drug dealers seek out school-aged children to sell Rohypnol pills. The dealer sells the pills to the child at a "wholesale" price of about $1 apiece. The child then sells the tablets to friends for $2 to $3 apiece. By targeting children in this way, drug dealers not only make money, but they broaden the potential market for other drugs such as marijuana and cocaine later on. They also increase the chance that the juvenile who is able to make fast money from selling Rohypnol will be willing to continue to sell that drug or other drugs for years to their classmates.

A national survey conducted in 1999 found that0.5% of eighth graders and 1% of tenth and twelfth graders report ever using Rohypnol. The survey, known as "Monitoring the Future," is conducted by the University of Michigan Institute for Social Research.

Another trend that has emerged is the intentional use of Rohypnol by depressed young women. In a study published in 2000 in the Journal of Pediatric and Adolescent Gynecology, it was reported that some of these women are using Rohypnol to cope with negative feelings and low self-esteem. A survey of more than 800 sexually active women between the ages of 14 to 26 found that 2% had used Rohypnol in the past and 5% indicated they would use it in the future. Compared with those who indicated they had not or would not use Rohypnol, potential users were three times more likely to be depressed, two times more likely to have low self-esteem, and six times more likely to be unable to "just say no." Such women also were more likely to have had sex before age 15 and to have had multiple sex partners at a young age. The researchers theorized that the powerful euphoric and "drunken" feelings produced by Rohypnol counteract the depression the women are feeling. However, public health officials say the use of Rohypnol also significantly increases a young woman's risk of getting pregnant and/or catching a sexually transmitted disease due to the loss of inhibition and control that occurs after taking the drug.

MENTAL EFFECTS

Rohypnol can cause amnesia—the person under its influence can remember little that happened in the hours after they ingested Rohypnol. When taken in combination with alcohol or other drugs such as cocaine or heroin, the amnesia will be more severe, and some users describe total "blackouts" from which they do not awaken until the next day.

When the drug leaves the body, the most severe symptoms of Rohypnol intoxication will subside, but many people continue to feel drowsy, confused, and dizzy for hours and even days afterward. Memories of the previous eight hours are usually hazy and may seem like a dream that is being remembered. Victims of date rate involving Rohypnol have reported disturbing memories of feeling paralyzed, powerless, and unable to resist. Some also reported a feeling of separation from their bodies. These hazy recollections can cause a great deal of mental stress and fear.

Chronic users will eventually develop physical and psychological dependence on Rohypnol. Often, chronic users may want to stop using the drug but are unable to stop on their own due to the strong physical need that has developed for the drug. The psychological dependence may lead them to believe they cannot cope with things in their life without using the drug, or that they cannot relax without taking it. This dependence, when it occurs at a young age, can set the stage for a lifetime of drug-seeking behaviors.

PHYSIOLOGICAL EFFECTS

Like other sedative/hypnotic drugs, Rohypnol produces a drowsy, relaxed feeling similar to being drunk. Muscles feel relaxed and speech may be slurred. Blood pressure can drop dangerously low. The effects of Rohypnol may last anywhere from two to eight hours, depending on the person taking it and the dosage they are taking. Some people report experiencing the physical effects for up to 12 hours or even longer. The drug may also cause insomnia when taken at high doses or when taken chronically by abusers who have become physically dependent.

Some effects that Rohypnol can produce include:

fearlessness/loss of inhibitions
impaired judgment
impaired coordination
confusion/disorientation
nausea
dizziness
unsteady walk

The day after taking Rohypnol, many people report what feels like the worst hangover they have ever had. This feeling may last anywhere from 24 to 48 hours.

This sensation is one reason many people who have been victims of Rohypnol-assisted assaults do not immediately realize what has happened. Instead, they may simply assume they drank too much the previous night, even though they may not remember drinking particularly heavily.

Although the drug acts as a depressant in most people, it may cause aggression and excitability in others. In one Swedish study published in the Journal of the American Academy of Psychiatry Law, nearly all teenage juvenile offenders who frequently abused Rohypnol had committed serious violent crimes, including impulsive violence. They reported increased feelings of power and self-esteem, reduced fear and insecurity, and an increased sense that "everything was possible" when taking Rohypnol.

Harmful side effects

In addition to memory loss, confusion, dizziness, and sleepiness, Rohypnol also causes a decrease in blood pressure; stomach and intestinal upset; and urinary retention.

A person who has overdosed on Rohypnol needs immediate medical attention, usually in a hospital emergency department. If the person is conscious, they may be induced to vomit or they may be given gastric lavage, otherwise known as "having your stomach pumped." Doctors also may give the person activated charcoal, which can reduce the amount of Rohypnol that is still being absorbed by the person's body. Depending on symptoms, doctors also may need to monitor the person's breathing and heart rate. In some cases, doctors also will administer another drug, called flumazenil, which can successfully reverse the adverse effects of Rohypnol on the central nervous system.

Rohypnol overdose alone is unlikely to be lethal, but the risk of coma and death increase significantly when Rohypnol is combined with alcohol or other drugs.

The number of hospital emergency department visits involving Rohypnol increased from just 13 cases in 1994 to a high of 624 cases in 1998, according to the DAWN. A disproportionately high percentage of these Rohypnol-related visits—more than 50%—involved Hispanic individuals. Also, many of these visits involved other drugs, with cocaine being the most frequent drug used in combination with Rohypnol.

Long-term health effects

Even when taken at recommended dosages, Rohypnol can cause dependence and addiction among frequent users. Some people addicted to Rohypnol experience seizures when they attempt withdrawal from the drug. The U.S. Department of Justice says such seizures may occur among chronic users after as little as one week without Rohypnol.

Long-term users may also experience headache, muscle pain, extreme anxiety, tension, confusion, irritability, and restlessness when they stop taking Rohypnol. Symptoms can also progress to more severe problems, such as numbness and tingling of the arms and legs, loss of identity, hallucinations, delirium, convulsions, shock and heart failure.

People who have been taking more than 6 mg of Rohypnol per day for a month or longer will experience the most severe symptoms when the drug is stopped. Fortunately, unlike barbiturates, large doses of benzodiazepines such as Rohypnol are rarely fatal, except when taken in combination with alcohol and/or other drugs.

REACTIONS WITH OTHER DRUGS OR SUBSTANCES

Combining Rohypnol with other substances makes the physical reactions and sensations longer and more intense. In the United States, the most frequent combined use of Rohypnol is with alcohol. This combination can produce dizziness and feelings of disorientation within as little as 10 minutes. It may also cause the person to feel extremely cold or extremely hot, as well as feeling nauseous.

Some individuals experience a type of paralysis after taking a combination of Rohypnol and another substance. They will have difficulty speaking and moving on their own and will often then pass out. When they awaken, they will have little memory of anything that happened prior to consuming a Rohypnollaced drink or other Rohypnol combination, such as Rohypnol and methamphetamine.

Although most people who consume Rohypnol in alcohol recover without serious physical consequences, there have been reports of deaths related to the drug. In those cases, death often resulted from breathing difficulties or the inhalation of vomit in a person who has passed out and is unconscious.

Some individuals take Rohypnol with heroin to enhance the high. This may be particularly true for users of low-quality heroin, according to The National Clearinghouse for Alcohol and Drug Information. Users of cocaine and crack cocaine may snort crushed Rohypnol or take Rohypnol pills after using cocaine to ease some of the negative side effects.

TREATMENT AND REHABILITATION

People who have become physically addicted to Rohypnol should not try to stop taking the drug on their own. Rather, they need qualified medical help to wean themselves from the drug.

Stopping the drug abruptly may include the following:

severe anxiety
confusion
irritability
headache
muscle aches
restlessness
intense dreaming
increased sensitivity to light and sound
grand mal seizures (rare)

These symptoms will peak after about three to five days of not taking the drug.

Withdrawal from benzodiazapines such as Rohypnol is similar to withdrawal from alcohol, and is typically more unpleasant and longer lasting than withdrawal from narcotic drugs. Rohypnol withdrawal frequently requires hospitalization. A medical withdrawal treatment that is sometimes used for people with Rohypnol addiction is phenobarbital, a drug that is more commonly used to treat epilepsy. One approach is to substitute 30 mg of phenobarbital for each 1 mg of Rohypnol the person has been taking each day. The dose is then reduced each subsequent day until withdrawal symptoms are eliminated. An essential element of Rohypnol withdrawal is tapering the dose gradually to avoid causing too many unpleasant side effects.

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.

PERSONAL AND SOCIAL CONSEQUENCES

Rohypnol has increasingly been linked to incidents of date rape and rape by strangers who drug unsuspecting women by slipping the pill into their drink in a bar or other social setting. Rohypnol is appealing to rapists because it acts so rapidly and often causes a loss of will and an inability of victims to fight back.

Rape is devastating to women and affects all aspects of their lives, including their future relationships. It is estimated that approximately one in four women will be raped in their lifetimes. In addition, approximately 75% of all rapes that occur are date or acquaintance rapes in which women report knowing their attacker well or at least being familiar with them. Many times, the rapist is someone with whom the woman is romantically involved or has been involved with in the past, but the sex is not consensual. The best defense against drug-induced date rape is to become educated about which drugs are used to commit sexual assaults and how to recognize and avoid them.

Many young women who go to dance clubs or parties where they know the people around them may feel the environment is safe and conclude that if someone did try to drug them, someone nearby would surely notice and try to intervene in the situation before anything bad happened.

Yet, a person who has ingested Rohypnol often simply appears drunk or "out of it." Even well-intentioned friends may not realize what is going on and will be reluctant to do anything. Experts in rape prevention say one thing these young women can do is have a prearranged plan with their friends when going out to a club, fraternity party, or even a party at someone's home. This plan should include checking in with each other periodically during the evening. (If someone is suspected of being under the influence of Rohypnol or has taken it voluntarily, they should never be left alone. It takes at least eight hours for the most severe effects of the drug to wear off.)

LEGAL CONSEQUENCES

People found to be in possession of Rohypnol, regardless of the quantity involved, are subject to a maximum sentence of three years in prison. People found to be importing or exporting Rohypnol, regardless of the quantity involved, are subject to a maximum sentence of 20 years. However, if death or bodily injury results, the minimum sentence is 20 years and the maximum sentence is life in prison. If the defendant has a prior felony conviction, the minimum sentence is 30 years in prison.

Law enforcement officials have improved their ability to detect the drug due to more sophisticated tests. Rohypnol remains detectable in urine for up to 72 hours. The drug's manufacturer, Hoffmann-La Roche maintains a free, 24-hour phone line providing information on Rohypnol and offers free comprehensive testing for the drug to hospital emergency departments, law enforcement officials, and rape crisis centers.

The DEA has documented approximately 4,500 federal, state, and local law enforcement investigations involving the distribution or possession of Rohypnol within the United States since 1985. The cases are spread across 38 states. However, at least two-thirds of those cases are in Florida and Texas, according to testimony given before Congress in 1999 by Terrance Woodworth, Deputy Director of the DEA's Office of Diversional Control. Since 1994, at least nine people have been convicted of sexual assault in five state court cases in which there was evidence that Rohypnol was used to incapacitate the victim. The DEA is aware of 17 other sexual assault cases that took place between 1994 to 1998 in which there is evidence to suggest Rohypnol was used.

Legal history

According to published reports, Rohypnol was first used to commit date rape in 1993. In 1996, President Clinton signed the Drug-Induced Rape Prevention and Punishment Act. This legislation provides for prison sentences of up to 20 years for anyone possessing a controlled substance with the intent to commit a violent crime, including rape, by secretly drugging someone else.

Advocates for rape victims in England and Australia have called for a ban on Rohypnol similar to the one in the United States, but officials there have yet to outlaw the drug. Officials in Germany took an aggressive step toward restricting the illegal use of Rohypnol by removing the 2-mg dose from the market and allowing only hospitals to use doses over 1 mg. Independently, Hoff-mann-La Roche discontinued production of the 2-mg tablet worldwide. The company also reduced the number of legal distributors of the drug in Mexico from 200 to16.

Federal guidelines, regulations, and penalties

The DEA temporarily classified Rohypnol as a Schedule IV drug in the mid-1980s because there was no evidence at that time of abuse or widespread distribution of the drug in the United States. However, because of an increase in use among young people across the country in the 1990s, and because of its mind-altering and potentially addictive properties, the DEA began considering re-classifying Rohypnol as a Schedule I drug. This would put it in the same restrictive class as heroin and LSD. Drugs in Schedule I have a high potential for abuse and are considered unsafe for use according to the standards set by medical professionals. Reclassification to Schedule I status also would be an indication that the medical community can find no evidence that Rohypnol has a valid medical purpose or benefit. The World Health Organization (WHO) also recognized the potential dangers of Rohypnol, and in 1995 they reclassified Rohypnol as a Schedule III drug, making it the first benzodiazepine to be so tightly controlled.

As of 2002, the DEA had not finalized the decision to reclassify Rohypnol, and it remained a Schedule IV drug. Independent of the DEA's actions, however, several states—including Florida, Idaho, Minnesota, New Mexico, North Dakota, Oklahoma, and Pennsylvania—have placed Rohypnol under Schedule I control.

RESOURCES

Books

Lindquist, Scott. Alcohol and Drugs: The Essential Guide for Girls and Women. Naperville, IL: Sourcebook, Inc., 2000.

Lindquist, Scott. The Date Rape Prevention Book: The Essential Guide for Girls and Women. Naperville, IL: Sourcebook, Inc.,2000.

Perkins, Scott W. Drug Identification: Designer and Club Drugs Quick Reference Guide. Cincinnati, OH: Thompson Learning,2000.

Periodicals

Anglin, D. "Flunitrazepam and Its Involvement in Date or Acquaintance Rape." Academic Emergency Medicine 4 (April1997): 323-26.

Schwartz, R., R. Milteer, and M. LeBeau. "Drug Facilitated Sexual Assault ('Date Rape')." Southern Medical Journal 93, no. 6 (June 2000): 558-61.

Walling, A. "Helping Patients Recognize and Avoid 'Date Rape' Drugs." American Family Physician 62, no. 2 (December 2000).

Other

Everitt, M., and L. White. "Adolescent Update: Drugs and Date Rape." American College of Emergency Physicians, 2002. <http://www.acep.org/1,2830.0.html>.

Fact Sheet on Rohypnol. The National Clearinghouse for Alcohol and Drug Information, June 1998. <http://www.health.org/nongovpubs/ondcp-rohypnol/>.

Organizations

Control Policy (ONDCP); Drug Policy Information Clearinghouse, P.O. Box 6000, Rockville, MD, USA, 20849-6000, (301) 519-5212, (800) 666-3332, [email protected], <http:/www.whitehousedrugpolicy.gov>.

National Institute on Drug Abuse (NIDA), National Institutes of Health, 6001 Executive Boulevard, Room 5213, Bethesda, MD, USA, 20892-9561, (301) 443-1124, (888) 644-6432, [email protected], <http://www.nida.nih.gov>.

Laura A. McKeown

Drugs and Controlled Substances: Information for Students