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Known by a variety of street names such as roofies, roach, R-2, trip and fall, and rope or "the date-rape drug," rohypnol is the trade name for the benzodiazepine Flunitrazepam, a sedative-hypnotic drug used medically in a number of countries. Rohypnol has recently become a widely abused drug in Sweden, Mexico, Italy, the United Kingdom, the United States, and South Africa, a trend made more troubling by the fact that many users regard it as relatively safe. Rohypnol, in fact, has many dangerous and undesirable effects for the illicit user. It has been associated with an increased risk of violence and accidents as well as stupor, coma, memory loss, and death. Its ability to induce unconsciousness and amnesia has led to its use in sexual assaults in the United States (hence, its reputation as a date-rape drug) as well as robberies.

Although never approved for use in the United States (where it is illegal) rohypnol is a commonly prescribed Benzodiazepine in Europe and elsewhere. Like other benzodiazepines, such as Valium (Diazepam) or Xanax (Alprazolam), it is useful in the medical treatment of sleep disorders and anxiety, though only under supervision by a doctor. Benzodiazepines act at brain receptors for the inhibitory neurotransmitter Gaba, which is also the site of action for another, older class of sedative-hypnotic drugs and barbiturates. Although generally safer than barbiturates, benzodiazepines like rohypnol share some of the same dangers especially when mixed with Ethanol, a common practice among illicit drug users. These dangerous effects range from incontinence, behavioral disinhibition, violence, delirium, and black-outs to stupor, respiratory depression, and death. These effects all stem from the ability of rohypnol to depress brain function.

At lower doses, benzodiazepines can reduce anxiety and cause relaxation and a loosening of inhibitions somewhat similar to the effects of Alcohol, another drug that acts as a depressant on the central nervous system. As with many abused drugs, the continued use of rohypnol results in increased tolerance, requiring larger doses to produce the same effects. Larger doses mean narrower margins of safety and the increased incidence of side effects, especially memory loss and deficits in learning. Drinking alcohol in combination with rohypnol makes serious consequences all the more likely. Of still greater concern for the illicit user is that chronic use of sedative-hypnotic drugs like rohypnol can produce a level of physiologic dependence greater than that resulting from Opiate drugs like Heroin or Morphine. Abrupt Withdrawal from regular use can produce complications ranging from the relatively mild, such as restlessness and anxiety, to more severe effects like tremor, hallucinations and convulsions similar to those experienced during severe alcohol withdrawal. These complications can be best avoided through a medically supervised withdrawal.

Rohypnol has received much media attention in the United States for its apparent involvement in a number of sexual assaults or rapes. Because it can quickly render an unsuspecting victim unconscious, rohypnol lends itself to this kind of crime. As rohypnol is odorless and tasteless and easily dissolved in drinks, it can be offered to a victim without arousing suspicion. Although media attention has focused on particular drugs like rohypnol and GHB, it should be noted that a variety of drugs can and are being used in this manner, including barbiturates, opiates, other benzodiazepines and ethanol. Ethanol remains several times more likely to be associated with sexual assault than any other drug, including rohypnol, even though rohypnol and drugs like it are more effective in rapidly producing the stupor and memory loss desired by this type of criminal.

Richard G. Hunter

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