An Outline of Rohypnol Abuse & Treatment Options
What is Rohypnol?
Rohypnol (flunitrazepam) is a benzodiazepine drug that is illegal in the United States but still available by prescription in some other countries. People who abuse the drug take it to get high, lower inhibitions, or heighten the effects of other drugs.
Predators may also use “roofies” to render victims unconscious prior to assaulting them, which is why it is often referred to as a “date rape drug.” This drug also produces anterograde amnesia, which means the individual won’t remember anything that happened for hours after taking it. Rohypnol can be addictive, and quitting without medical assistance can be dangerous.
What Is Rohypnol?
Rohypnol (flunitrazepam) belongs to a class of drugs known as benzodiazepines, which are commonly used to treat anxiety, panic disorder, seizures, and muscle spasticity. Other drugs in this class include Xanax (alprazolam), Valium (diazepam), and Ativan (lorazepam).1 Rohypnol is extremely potent (up to 10 times stronger than Valium).1
Rohypnol is prescribed in some European and Latin American countries to treat anxiety and insomnia, and it may be used to sedate people before surgery.1,2 However, the United States has never approved it for use or sale.1 Flunitrazepam is used illicitly and is notorious for its association with drug-facilitated sexual assault (DFSA).
Those abusing Rohypnol may refer to it by one of the following street names:3,4
- Forget-me pill
- La rocha
- Lunch money drug
- Mexican valium
How Is It Used?
Rohypnol is most commonly encountered in tablet form. Users may swallow the tablets, crush and snort them, or dissolve them in a liquid. Some users will dissolve the pills in solution and inject it. They may also sprinkle the crushed powder on marijuana and smoke it.1
The drug is commonly abused with other substances. Cocaine abusers may take Rohypnol in an attempt to ease the “come down” from a binge. And heroin users may take it to intensify the effects of low-quality heroin or to ease the symptoms of withdrawal.1
Some users may see the drug as a way to relax and reduce their inhibitions.4 In addition, young people who attend dance parties and clubs may combine Rohypnol with other common club drugs such as ecstasy (MDMA), GHB, and ketamine.2 These drugs are inexpensive and offer an intense high. This is extremely risky and can cause serious problems such as blackouts, paranoia, memory loss, hallucinations, and even death.2 Alcohol is also commonly part of the equation, heightening the already high risk of blackouts, stupor, and amnesia (and, in turn, assault).1,2 Drinking alcohol with Rohypnol also increases the likelihood of respiratory depression and fatal overdose.1
Short-Term Effects of Rohypnol
Rohypnol depresses central nervous system activity, and within 15-20 minutes may bring about symptoms such as:1,4
- Reduced anxiety.
- An inability to recall events that occurred while intoxicated.
- Changes in reaction time.
- Impaired mental functioning and judgment.
- Decreased blood pressure.
- Muscle relaxation.
- Slurred speech.
- Loss of motor coordination.
In some users, the expected relaxation and drowsiness are replaced by excitability and aggression. Rohypnol intoxication doesn’t end quickly; symptoms tend to last for 12 or more hours.1
“Roofies” and Sexual Assault
In the mid-90s, Rohypnol developed a reputation as a “date rape drug” or a “roofie” used to incapacitate victims for sexual assault.1 People were particularly susceptible to flunitrazepam-related victimization because the drug was odorless, tasteless, and could quickly incapacitate the unsuspecting user.
Assault victims may wake up to discover evidence of having been violated but have no memory of the event.Its effects are magnified when taken with alcohol, which is common (especially as it may be slipped into a drink by a predator while the victim is unaware).
In fact, Rohypnol was considered especially insidious as a substance used in DSFAs because aside from being impossible to taste or smell it, it was also visually undetectable when dissolved in a drink. However, the manufacturer responded to this danger in 1997 by changing the pill color and including a blue dye that is visible in light-colored liquids.1,4 Unfortunately, generic versions may not contain the dye.4
Due to flunitrazepam’s amnestic effect, those who have been intoxicated may have no memory of what happened up to the time the drug wore off. Assault victims may wake up to discover evidence of having been violated but have no memory of the event. This may delay the reporting of the crime to law enforcement or make it difficult or even impossible for the victim to prove what happened.1,4
It’s difficult to gather statistics on sexual assaults committed with Rohypnol, because many cases go unreported. Cases that are reported are usually done so after the drug has left the person’s system, which limits law enforcement’s ability to gather evidence.
How to Avoid Sexual Assault
The West Virginia Foundation for Rape Information and Services offers these tips for preventing sexual assault:
- Don’t drink beverages that you didn’t open yourself.
- Don’t share or exchange drinks with another person.
- If someone offers you a drink at a club or a party, go with the person to get the drink, watch the drink being poured, and carry the drink yourself.
- Don’t let your drink out of your sight while talking, dancing, using the bathroom, or making a phone call.
- Don’t drink anything that has a strange taste or appearance.
If you think you’ve been sexually assaulted, call 911 and get medical care. Don’t shower, douche, urinate, or throw away the clothing you wore during the incident. Save other materials that could be used as evidence, such as the glass you drank out of.6
Can You Get Addicted to It?
Rohypnol is not legal in the U.S., so any use is abuse. As abuse continues, the individual will need to take higher or more frequent amounts to achieve a high, risking not only deadly overdose but also the potential for eventually becoming physically dependent and addicted.1
A person who abuses Rohypnol or other drugs may show certain changes in their behavior and personal lives, such as:7
- Increased secretiveness and/or lying.
- Abrupt changes in friends/social groups.
- Relationship conflicts.
- Legal problems.
- Failure to take care of responsibilities at work, school, or home.
- Suddenly needing money for unexplained or suspicious reasons.
- Using the drug in ways or under conditions that are knowingly dangerous (e.g., using while driving, sharing needles, etc.)
Physical and psychological signs of Rohypnol abuse may include:2
- Slurred speech.
- Poor coordination.
- Stomach problems.
- Sleepiness or struggling to fall asleep.
- Trouble remembering recent events.
Long-term use of Rohypnol puts the user at risk for a number of consequences.
- Regular users can face injuries due to the drug’s impairment of coordination and motor control. In addition to physical injuries, someone who tries to drive while under the influence of the drug could get into a vehicle accident, hurting or killing themselves or others.
- Rohypnol’s effects include compromised judgment and reduced inhibitions, so someone under the influence could make poor decisions, such as having unprotected sex.9
- Long-term abuse can also lead to mental and physical health issues such as depression, sleep problems, impaired sexual function, cardiovascular collapse, and respiratory problems.9,10 Those who inject the drug are also at risk of contracting HIV, hepatitis B and C, and other bloodborne viruses.3
- Adolescents who abuse drugs can develop antisocial behaviors and even thoughts of suicide and homicide. They often perform poorly in school and may be at risk of dropping out. Additionally, drugs can harm their physical appearance and friendships.16
- Continued use of the drug can result in dependence and addiction, which can make it very difficult or even dangerous to stop using without medical and therapeutic intervention.8
Overdose Signs and Symptoms
Rohypnol overdose can be fatal, and death is more likely to occur when Rohypnol is taken in combination with other depressants like alcohol. Signs and symptoms of a Rohypnol or flunitrazepam overdose include:4
- Severe sedation.
- Slowed heart rate.
- Slowed or stopped breathing.
If you think you or someone you know is overdosing on Rohypnol, call 911 immediately.
Withdrawal Symptoms and Detox
When a person uses Rohypnol on a regular basis, they can develop physiological dependence to the substance. This means their body adapts to the presence of the drug and begins to rely on it to function normally. When the person stops using or reduces their dose, their body must re-adjust to the sudden lack of the drug in their system, which results in withdrawal. Withdrawal symptoms from Rohypnol include: 1,11
- Muscle pain.
- Sensitivity to sunlight.
- Numbness and tingling in the arms and legs.
Anxiety is also a common symptom in people who withdraw from benzodiazepines such as Rohypnol, and some studies have found that people who stop using benzodiazepines develop depressive symptoms that may become severe.11,12
Withdrawal symptoms may not emerge right away, and, in fact, seizures may occur more than a week after the last dose, so assuming you’re medically in the clear if you feel ok a few days after stopping is dangerous. To ensure your safety, seek the care of professionals in a supervised medical detox program where your symptoms can be monitored and managed throughout the entirety of the acute withdrawal period.
To mitigate the potential for medical emergencies related to Rohypnol withdrawal, dependent individuals should detox in a facility equipped to handle complications such as seizures that may arise.
Detox helps the person safely get through withdrawal, but it seldom helps a person stay sober in the long run.Medically detox programs (usually offered as part of inpatient hospital or residential treatment) can provide ongoing monitoring and symptom management. They can also prescribe medications to ease the physical and psychological distress associated with withdrawal.
Detox programs are vital for safely removing Rohypnol from the body; however, they are not enough to sustain abstinence. They provide only a fresh starting point from which to begin the work of recovery. Additional treatment, such as is found in inpatient rehab or outpatient therapy, is vital to staying sober and preventing relapse. According to the National Institute on Drug Abuse, detox helps the person safely get through withdrawal, but it seldom helps a person stay sober in the long run.14
During the detox period, the recovering individual will be advised to continue their recovery efforts either in the same facility or in another program. Program staff and/or a medical professional can help to come up with a follow-up plan for care.
The level of addiction treatment a person needs will vary depending on how heavily they abused Rohypnol, whether they have any medical conditions or mental health concerns, and other factors.
Since many people who abuse Rohypnol are teenagers and young adults,3 parents may want to consider teen rehab programs. These programs offer many of the same services as the programs outlined below. But they include therapy sessions on issues specific to teens such as self-esteem, peer pressure, and body image.
Common options include:13,15
- Inpatient or residential—A person in this type of program lives at the treatment center. Inpatient hospitalization is typically appropriate for people who have medical or psychiatric problems or who have ongoing addiction with multiple relapses. Residential programs often teach recovering users social and vocational skills and incorporate psychotherapy and 12-step meetings.
- Outpatient—There are several levels of intensity of outpatient treatment. Partial hospitalization typically involves no more than 20 hours a week in the hospital during the day. The person attends individual and group counseling, receives medical services, and goes home at night. A person in an intensive outpatient program comes to a treatment center 3 to 5 times each week for several months to attend individual and group therapy. Standard outpatient consists of a few hours a week of one-on-one or group therapy.
- Therapy—Addiction therapy is usually part of a comprehensive treatment program or an outpatient aftercare program. The most common forms of therapy used in substance abuse treatment are cognitive behavioral therapy, interpersonal therapy, and group therapy. These therapies teach the person how to cope with urges and triggers, improve social skills, build a support system, and manage stress.
- Support groups—Support groups bring together people in recovery so that they can motivate each other and share strategies for staying sober. The two most popular are Alcoholics Anonymous and Narcotics Anonymous, which both use the 12-step approach. Non 12-step groups that don’t incorporate the spiritual aspect of recovery are also available and include SMART Recovery and LifeRing.
- Aftercare—Most people need ongoing support and encouragement once they complete a rehab program. Before discharge, treatment center staff help the person find local resources for continued care, such as recovery meetings, therapists, and sober living homes.
Get Help Today
It takes a great deal of courage to admit you have a problem with drugs, but it’s the first step to recovery. If you or someone you know struggles with Rohypnol addiction, don’t be afraid to reach out for help. Treatment can help you get back to living the life you want.
- University of Maryland Center for Substance Abuse Research (2013). Flunitrazepam (Rohypnol).
- Adams, C. (2007). Rohypnol: Roofies—“The Date Rape Drug.” New York: Rosen Publishing Group.
- U.S. Department of Justice, National Drug Intelligence Center. (2003). Rohypnol Fast Facts.
- Drug Enforcement Administration. Drug Fact Sheet: Rohypnol.
- Chakraborty, K., Neogi, R., & Basu, D. (2011). Club drugs: review of the “rave” with a note of concern for the Indian scenario. The Indian Journal of Medical Research, 133(6), 594–604.
- West Virginia Foundation for Rape Information and Services, Inc. When Drugs Are Used for Rape.
- Indian Health Service. Warning Signs of Drug Abuse and Addiction.
- National Institute on Drug Abuse. (2014). DrugFacts: Club Drugs (GHB, Ketamine, Rohypnol).
- Nemours. (2014). Rohypnol.
- Substance Abuse and Mental Health Services Administration, Office of the Surgeon General. (2016). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health.
- Gahlinger, P. (2004). Club Drugs: MDMA, Gamma-Hydroxybutyrate (GHB), Rohypnol, and Ketamine. American Family Physician 69(11), 2619-2627.
- Lader, M. (1994). Anxiety or depression during withdrawal of hypnotic treatments. Journal of Psychosomatic Research 38(1), 113-123.
- Collins, G., McAllister, M., and Adury, K. (2010). Drug Abuse and Addiction. Cleveland Clinic Center for Continuing Education.
- National Institute on Drug Abuse. (2012). Principles of Effective Treatment.
- Johns Hopkins Medicine, Center for Substance Abuse Treatment and Research. Treatment Settings.
- Smith, M., and Emmer, L. (2003). Adolescents and Club Drugs. National Association of Social Workers.