17 Aug 2022

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Rohypnol (Flunitrazepam): Uses, Dosage, Side Effects

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Drugs continue to saturate societies the world over. Presently, the possibility of scaling down drug supply and types is minuscule and next to impossible. Every time, new and more lethal drugs surface, thereby, challenging the notion of countermeasures or cutbacks. The contemporary society produces, distributes, uses and abuses drugs. As such, drugs have the potential of being either extremely dangerous and possibly morbid or simply bad for one’s health depending on the mode and frequency of consumption. One possibly significant substance considered a drug remains to be Flunitrazepam, commonly known as Rohypnol or the date drug. Due to the menacing nature of this drug and its extensive use within social settings, its classification remains that of being dangerous. Moreover, the drug causes numerous side effects that are both short-term and long-term.

To comprehend the effects of Rohypnol, understanding its nature is imperative. Rohypnol affects the central nervous system (CNS) through depressing it. The drug itself falls under a class of CNS depressants called benzodiazepines, which are hypnotics of a sedative nature used while treating various conditions such as sleep disorders, anxiety, seizure disorders, and insomnia. Moreover, the drug is commonly used as a muscle relaxant. Other benzodiazepines include bromazepam chlordiazepoxide (Librium) and diazepam (Valium) among others. Nonetheless, Rohypnol remains ten times more powerful than Valium and is often prescribed for sleep disorders and anxiety in Latin America, Europe, as well as other countries except for America. In the United States, the drug has the consideration of being illegal as per law. However, it is often smuggled via overt means such as the international mail service or through blister packaging. Its nature of being odorless and tasteless, as well as its attribute of dissolving undetected in liquids, makes it ideal for individuals with malicious intent.

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According to Title II of the Comprehensive Drug Abuse Prevention and Control Act (CSA) of 1970, the manufacture, possession, importation, distribution, and use of particular drugs are highly controlled (Gabay, 2013). This control places drugs into classifications according to various attributes from Schedule one through to Schedule five. Under Schedule I, drugs often have the consideration of bearing high potentials for abuse with no accepted medical use. Moreover, drugs under this category do not have an acceptable level of use. Drugs under this Schedule include lysergic acid diethylamide (LSD) and Tetrahydrocannabinol (THC) or Marijuana among others (Gabay, 2013). Under Schedule IV, of which Rohypnol is a member, substances often have the characteristic of having low abuse potentials and current medical use. Other drugs within this category include Nitrazepam and Cathine (found naturally as a derivative in Khat) among others (Gabay, 2013). Therefore, as the drug Schedule increases, the potential of these drugs to cause harm decreases. However, while this is the case, certain drugs often have grotesque effects yet have lenient Schedules.

Considering the positive effects of Rohypnol can be achieved by a wide array of other depressants, while abused, its effects are for the most part negative. To begin with, through a social perspective, the drug facilitates sexual assault. During the mid-1990s, numerous reports surfaced indicating the use of this drug during sexual assault among both women and men. Later, the drug became known infamously as the “date-rape” drug. Would be victims were often unaware of the dangers posed by sexual predators who slip Rohypnol into drinks, where the drug would dissolve undetected. Such actions, often involving the mixing of alcohol with the drug, resulted in the incapacitation of victims and the subsequent induction of amnesia, thereby, rendering victims highly vulnerable to rape as well as other assaults. Moreover, when mixed with alcohol, Rohypnol results in more severe effects to the physiological as well as the psychological aspects of the body.

The sociological effect of Rohypnol is quite daunting since predators often appear as wolves in sheep clothing masquerading as good Samaritans while having ill intents. Once predators target victims with Rohypnol, victims are often left incapacitated, unable to negotiate or fight back their attackers. Moreover, in combination with other substances or in excess, Rohypnol causes amnesia, which results in confusion and an inability to recall. Such circumstances often results in poor recollection of rape incidents, consequently, delaying law enforcement intervention. Moreover, the inability to recollect past events, particularly among rape victims, may result in posttraumatic trauma and incidents. Commonly, drug-facilitated sexual assaults cause victims to have feelings of indignation, disgrace, powerlessness, humiliation, and horror related to the not knowing of what transpired to them.

As such, due to this effect of drug-facilitated sexual assault, the United States Congress affirmed the Drug Induced Rape Prevention Act in 1996, which accords stricter penalties for the dispensation of controlled substances without consent and in addition to the intent of indulging in violent crime such as sexual assault. In service to this act, the punishment for importing and distributing Rohypnol encompasses up to 20 years in prison, which includes a substantial fine (Lloyd, 2002). Moreover, the possession of Rohypnol renders one punishable by up to three years imprisonment, including a fine.

Aside from its social effects, Rohypnol leads to numerous paradoxical effects, which manifest intensely while under the influence of the drug. Typically, paradoxical reactions emanate from the effects of medical treatment being undesirable from the expectations of the treatment. In this case, an example may be pain caused by medication taken to relieve pain. Such paradoxical effects are often compounded by the combinatory use of other substances such as alcohol. As such, paradoxical reactions among some persons include aggressive tendencies, anxiety, a loss in the control of impulses, confusion, agitation, violent behavior as shall be seen in combination with alcohol, talkativeness, and in extreme cases convulsions. Moreover, in some cases, paradoxical effects may be adverse to the point that it leads to criminal behavior.

In a study to determine the effects of Flunitrazepam in combination with alcohol, conclusions indicated that this combination engendered higher levels of aggression among rats and mice (de Almeida, Saft, Rosa & Miczek, 2010). The rationale behind these studies showed that in high doses, Benzodiazepines, the family of drugs from which Rohypnol is derived, causes sleep and sedation, while in low doses, the drug results in aggressive behavior. As such, this study, done focusing on GABA (A) receptor modulators that act as progesterone as well as alcohol and Benzodiazepine metabolites, affirms the nature of Rohypnol in combination with alcohol as that characterized by aggression, anxiety, and irritability, predominantly, at minuscule doses. More than all other drugs, scholars have verified alcohol’s association with violent and aggressive behavior on numerous occasions. As such, the combination of Rohypnol and alcohol undisputedly results in and exacerbates its paradoxical effects.

When consumed orally and mildly, Rohypnol causes short-term effects on the body’s physiology and mind. While many individuals experience these effects, they often dissipate within a few days to a couple of weeks. Since the drug primarily affects the central nervous system and overall brain function, depressed CNS activity commensurately becomes apparent through symptoms such as relaxed muscles, sleep, reduced anxiety, and sedation. Primarily effects may include decreased blood pressure, dizziness, memory impairment, confusion, tremors, nightmares, headaches, disinhibition, broadly seen through social and psychological liberation, and anterograde amnesia. All these signs and symptoms indicate adverse negative effects of the drug while abused. Others include bloodshot eyes, gastrointestinal disturbances, the retention of urine, and reduced reaction time. Therefore, while the combination of impaired judgment, reduced reaction time, and sedation may be safer at home, in public or while operating heavy machinery such as vehicles, these combinations are quite dangerous. Numerous car accidents occur due to individuals who decide to drive under the influence of impairing drugs such as Rohypnol.

As mentioned above, Rohypnol is a drug that depresses the CNS. Such depression often suppresses the normal functioning of critical body systems such as the respiratory system and the heart. Often, excessive doses render individuals with severe respiratory depression characterized by signs such as slow breath and lung congestion. During overdoses, individuals often breathe shallowly and slowly resulting in low oxygen absorption. Such occurrences result in limited oxygen levels in the brain, which can lead to brain damage or cognitive impairment. Moreover, the drug can cause one to stop breathing altogether, which can be fatal. Due to these effects of the drug, most individuals who want to commit suicide prefer intentional overdose with Rohypnol. One Swedish study affirms this sociological disorder through its conclusions on the involvement of Rohypnol in more than 15 percent of all suicide cases, exceeded by DXP only. The combination of anterograde amnesia and sedation results in numerous adverse effects on the brain, often, leading to cognitive impairment (Joshua Oladele, 2017).

Consistent use of Rohypnol brings about tolerance to the drug. Over time, such users indulge in larger doses to fill their needs and achieve similar effects. This, among other addiction signs such as persistent failure to reduce consumption and continued use despite negative consequences, show the eminently addictive nature of Rohypnol. Therefore, as with other substances classified within Schedule IV, the physical dependence of Rohypnol is a reality that can lead to severe withdrawal symptoms. These symptoms can range from anxiety and restlessness to more severe ones akin to those of alcohol withdrawal such as hallucinations, tremors, and convulsions. Other withdrawal symptoms may also surface as muscle pain, headaches, tension, loss of identity, extremities tingling, shock, and delirium. In addition to these, individuals may also experience seizures more than a week after the stoppage.

Due to attributes such as anesthesia, sedation, anxiolytic effects, and anticonvulsant effects, Flunitrazepam has positive effects when prescribed and taken according to the prescription (Nelson, Bundoc-Baronia, Comiskey & McGovern, 2017). Often, the drug is used to counteract severe insomnia in individuals. Also, it is used as a muscle relaxer and in other times to induce anterograde amnesia during surgery to aid patients in forgetting the ordeal. While the United States, France, and the United Kingdom among others prohibit the production, sale, or distribution of the drug, other countries such as Germany, Sweden, and Japan allow its production and use. In Germany, Flunitrazepam is extensively available by prescription and sold under the brand “Rohypnol.” It is normally produced by Roche, which packages 10 to 20 tablets each having a concentration of 1 mg. In Sweden, while Flunitrazepam is a class 2 drug, it is available under prescription with a concentration of either 1 or 0.5 mg. In Japan, Flunitrazepam is used as a pre-anesthetic medication as well as for insomnia treatment (Kaur Kanwal, 2018).

Considering Rohypnol stays in the blood for close to 60 hours after ingestion, the abuse of this drug is decidedly detrimental to the body’s intricate systems of life support. Ultimately, long-term abuse results in irreversible consequences that render marked retrogression in the quality of life among users. While it has medical use, its potential for abuse can lead to addictions and ultimately numerous issues bordering on personal health as well as social life.

References

de Almeida, R., Saft, D., Rosa, M., & Miczek, K. (2010). Flunitrazepam in combination with alcohol engenders high levels of aggression in mice and rats.  Pharmacology Biochemistry And Behavior 95 (3), 292-297. doi: 10.1016/j.pbb.2010.02.004

Gabay, M. (2013). The Federal Controlled Substances Act: Schedules and Pharmacy Registration.  Hospital Pharmacy 48 (6), 473-474. doi: 10.1310/hpj4806-473

Joshua Oladele, O. (2017). Modelling Rohypnol [Flunitrazepam] and Alcohol Abuse and Resultant Effects on Hippocampal Histoarchitecture and Biochemicals in Wistar Rats.  American Journal Of Laboratory Medicine 2 (6), 112. doi: 10.11648/j.ajlm.20170206.11

Kaur Kanwal, N. (2018). A contemporary facet on Rohypnol: a date rape drug.  MOJ Toxicology 4 (1). doi: 10.15406/mojt.2018.03.00080

Lloyd, J. (2002).  NIDA InfoFacts. Rohypnol and GHB . Retrieved from https://www.drugabuse.gov/drugs-abuse/commonly-abused-drugs-charts 

Nelson, J., Bundoc-Baronia, R., Comiskey, G., & McGovern, T. (2017). Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health: A Commentary.  Alcoholism Treatment Quarterly 35 (4), 445-454. doi: 10.1080/07347324.2017.1361763

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StudyBounty. (2023, September 16). Rohypnol (Flunitrazepam): Uses, Dosage, Side Effects.
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