Flunitrazepam
The best-known but by no means the only drug associated with sexual assault is flunitrazepam manufactured by Roche under the name Rohypnol. Flunitrazepam (5-(2-fluorophenyl) 1,3-dihydro-1-methyl-7-nitro-2H-1,4-benzodi azepin-2-one)) belongs to the 7-nitro group of benzodiazepines. Its hypnotic effect predominates over the sedative, anxiolytic and muscle relaxing effects of other compounds from the same pharmacological group (Figure 1). Flunitrazepam is available in oral tablets and in injectable form in about 80 countries around the world. It has a much stronger affinity for the gamma-aminobutyric acid (GABA) receptor than diazepam. In fact, it is 10 times as potent as diazepam. Flunitrazepam is readily (80–90%) absorbed through the gastrointestinal tract and metabolised almost completely by the liver. Its metabolism includes reduction to 7 amino flunitrazepam and then to the N glucuronide, demethylation to the N-demethyl metabolite, hydrolysis to the 3-OH metabolite and then to the O-glucuronide. Approximately 90% of its metabolites are excreted through the urine and 10% in the faeces. Deaths involving flunitrazepam in conjunction with other central nervous system (CNS) depressants, such as ethanol, but also due to overdose of flunitrazepam alone, have been reported.
The first seizure of Rohypnol in the USA took place in 1989, and reports of the misuse of the drug have increased since then. Flunitrazepam is often used to enhance the effects of heroin, alcohol or marijuana. Rohypnol tablets are smuggled into the USA (mainly from Mexico) and sold with street names such as Roofies, Rophies, Roopies, Rib, Rope, Pappas, Peanuts, Pastas, Forget pills, Ro-shays, Roaches and Roche 2. In the early 1990s flunitrazepam was identified as the drug of choice in DFSA. As of 1996, the prescription, sale and importation of flunitrazepam into the USA has been banned. Rohypnol is available in the UK as a prescription drug. Roche have reformulated tablets so that they give a blue colour when dissolved in water, thereby alerting drinkers to the fact that their drinks have been spiked.
Figure 1 Chemical structure of flunitrazepam and its major metabolite 7-aminoflunitrazepam.
