| Gary Ludwig |
"Roofies"
The Date Rape Drug
| Gary Ludwig is the Chief Paramedic/EMS Bureau Chief for the St. Louis Fire Department. He is currently serving his third term as an elected board member to the EMS Section for the International Association of Fire Chiefs and lectures quite frequently at fire and EMS conferences. He has a Master's Degree in Management and is a licensed paramedic. |
This article can be found on
page 60 of the Jan/Feb 1998
issue of 9-1-1 Magazine.
You receive a call at a fraternity house where a young woman reported waking up with no clothes on, finding herself in unfamiliar surroundings with unfamiliar people. She tells you that she believes she may have been sexually assaulted. She further tells you that last thing she remembers is drinking at a local bar.
How could this happen? What could have possibly caused this woman to not remember any events of where or how she got there. There is a possibility she was drugged with Rohypnol. Rohypnol is a brand name for flunitrazepam (a benzodiazepine), a very potent tranquilizer similar in nature to valium (diazepam), but far stronger. The drug produces a sedative effect, amnesia, muscle relaxation, and a slowing of psychomotor responses. Sedation occurs 20-30 minutes after administration and lasts for several hours. The drug is often distributed on the street in it's original "bubble packaging" which adds an air of legitimacy and makes it appear to be legal. The drug is not commonly used by physicians in the United States and is not even listed in the Physician's Desk Reference.
During the past few years, there has been increasing abuse of Rohypnol, initially reported in Florida and Texas, but is now becoming more widespread. Like other benzodiazepines, flunitrazepam taken alone is unlikely to produce death, even if an overdose is taken. Combining it with alcohol reduces the safety margin, however, and is more likely to be lethal due to enhanced central nervous system depression.
Rohypnol intoxication is generally associated with impaired judgment and impaired motor skills, and the combination of alcohol and flunitrazepam is also particularly hazardous because together their effects on memory and judgment are greater than the effects resulting from either taken alone. Disinhibition is another widely reported effect of Rohypnol, when taken either alone or in combination with alcohol.
Rohypnol is known by various street names: Roachies, La Roche, Rope, Rib, Roche, Rophies, Roofies, Ruffies. In an unconfirmed report out of Australia, it was referred to as "Stupefi," and it has also been designated "the Qualude of the `90s" in some media reports.
Some rapists lace their victim's drink with the pill and wait 20 to 30 minutes for the debilitating effects to take over. The drug is nicknamed the `forget pill,' because most victims report that they wake up without any memory of being assaulted.
As insidious and perilous as this may sound, the dangers don't stop there. Besides the worries of unprotected sex and the dangerous practice of mixing Rohypnol with alcohol or other drugs, it can lead to dependence when taken repeatedly. An amnesia-producing effect of "Roofies" may prevent users from remembering how or why they took the drug or even that they were given it by others. This makes investigation of sexually related or other offenses very difficult and may account for repeated reports of "date rapes" involving the use of the drug.
Reports have also been received of it being popular in "gay bars" in selected locations on both the East and West coasts. In fact, Rohypnol is now being reported as being one of the "in" drugs on high school and college campuses and particularly in college fraternities. And to make matters worse, "Roofies" are inexpensive and reportedly being sold for as little as $2.00-$4.00 per tablet in several locations.
Besides its use in rape cases, Rohypnol is abused in combination with alcohol and heroin, especially among high school and college students who want to intensify the "high" of heroin or the "buzz" of alcohol or as a "parachute" to come down from a cocaine high. It is difficult to detect Rohypnol through urine tests and nearly impossible through breath tests, which hinders prosecution efforts.
So how do you manage an overdose of "roofies?" Following overdose with oral benzodiazepines, vomiting should be induced (within one hour) if the patient is conscious, or gastric lavage undertaken with the airway protected if the patient is unconscious. Beyond one hour, activated charcoal should be given to reduce absorption. Respiratory and cardiovascular function should be monitored as they may evidence depression. Central nervous system depression may manifest in degrees ranging from drowsiness, mental confusion, lethargy, to coma and death.
Being prepared for this "date rape" drug and recognizing its tragic effects will certainly help EMS providers care better for their patients.
