Unlike many other substances that people misuse, Flunitrazepam, or Rohypnol, also known as Roofies, is a potent central nervous system depressant that can lead to sedation, muscle relaxation, and amnesia. It is not cleared by the United States Food and Drug Administration for medical use. In fact, the FDA considers it a controlled substance, not for the least of reasons because of its use in cases of sexual assault and/or rape and is infamously dubbed the date-rape drug, Forget Pill, Forget-Me Pill, La Rocha, Lunch Money, and Mexican Valium, is a prescription benzodiazepine about 10 times stronger than similar drugs, like Valium and Xanax. Like all substances whose name ends with “-pam,” it’s a sedative that was originally intended as a treatment for conditions like insomnia and anxiety, for which it is used outside of North America.
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What Are Rohypnol’s Effects on the Body?
The general effects of rohypnol is to cause sedation, which usually results either in drowsiness or sleep as well as reduced anxiety. However, its insidious side effects increases risk of blackouts, stupor, and memory loss or amnesia, which is one of the reasons that rapists use it on their victims: They can’t remember anything, so they can’t be witnesses to the assaults they experience.
Rohypnol also adversely affects judgment, higher reasoning, and impulse control. People who misuse it are often aggressive and excitable well beyond their unimpaired personalities. Rohypnol also causes motor difficulties, weakness, and slurred speech, Uncommonly, it also slows slow their body down to the point of respiratory depression, which can be dangerous in cases of overdose. As a benzo, Rohypnol is a mental health drug that can also lead to suicidal ideation, making it dangerous even if the user survives the drug use.
Effects of Misuse
Because Rohypnol is illegal in the United States, there is precious little research into either its long-term effects or its medication-assisted treatment options. The latest information from the government regarding Rohypnol Use Disorder, or RUD, dates from 2016. The collective data shows that physical dependence is prevalent along with psychological dependence, which is similar to the profile of other benzodiazepines. Cardiovascular collapse and death are both considered likely outcomes for long-term RUD.
Unfortunately, people with RUD often mix it with alcohol, which can exacerbate the sedative effects of Rohyypnol. There is a small correlation between Alcohol Use Disorder, or AUD, RUD, and delirium tremens, or the DTs. Therefore, mixing the two substances is extremely dangerous. Even without the possibility of death, the withdrawal symptoms and cravings from RUD is excessively unpleasant. An increase in blood pressure and heart rate, severe headaches and muscle pain, extreme anxiety, and confused irritability are common. People also sometimes experience convulsions and/or seizures.
The Treatment Options
As already referenced above, since 2016, there is no FDA-approved medication-assisted treatment specifically for RUD. Further, the efficacy of therapy in the treatment of RUD, or that of other similar sedatives, is currently unsubstantiated. Equally unfortunate, the Drug Enforcement Agency of the United States classifies all benzodiazepines as Schedule IV substances, which means that the DEA thinks that they have a low propensity for misuse. As Medical News Today indicates, there is research to contradict this classification. Still, because of the lack of specific efficacious treatment programs and options for RUD, the fallback position is to treat RUD in the same manner as other benzodiazepines.
Also as Medical News Today reported in 2022, “cold-turkey” stopping of Rohypnol when someone has RUD can be fatal. Since 2020, the FDA has required such a warning on all benzodiazepines, but because Rohypnol is illegal, it won’t have the warning. Despite the unpleasantness of the inevitable withdrawal, the best overall strategy is therapy-supported detox and tapering off of use. Despite its success at treating benzodiazepine overdose, Flumazenil is not effective at treating withdrawal or in helping clients successfully taper off of Rohypnol. It’s important that medical professionals oversee a person’s tapering off of the drug because Rohypnol withdrawal is fraught with danger even when done slowly.
The Role of Therapy
In spite of the FDA’s finding that further research is necessary to show a stronger degree of correlation between psychotherapy and the treatment of Rohypnol withdrawal, a 2015 study showed that a combination of psychotherapy of various kinds and a tapering strategy was better than the tapering strategy by itself at treating benzodiazepine withdrawal and recovery. The effect was only moderate.
Forms of Psychotherapy
Cognitive behavioral therapy, or CBT, is a method of psychotherapy where the therapist helps clients discover their thoughts about not only their substance use disorder itself but also their thoughts about how they perceive their SUD. In short, it’s “thinking about thinking.” The idea is to help clients understand and make sense of their lives and how their SUD affects their lives.
Generally, it’s a focused method for a short period of time. The therapist will help clients determine what achievable goals are applicable and then help them to reach those goals. Secondarily, the idea is to teach coping strategies for those times when clients cannot, for whatever reason, reach their goals. One of the coping strategies is for clients to be able to consider their thoughts as perceptions rather than facts, which is a powerful realization. For example, a person might say, “I can’t stop using because I have to have the drug when I …,” with the blank indicating some task or action in the person’s life that was always associated with use. If the person accepts this as simply a perception and not a fact, then that will help to reduce the chance of the person returning to use.
Dialectical behavioral therapy is based upon the conjunction of two opposites. First, the person must accept having SUD and realize that it is not a personality defect but rather a valid and legitimate disease. The person’s experiences are also valid and legitimate. The “opposite” is that, while valid and legitimate, the person’s SUD and accompanying experiences must be changed so that the person can move forward successfully in life.
Unlike CBT, which might last for only a dozen sessions or so, DBT is designed to play out over a year or more. Usually, this one-year program will comprise a 24-week set of group sessions where clients learn mindfulness techniques, tolerance of distress, emotional regulation, and a combination of self-respect and interpersonal effectiveness. The second half of the one year will be a repeat of the first set of sessions. Also, each member of the group will undergo individual psychotherapy along a separate but parallel track. The other chief difference between DBT and CBT is that CBT actively encourages clients to change their behaviors while DBT adds the step of acceptance of said behaviors before teaching the skills and techniques necessary to change them.
Motivational enhancement therapy is another short-term option. Before beginning the sessions, clients will complete a series of assessments, usually seven or eight, that will give the practitioners an idea of where the clients stand in their journey to recovery. After the completion of the assessments, the therapist will begin working with the client to build the motivation to change. The key is for the therapist to ask open-ended questions that are applicable to client’s life based on the assessments. By getting clients to talk openly about their lives and how SUD affects them, the therapist can create motivational and empathic language to encourage them to strive for recovery.
The therapist is a guide in this process and not a leader. The second stage of MET is to help clients to begin to form a plan for their recovery. The client has the final say on what will be part of the plan. Once the plan is in place, the third stage of MET is the consolidation phase. The therapist will help the client to implement the plan, review progress based upon what was agreed as part of the plan, and reinforce the commitment to the plan to achieve recovery.
The Comprehensive Strategy
Unfortunately, because much of the current treatment of RUD relies on established benzodiazepine treatment strategies rather than actual strategies for treating RUD, no one treatment will likely be effective. However, certain parts of all previously mentioned strategies can comprise a comprehensive approach to treatment.
These will include behavioral, psychological, and in some cases, pharmacological methods along with the tapering off of Rohypnol. If pharmacological support is necessary in a certain case of RUD, then the idea is to switch to longer-acting benzodiazepines, such as diazepam, and then to begin the taper. Of course, the switch might not be possible in a client’s case because on one reason or another, so a medical professional will have to make the final determination regarding pharmacological treatment.
How We Can Help
At Live Free Recovery Services, we can advise you regarding drug addiction and your Rohypnol Use Disorder and recommend a treatment plan that will likely be successful for you. To get started toward Rohypnol Addiction recovery, If you or a loved one struggles with substance abuse, give us a call today to set up an appointment.
Published on: 2024-02-26
Updated on: 2024-03-18