BE AWARE OF ROHYPNOL: A SHORT COMMUNICATION

ABOUT AUTHORS:
Tahseen Sameena*¹, S.P.Sethy, Prathima Patil, G.Naresh, Md.Owais Ashraf, Radhika
Department Of Pharmaceutics.
Sushrut Institute of Pharmacy
Taddanpally (V), Pulkal (M), Medak-502293
tahseensameena1992@gmail.com

ABSTRACT:
Scientific research on drug abuse indicates this as being a rising trend among the youth around the globe. An investigation into the experimentation with drugs among the youth showed a rate of increase of 8%. The study also revealed an 85.9% increase in alcohol use and 35.2% increase in tobacco use.  Furthermore, the study also suggests an increase in the rate of ecstasy and alcohol usage coupled with drugs and opiates such as heroin.  This article will thus endeavour to form a network of Civil Society Organisations (CSOs) whose purpose will be the development and implementation of a joint action plan to prevent substance abuse in around the world, in order to promote active engagement of civil society in this field.

REFERENCE ID: PHARMATUTOR-ART-2016

INTRODUCTION:
Drug abuse, is a patterned use of a substance (drug) in which the user consumes the substance in amounts or with methods which are harmful to themselves or others. The term "drug abuse" does not exclude dependency, but is otherwise used in a similar manner in nonmedical contexts. The terms have a huge range of definitions related to taking a psychoactive drug or performance enhancing drug for a non-therapeutic or non-medical effect. All of these definitions imply a negative judgment of the drug use in question (compare with the term responsible drug use for alternative views). Some of the drugs most often associated with this term include alcohol, amphetamines, barbiturates, benzodiazepines (particularly alprazolam, temazepam, diazepam and clonazepam, cocaine, methaqualone, and opioids. Use of these drugs may lead to criminal penalty in addition to possible physical, social, and psychological harm, both strongly depending on local jurisdiction.There are many cases in which criminal or antisocial behavior occur when the person is under the influence of a drug. Long term personality changes in individuals may occur as well.Other definitions of drug abuse fall into four main categories: public health definitions, mass communication and vernacular usage, medical definitions, and political and criminal justice definitions. Substance abuse is prevalent with an estimated 120 million users of hard drugs such as cocaine, heroin, and other synthetic drugs. These are drugs that are sometimes used to assist a sexual assault. Sexual assault is any type of sexual activity that a person does not agree to. It can include touching that is not okay; putting something into the vagina; sexual intercourse; rape; and attempted rape. These drugs are powerful and dangerous. They can be slipped into your drink when you are not looking. The drugs often have no color, smell, or taste, so you can't tell if you are being drugged. The drugs can make you become weak and confused -- or even pass out -- so that you are unable to refuse sex or defend yourself. If you are drugged, you might not remember what happened while you were drugged.

DRUG MISUSE: Drug misuse is a term used commonly for prescription medication with sedative, anxiolytic, analgesic, or stimulant properties are used for mood alteration or intoxication ignoring the fact that overdose of such medicines have serious adverse effects. Prescription misuse has been defined differently and rather inconsistently based on status of drug prescription, the uses without a prescription, intentional use to achieve intoxicating effects, route of administration, co-ingestion with alcohol, and the presence or absence of dependence symptoms. Chronic use leads to a change in the central nervous system which means the patient has developed tolerance to the medicine that more of the substance is needed in order to produce desired effects. When this happens, any effort to stop or reduce the use of this substance would cause withdrawal symptoms to occur. The rate of prescription drug abuse is fast overtaking illegal drug abuse in the United States. According to the National Institute of Drug Abuse, 7 million people were taking prescription drugs for nonmedical use in 2010. Among 12th graders, prescription drug misuse is now second only to cannabis. "Nearly 1 in 12 high school seniors reported nonmedical use of Vicodin; 1 in 20 reported abuse of OxyContin."Avenues of obtaining prescription drugs for misuse are varied: sharing between family and friends, illegally buying medications at school or work, and often "doctor shopping" to find multiple physicians to prescribe the same medication, without knowledge of other prescribers. Increasingly, law enforcement is holding physicians responsible for prescribing controlled substances without fully establishing patient controls, such as a patient "drug contract." Concerned physicians are educating themselves on how to identify medication-seeking behaviour in their patients, and are becoming familiar with "red flags" that would alert them to potential prescription drug abuse

COMMON DRUGS OF ABUSE THE THREE MOST:
A)Rohypnol (roh-HIP-nol). Rohypnol is the trade name for flunitrazepam (FLOO-neye-TRAZ-uh-pam). Abuse of two similar drugs appears to have replaced Rohypnol abuse in some parts of the United States. These are: clonazepam (marketed as Klonopin in the U.S. and Rivotril in Mexico) and alprazolam (marketed as Xanax). Rohypnol is also known as: Circle, Forget Pill, LA Rochas ,Lunch Money, Mexican Valium, Mind Erasers, Poor Man's Quaalude, R-2 , Rib, Roach, Roach-2, Roches, Roofies, Roopies, Rope, Rophies, Ruffies, Trip-and-Fall, Whiteys.

B)GHB, which is short for gamma hydroxybutyric (GAM-muh heye-DROX-ee-BYOO-tur-ihk) acid. GHB is also known as : Bedtime Scoop, Cherry Meth , Easy Lay , Energy Drink, G, Gamma 10, Georgia Home Boy, G-Juice, Gook , Goop, Great Hormones, Grievous Bodily Harm (GBH), Liquid E, Liquid Ecstasy. Liquid X, PM, Salt Water, Soap, Somatomax, Vita-G .

C)Ketamine (KEET-uh-meen), also known as: Black Hole, Bump, Cat Valium, Green, Jet, K, K-Hole, Kit Kat, Psychedelic Heroin, Purple, Special K , Super Acid.

These drugs also are known as "club drugs" because they tend to be used at dance clubs, concerts, and "raves."

The term "date rape" is widely used. But most experts prefer the term "drug-facilitated sexual assault." These drugs also are used to help people commit other crimes, like robbery and physical assault. They are used on both men and women. The term "date rape" also can be misleading because the person who commits the crime might not be dating the victim. Rather, it could be an acquaintance or stranger

ABOUT ROHYPNOL:
Rohypnol is a brand name for flunitrazepam (a benzodiazepine), a very potent tranquilizer similar in nature to valium (diazepam), but many times 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. It is known by several street names: Roachies, La Roche, Rope, Rib, Roche, Rophies, Roofies, Ruffies, Mexican valium, or the "forget (me) pill." Rohypnol is especially dangerous because it is inexpensive; a tablet may cost  USD 1 to 5. This makes it popular in high schools, college campuses, clubs, bars, and at private parties. Rohypnol became (in)famous because it can cause memory "blackouts," periods of memory loss that follow ingestion of the drug with alcohol. Victims who have been raped with Rohypnol have report waking up in strange rooms, with or without clothing, sometimes with a used condom on the bed, occasionally with bruises on their body... but they have no memory of the previous night.

HOW ROHYPNOL LOOK LIKE:
Rohypnol tablets are white with a score on one side and the word "ROCHE," paired with an encircled one or two (depending on the dosage), on the other. They are sold in pre-sealed bubble packs. Rohypnol can be dissolved in a drink and is undetectable, which makes is a big part of what makes it appealing to criminals looking to drug unsuspecting victims.

WHO USES ROHYPNOL AND HOW?
It is largely used by adults, although teen use of Rohypnol is increasing. The most common use among teenagers and young adults is as an alcohol extender -- an attempt to create a dramatic "high," most often in combination with beer -- or as a drug to incapacitate a victim before a sexual assault. The drug's low cost (sold for less than usd 5 per tablet on the black market) makes it more accessible. But the rise in usage in this age group can also be tied to common misconceptions about the drug, erroneous belief that the drug's pre-sealed packaging means that their supply could not have been adulterated, and a misbelief that the drug cannot be detected by a urine test.

A COMMON SCENARIO ABOUT RHYNOPOL:

• The victim is at a party or bar and has something to drink. The attacker somehow slips a Rohypnol tablet into the liquid - perhaps when the victim turns their head or leaves their drink to go to the bathroom

• About twenty minutes after finishing their drink, the victim begins to feel very disoriented, or "drunk." Victims of Rohypnol have often only had one or two drinks, and they remember feeling much more drunk than they should have been.

• The attacker volunteers to escort the "sick" or "drunk" person home. Once out of the public eye, the attacker may take the victim to a hotel, to the victim's home, or to other places.

• Several hours later, the victim wakes up feeling very disoriented. They can't remember what happened after they left the party, but they may find evidence that something was done to their body while they were "asleep."

• Many victims raped under the influence of Rohypnol are unsure whether or not they were raped, because they have no memory of the event. It can take several days to piece together a story from eyewitness reports

• Rohypnol has been used to rape both men and women

WHAT ROHYPNOL LOOKS AND FEELS LIKE:

• Rohypnol is similar to Valium but about 10 times as strong. In Europe and South America, it is a prescription drug used as a preanesthetic agent and as a potent sedative.

• Rohypnol comes as a small pill that can be dropped into the drink of an unsuspecting victim. The pill can dissolve in either alcoholic or non-alcoholic drinks, and the drug is odorless and tasteless.

• Initially, Rohypnol causes muscle relaxation, dizziness, and headaches, slows psychomotor responses, and lowers inhibitions. Victims may have difficulty moving or speaking. Victims often remember the effects of the drug as a feeling of being "drunk." Rohypnol takes 20-30 minutes to take effect.

• Rohypnol has a synergistic effect with alcohol. When taken with alcohol, Rophypnol can cause severe disorientation and a loss of memory. These memory blackouts are typically 8-12 hours long. The victim may or may not appear "awake" during this time.

• Victims often feel nauseous the day after they have received Rohypnol.

• Rohypnol is a physically addictive drug. Repeated use will lead to addiction.

• There are multiple forms of the drug on the market. The original tablets, marketed by the pharmaceutical company Hoffman La Roche (see picture on right), look like aspirin and dissolve rapidly in liquid. In response to widespread abuse of this drug, Hoffman La Roche changed the tablets; the new tablets dissolve more slowly and will turn a drink blue. "Copycat" flunitrazepam tablets have also been produced by pharmaceutical companies in South Africa, South America, and possibly Egypt-the copycat tablets are reddish-brown to white and dissolve well in liquids.

• Rohypnol can be found in large urban areas and even in rural areas. The drug is most common in the southern and eastern parts of the U.S., where there have been several widely publicized seizures and rape cases.

• A less common use of Rohypnol: the tablets are crushed, often mixed with other drugs, and snorted. This route of administration is more common for recreational drug users than for rapists.

SIDE EFFECTS OF ROHYPNOL ARE:
Adverse effects of Rohypnol use include decreased blood pressure, memory impairment, drowsiness, visual disturbances, dizziness, confusion, gastrointestinal disturbances and urinary retention.

ROHYPNOL IS ILLEGAL BECAUSE:
It is illegal to manufacture, sell, or use Rohypnol in the United States because taking it can produce physiological and psychological dependence and benzodiazepine withdrawal syndrome. The drug is legal in other countries (e.g., Mexico) and is smuggled into the US through the mail or other delivery services.

LEGAL CONSIDERATIONS:

• There is a urine test for Rohypnol. However, the drug can only be detected for up to 72 hours after ingestion. If you or a friend think you have been raped with Rohypnol, it is important to get a urine test as soon as possible. Rape crisis centers and the police are best equipped to handle any testing.

• A urine test that is performed without police intervention may be thrown out in court. This is because the legal system requires the prosecution to show "chain of custody" of the urine sample- to prove that the sample came from the victim and could not have been mixed up with anyone else's urine.

• Rohypnol is illegal in the United States. According to the Drug Induced Rape Prevention and Punishment Act of 1996, it is a crime to give a controlled substance to anyone, without their knowledge, with the intent of committing a violent crime (such as rape). Violation of this law is punishable by up to 20 years in prison and a fine of usd 250,000.

• There has been much talk of reclassifying Rohypnol into the same legal category as LSD (a Class I controlled substance), which would greatly increase the penalties for possession, but this has not yet happened.

• Hoffmann-LaRoche has established toll-free numbers to provide information on Rohypnol and instructions for drug testing. The general information number is (800) 720-1076.

REDUCING YOUR RISK:

• Never leave your drink unattended. If you have to go to the bathroom, either finish your drink or throw it away.

• Beverages that come in sealed containers (unopened cans or bottles) are much safer than mixed drinks.

• If you order a mixed drink, watch the person who mixes it.

• Do not take any open beverages, including alcohol, from someone you do not know well and trust.

• Never drink anything out of a common punch bowl.

• If someone offers to buy you a drink, go up to the bar with them to accept the drink.

• Subscribe to the "buddy system": always party with one or more friends, and keep an eye on each other. If someone begins to appear "too drunk," get them to a safe place. More than one attempted Rohypnol rape has been prevented by watchful friends.

CONCLUSION:
Drug prevention is a critical component in our  nation’s effort to reduce drug  use, particularly among young people. When it is part of a  comprehensive strategy which  includes law enforcement and  drug treatment, prevention is  a very powerful tool to reduce  drug use. Over the decades,  various types of drug prevention approaches have been  implemented to help people  reject drugs and choose  healthy alternatives. Over the  years, many lessons have  been learned in the prevention  field, and evaluating whether  prevention programs actually  work has been critical to their  success. While drug prevention efforts continually evolve  based on actual situations and  needs, there are some guiding principles which are basic  to successful drug prevention  efforts. The ultimate aim of drug  prevention programs is to  change behaviors which  encourage drug abuse and to  reinforce positive behaviors which lead to the rejection.

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