Flunitrazepam-marketed under the trade name Rohypnol-is manufactured worldwide, particularly in Europe and Latin America, in 1- and 2-milligram tablets by Hoffman-La Roche, Inc., a large pharmaceutical manufacturer. However, the drug neither is manufactured nor approved for medical use in the United States.

Q) What does Rohypnol look like and how is it used?

A) Rohypnol is typically sold in its original bubble packing, conveying a sense of legality and security in its use. The perceived safety of the drug along with the trend of use in combination with other substances, creates the possibility of Rohypnol becoming a gateway to harder drugs.

Rohypnol is ingested orally, frequently in conjunction with alcohol or other drugs, including heroin.

Q) What are the effects of Rohypnol?

A) Adverse effects associated with the use of Rohypnol include decreased blood pressure, memory impairment, drowsiness, visual disturbances, dizziness, confusion, gastrointestinal disturbances, and urinary retention. Paradoxically, although the drug is classified as a depressant, Rohypnol can induce excitability or aggressive behavior in some users.

Q) Is Rohypnol addictive?

A)The use of Rohypnol itself is dangerous, leading to physical and psychological dependence, which increases with dose and duration of use.

Q) What are the slang terms used for Rohypnol?

A) Some nicknames used for Rohypnol are: rophy, circles, Mexican valium, rib, roach-2, roofies, roopies, rope, ropies, ruffies. Being under the influence of the drug is referred to as being "roached out." In Texas, Rohypnol is called "R-2," or "roaches."

Q) Can you overdose on Rohypnol?

A) Lethal overdose is unlikely but possible. However, continued use will result in physical dependence.

Q) What is the extent of use of Rohypnol?

A) In the United States, Rohypnol is used widely in Texas where it is popular among high school students. Rohypnol is reported to be readily available in the Miami area, and epidemiologists from that area have stated that it is South Florida's fastest growing drug problem. Additional reports from Miami indicate that the largest and fastest growing groups of Rohypnol users are high school students who take the drug with alcohol or use it after cocaine ingestion. Two common misperceptions about Rohypnol may explain the drug's popularity among young people: first, many erroneously believe that the drug is unadulterated-and therefore "safe"-because it comes in pre sealed bubble packs; second, many mistakenly think its use cannot be detected by urinalysis testing.

Illicit use of Rohypnol originated in Europe in the 1970s and has increased worldwide since then. However, the substance did not appear in the United States until the early 1990s. In 1992, a South Florida hotline began receiving calls reporting occasional to chronic abuse of the drug. Around the same time, the drug appeared in Texas as well. Today, use of Rohypnol is one of the fastest growing drug problems in both areas. In addition, the drug appears to be spreading across the United States. As of April 1995, the Drug Enforcement Administration had documented over 1,000 cases of Rohypnol possession across 13 states.

Rohypnol use by youths of all socioeconomic status has been reported. The inexpensive cost, ranging from $2 to $3 per pill, attracts young users. High school students report use of the drug as a cheap drunk and as a cure for alcohol hangovers. Typically, however, Rohypnol is used along with alcohol and other drugs. College students using Rohypnol report mixing it with beer to enhance the feeling of drunkenness. It has also been reported to be used in combination with marijuana and cocaine, as well as heroin. Rohypnol use appears to be spreading in the United States among high school and college youth. In some areas, it is associated with gangs, and it is becoming known as a club drug.