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Mixing Rohypnol (Flunitrazepam) And Alcohol: Effects And Dangers

Isaac Alexis, M.D., AAMA, AMP-BC

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

May 17, 2019

Rohypnol (“roofies”) can cause heavy sedation when mixed with alcohol. This, as well as other Rohypnol effects, can put people in dangerous situations and pose additional health risks.

Rohypnol (flunitrazepam) is a highly-potent drug with sedative effects. About ten times more potent than Valium (diazepam), Rohypnol is sometimes used to treat severe anxiety, insomnia, or as a muscle relaxant.

One of the most common ways Rohypnol is abused is by mixing it with alcohol. This can have dangerous effects, including blackouts and respiratory depression. In the most serious cases, the combined effects of Rohypnol and alcohol can also be fatal.

Although still prescribed in other countries, Rohypnol is currently illegal in the United States. However, it is trafficked into the U.S. through various sources involved in drug smuggling and illicit manufacturing.

What Is Rohypnol?

Rohypnol (flunitrazepam) belongs to the benzodiazepine drug class, which includes drugs like Xanax, Ativan, and Librium. These drugs are typically used to treat anxiety and panic disorders.

Rohypnol works by slowing activity in the central nervous system (CNS). This results in effects such as slower breathing, relaxation, and drowsiness. Effects may take up to 15 to 20 minutes to set in and last for as long as 12 hours.

Rohypnol has an extensive history as a drug of abuse and is classified as a club drug. Referred to in social or recreational settings as “roofies,” Rohypnol has been used to facilitate acts of sexual assault. Often, this involves dropping roofies into an alcoholic drink, which can cause even more intense effects than taking Rohypnol alone.

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Effects Of Mixing Rohypnol And Alcohol

Rohypnol and alcohol are both depressants, which means they can slow down certain functions in the body. Mixed together, their effects can become more intense, producing a more powerful high. It can also lead to several dangerous and potentially life-threatening symptoms.

Effects of mixing alcohol and Rohypnol can include:

  • blackouts
  • euphoria
  • stupor
  • slowed or shallow breathing
  • low blood pressure
  • dizziness
  • headaches
  • memory problems
  • confusion
  • tremors

Rohypnol can also cause changes in behavior. People may be more likely to engage in risky behaviors, and in some cases may become aggressive or hostile.

What Are The Dangers Of Mixing Rohypnol And Alcohol?

Alcohol is the most commonly abused substance in the United States. Heavy alcohol abuse alone can pose several dangers to a person’s health. Mixing it with a highly-potent drug like Rohypnol can increase the chance of life-threatening symptoms and other dangers.

Drug-Facilitated Sexual Assault

One of the most powerful effects of mixing Rohypnol and alcohol is heavy sedation, or sleepiness. People who mix the two may become so sedated that they are unable to control their physical movements. They may also experience a blackout and amnesia.

Starting in the mid-1990’s, reports emerged that these effects were being abused by people in order to commit sexual assault. In addition to memory blackouts, slipping Rohypnol into an alcoholic drink can make a person less able to remain conscious and fight back against an assaulter.

Alcohol that has been “roofied” may not show any visible signs of being tampered with. The substance is tasteless and usually colorless. Depending on the type of tablet and drink, however, Rohypnol may turn a lighter liquid a blue-ish color.

In 1996, the Drug-Induced Rape and Prevention Act passed by U.S. Congress provided harsher punishment for using drugs like Rohypnol for assault. This includes up to three years in prison for possession of Rohypnol, and up to twenty for importation or distribution.

Liver Damage

Several drugs, including Rohypnol, can damage the liver when mixed with alcohol, which by itself can have a serious impact on the liver. The liver is often the primary organ responsible for processing drugs and alcohol. When these substances are abused, over time the liver can become less able to process drugs properly. This can lead to damage and sometimes disease.

Risk factors for organ damage may include pre-existing liver problems, age, how long you’ve been abusing Rohypnol and alcohol, and more.

Overdose Risk

Taking high doses of Rohypnol may lead to overdose. This can cause several negative symptoms, including loss of coordination and respiratory arrest. Rohypnol overdose is not often fatal on its own. However, mixing Rohypnol with alcohol may cause serious symptoms, such as respiratory depression and coma, that can lead to death.

Other overdose symptoms can include:

  • impaired speaking
  • loss of balance
  • extreme sedation
  • low blood pressure and heart rate
  • nausea and vomiting
  • hallucinations
  • loss of consciousness

Rohypnol Addiction

Regular use of Rohypnol over time can lead to tolerance and dependence, similar to other benzodiazepines. Becoming tolerant to Rohypnol requires taking higher doses of the drug to feel its effects.

People who abuse Rohypnol by taking large or frequent doses may develop tolerance much quicker. This can put a person at increased risk for addiction. Addiction can be both physical and psychological. In most cases, people who become addicted to a drug are unable to stop or reduce their dose on their own.

Signs of Rohypnol abuse and addiction can include:

  • droopy eyelids
  • slow or slurred speech
  • excitable or aggressive behavior
  • chewing Rohypnol tablets
  • mixing it with other drugs
  • snorting or injecting dissolved Rohypnol tablets/pills
  • hiding or lying about drug use
  • forgetfulness

Abusing both Rohypnol and alcohol may lead to faster dependence and can have more serious side effects. It may also lead to worsened withdrawal symptoms.

Mixing drugs, known as polysubstance abuse, is a serious problem. Trying to withdraw from alcohol and Rohypnol after developing dependence can be dangerous without treatment.

Treatment For Polysubstance Abuse

Millions of people in the United States struggle with drug abuse, and too many do not seek help. Mixing Rohypnol with alcohol can be dangerous and sometimes fatal.

Entering treatment for polysubstance abuse can be a life-saving decision. People who enter a treatment program may receive a personalized treatment plan that is able to suit their needs. Each person’s path towards recovery will look different, but begins with reaching out for help.

Medical Detox

Stopping Rohypnol use all at once can result in serious symptoms including convulsions and hallucinations. With alcohol involved, other life-threatening symptoms may also occur. Withdrawing from benzodiazepine dependence usually requires a tapering process. This involves reducing a person’s dosage slowly over a period of weeks or months.

It can be dangerous to try to detox from Rohypnol and alcohol alone. Medical detox programs are commonly recommended to provide beneficial support during the early stages of withdrawal. Doctors can plan a weaning schedule for patients based on their drug history and other personal needs.

Inpatient Rehab Treatment

Detox does not provide complete treatment. People struggling with drug and alcohol abuse can often benefit from entering an inpatient program.

Inpatient rehab programs can help a person learn healthy coping and life skills, reducing their risk for relapse. Patients often see several specialists within these programs to determine a treatment plan that meets their needs. These programs typically last between 30 to 90 days and involve living onsite in a rehab center.

Contact us today to learn more about treatment options for Rohypnol and alcohol abuse.

Center for Substance Abuse Research (CESAR) - Flunitrazepam (Rohypnol)

U.S. Department of Justice: National Drug Intelligence Center - Rohypnol Fast Facts

American Journal of Chemistry and Materials Science - Effects of Alcohol and Rohypnol Combination on the Liver Function of Adult Albino Rats

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