
Note: This is intended primarily for parents and teachers of secondary K12, Junior high and highschool.
The stories behind the question vary, but include overdoses, students sent
home for lethargy, and angry parents finding tablets in their teenager's
belongings.
Ruffie (or Roofie) is a slang term for a flunitrazepam
tablet (Rohypnol® by Roche). Flunitrazepam is a benzodiazepine similar
to many on the US market (eg, diazepam, triazolam) that is only available
legally in other countries. Flunitrazepam is commonly abused in Europe,
Asia, South America, especially Chile, where it is available without a
prescription.1 Another name commonly used is Rufinol, but this
brand has not been found anywhere in the drug literature. Perhaps over time
this name developed from a combination of the street and brand names. No
matter what it is called, flunitrazepam has become a popular recreational
drug in Florida.
Flunitrazepam's increase in popularity in the US may be due to its easy access from foreign countries and to exposure in media such as Internet news groups and radio talk shows. It is manufactured in tablet and injection forms, and is used in other countries as a hypnotic and for the induction of anesthesia.
Flunitrazepam, like other
benzodiazepines, exerts its depressive effect by facilitating the inhibitory
effects of the neurotransmitter GABA.2 It rapidly distributes
to tissues and is about 10-times as potent as diazepam. The depressive
effects last from 8 to 12 hours. The tablets are sometimes crushed and
"snorted" to hasten the onset and intensity of the effect. There are
anecdotal reports of it being smoked.
Drowsiness, dizziness, ataxia, nightmares, headache, and memory impairment have occurred following the administration of flunitrazepam. Symptoms of overdose include somnolence, confusion, respiratory depression, impaired coordination, slurred speech and seizures. Treatment includes supportive measures, but flumazenil can reverse the sedative effects. While benzodiazepines are not as dangerous in overdose as other sedative/hypnotics, deaths have occurred. Flunitrazepam is commonly abused with alcohol. Taking flunitrazepam with other CNS depressants is extremely dangerous.
Education is the best way to prevent disasters due to drug abuse. Health professionals should be part of the solution.

