How would flunitrazepam (roofies) be listed on a toxicology screen?

Detection of Flunitrazepam (Roofies) on Toxicology Screens

Flunitrazepam (Rohypnol) is not identified in routine tests for benzodiazepines and requires specialized testing methods for detection. 1, 2, 3

Key Facts About Flunitrazepam Detection

• Standard drug-screening panels do not include flunitrazepam, making it impossible to detect through routine toxicology screens 1
• Flunitrazepam has a very limited detection window - approximately 24 hours in blood and up to 48 hours in urine after ingestion 3, 4
• When specifically testing for flunitrazepam, it would be listed as "flunitrazepam" or its major metabolite "7-aminoflunitrazepam" on specialized confirmatory testing 5, 6
• Flunitrazepam is rarely detected in sexual assault cases - studies show it's confirmed in only about 0.33% of suspected drug-facilitated sexual assault cases 1
• If flunitrazepam is suspected, toxicology screening should be performed immediately, even before completing history and physical examination 1

Detection Methods and Challenges

• Specialized testing methods required for flunitrazepam detection include:

  • Gas chromatography-mass spectrometry (GC-MS) 5, 6
  • Micro-plate enzyme immunoassay specifically calibrated for 7-aminoflunitrazepam 5
  • Negative ion chemical ionization mass spectrometry 5

• Common pitfalls in detection:

  • Waiting too long to collect samples (detection window is very short) 3
  • Relying on standard benzodiazepine panels (will miss flunitrazepam) 1, 2
  • Not collecting the first urine sample after suspected exposure 1
  • Failing to maintain proper chain of custody for legal proceedings 1

Clinical Implications

• When flunitrazepam exposure is suspected, healthcare providers should:

  • Collect samples immediately (first urine produced after suspected exposure is ideal) 1
  • Consult with toxicologists or sexual assault centers about proper collection methods 1
  • Request specific testing for flunitrazepam and 7-aminoflunitrazepam 5, 6
  • Consider testing for other substances commonly used in sexual assault (alcohol, GHB, other benzodiazepines, antihistamines) 2

• If a general toxicology screen is positive, the same sample should be sent for confirmatory testing using gas chromatography or mass spectroscopy 1

• Be aware that flunitrazepam use may be more common in geographic areas where it is legal or more accessible (e.g., Mexico and border areas) 1