From the Guidelines
If you suspect you've been drugged with Rohypnol (roofies) and alcohol, seek immediate medical attention to minimize the risk of morbidity, mortality, and long-term impact on quality of life. According to the most recent and highest quality study available, 1, benzodiazepine overdose, such as that caused by Rohypnol, can be managed with standard life support measures, including establishing an open airway and providing bag-mask ventilation, followed by endotracheal intubation when appropriate.
Key Considerations
- Drink water to stay hydrated and help flush the substances from your system, as dehydration can exacerbate the effects of benzodiazepines and alcohol 1.
- Avoid consuming more alcohol or taking other drugs, including over-the-counter medications like aspirin or ibuprofen, as these can interact dangerously with the substances already in your system 1.
- Don't drink coffee or energy drinks, as caffeine can worsen dehydration and potentially interact with benzodiazepines 1.
- Medical professionals may administer activated charcoal if the ingestion was recent, or provide supportive care including IV fluids for dehydration and monitoring of vital signs 1.
Medical Management
- There is no specific antidote for Rohypnol, but treatment focuses on managing symptoms until the drug clears your system, which typically takes 12-24 hours 1.
- Flumazenil, a competitive antagonist at the benzodiazepine binding site on the GABA-A receptor, may be used to reverse CNS and respiratory depression, but its use is not without risks, including the potential to precipitate refractory benzodiazepine withdrawal and seizures in patients with benzodiazepine tolerance 1.
- The combination of sedatives and alcohol can dangerously suppress your central nervous system, potentially causing respiratory depression, so professional medical monitoring is crucial during this period 1.
From the FDA Drug Label
Not to take any alcohol or non-prescription drugs during the first 24 hours after flumazenil administration or if the effects of the benzodiazepine persist. The patient should avoid taking any alcohol or non-prescription drugs for at least 24 hours after being treated with flumazenil or if the effects of the benzodiazepine (such as ruffies) are still present 2.
From the Research
Immediate Actions
- If you suspect you have been drugged with Rohypnol (flunitrazepam, also known as "ruffies") and alcohol, seek medical attention immediately 3, 4.
- Try to get to a safe place and have someone you trust stay with you 4.
- Do not attempt to drive or operate heavy machinery, as this can increase the risk of accidents and injuries 4, 5.
Medical Treatment
- Medical professionals may administer activated charcoal to help absorb the drug and prevent further absorption into the bloodstream 3.
- Vital signs will be monitored, and respiratory support may be provided if necessary 3.
- In some cases, the antidote flumazenil may be administered to reverse the effects of the benzodiazepine 3, 6.
- However, flumazenil should be used with caution, as it can cause adverse effects, such as seizures, especially in individuals with a history of benzodiazepine use or dependence 3, 6.
Substance Interactions
- Avoid consuming any more alcohol or other substances, as this can increase the risk of adverse interactions and worsen symptoms 7, 5.
- Be aware that flunitrazepam can interact with other central nervous system depressants, such as alcohol, and increase the risk of respiratory depression and other adverse effects 7, 5.
Follow-up Care
- After receiving medical attention, it is essential to follow up with a healthcare professional to ensure that the effects of the drug have worn off and to address any potential long-term consequences 4.
- Consider seeking support from a counselor or therapist to address any emotional or psychological trauma related to the incident 4.