Editing Flunitrazepam (section)

==Society and culture==

===Recreational and illegal uses===
[[File:Hypnodorm.jpg|thumb|Hypnodorm 1 mg flunitrazepam tablets, Australia]]
[[File:rohypnol2.jpg|thumb|Rohypnol]]

====Recreational use====
A 1989 article in the ''[[European Journal of Clinical Pharmacology]]'' reports that benzodiazepines accounted for 52% of prescription forgeries in [[Sweden]], suggesting that benzodiazepines were a major prescription drug class of abuse. [[Nitrazepam]] accounted for 13% of forged prescriptions, and accounted for 44% of forgeries specifically for benzodiazepines while flunitrazepam, diazepam, and oxazepam accounted for the majority of the rest of benzodiazepine forgeries. Prescription forgeries for other benzodiazepines marketed in Sweden (alprazolam, clonazepam, lorazepam, clobazam, and bromazepam) were negligible. When calculated in relation to utilization, the narcotic analgesics codeine, pentazocine, and ketobemidone were at the top of the list for the highest number of overall prescription forgeries, suggesting a higher abuse potential of these drugs.<ref>{{cite journal | vauthors = Bergman U, Dahl-Puustinen ML | title = Use of prescription forgeries in a drug abuse surveillance network | journal = European Journal of Clinical Pharmacology | volume = 36 | issue = 6 | pages = 621–623 | date = November 1989 | pmid = 2776820 | doi = 10.1007/BF00637747 | s2cid = 19770310 }}</ref> In neighboring [[Finland]], temazepam accounts for roughly 40–50% benzodiazepine prescription forgeries annually, while flunitrazepam accounts for approximately ~15% of benzodiazepine prescription forgeries.<ref name="Europedrugs">{{cite web|title=Classification of controlled drugs|url=http://www.emcdda.europa.eu/html.cfm/index146601EN.html|publisher=EMCDDA|access-date=30 June 2022}}</ref>

Flunitrazepam and other sedative hypnotic drugs are detected frequently in cases of people suspected of driving under the influence of drugs. Other benzodiazepines and nonbenzodiazepines ([[anxiolytic]] or [[hypnotic]]) such as [[zolpidem]] and [[zopiclone]] (as well as [[cyclopyrrolones]], [[imidazopyridine]]s, and [[pyrazolopyrimidine]]s) are also found in high numbers of suspected drugged drivers. Many drivers have blood levels far exceeding the therapeutic dose range, suggesting a high degree of [[abuse potential|potential for addiction]] for benzodiazepines and similar drugs.<ref>{{cite journal | vauthors = Jones AW, Holmgren A, Kugelberg FC | title = Concentrations of scheduled prescription drugs in blood of impaired drivers: considerations for interpreting the results | journal = Therapeutic Drug Monitoring | volume = 29 | issue = 2 | pages = 248–260 | date = April 2007 | pmid = 17417081 | doi = 10.1097/FTD.0b013e31803d3c04 | s2cid = 25511804 }}</ref>

====Suicide====
In studies in Sweden, flunitrazepam was the second most common drug used in suicides, being found in about 16% of cases.<ref>{{cite journal | vauthors = Jonasson B, Jonasson U, Saldeen T | title = Among fatal poisonings dextropropoxyphene predominates in younger people, antidepressants in the middle aged and sedatives in the elderly | journal = Journal of Forensic Sciences | volume = 45 | issue = 1 | pages = 7–10 | date = January 2000 | pmid = 10641912 | doi = 10.1520/JFS14633J }}</ref> In a retrospective Swedish study of 1,587 deaths, in 159 cases benzodiazepines were found. In suicides when benzodiazepines were implicated, the benzodiazepines flunitrazepam and nitrazepam occurred in significantly higher concentrations compared to natural deaths. Of the 159 deaths where any benzodiazepines were found, 4 deaths were caused by benzodiazepines alone (in the other 155 cases, benzodiazepines were combined with something else). One conclusion of the study was that flunitrazepam and nitrazepam might be more toxic than other benzodiazepines available in the Swedish market.<ref>{{cite journal | vauthors = Ericsson HR, Holmgren P, Jakobsson SW, Lafolie P, De Rees B | title = [Benzodiazepine findings in autopsy material. A study shows interacting factors in fatal cases] | journal = Läkartidningen | volume = 90 | issue = 45 | pages = 3954–3957 | date = November 1993 | pmid = 8231567 }}</ref><ref>{{cite journal | vauthors = Drummer OH, Syrjanen ML, Cordner SM | title = Deaths involving the benzodiazepine flunitrazepam | journal = The American Journal of Forensic Medicine and Pathology | volume = 14 | issue = 3 | pages = 238–243 | date = September 1993 | pmid = 8311057 | doi = 10.1097/00000433-199309000-00012 | s2cid = 28937806 }}</ref>

====Drug-facilitated sexual assault====
{{Main|Drug facilitated sexual assault}}
Flunitrazepam is known to induce [[anterograde amnesia]] in sufficient doses; individuals are unable to remember certain events that they experienced while under the influence of the drug, which complicates investigations.<ref>{{cite news | vauthors = Liljesson S | date = 3 June 1999 |url= http://drugnews.nu/article.asp?id=199 |title=Bankrånare stärkte sig med Rohypnol?|publisher=DrugNews |access-date=May 19, 2006|archive-url= https://web.archive.org/web/20070929165033/http://drugnews.nu/article.asp?id=199|archive-date=September 29, 2007|url-status=dead}}</ref><ref>{{cite news|url=http://www.expressen.se/index.jsp?d=737&a=116288|title=Mijailovic var påverkad av våldsdrog|newspaper=Expressen}}</ref>  This effect could be particularly dangerous if flunitrazepam is used to aid in the commission of [[sexual assault]]; victims may be unable to clearly recall the assault, the assailant, or the events surrounding the assault.<ref name=Kiss2016/>

While use of flunitrazepam in sexual assault has been prominent in the media, as of 2015 it appears to be fairly rare, and use of alcohol and other benzodiazepine drugs in date rape appears to be a larger but underreported problem.<ref name=EU/>

In a 2001 study, the benzodiazepines [[midazolam]] and [[temazepam]] were the two most common benzodiazepines utilized for date rape.<ref>{{cite book | vauthors = El-Sohly MA, Lee LF, Holzhauer LB, Salamone SJ | editor-first1 = Salvatore J. | editor-last1 = Salamone | chapter = Analysis of Urine Samples in Cases of Alleged Sexual Assault | title = Benzodiazepines and GHB | series = Forensic Science and Medicine | year = 2001 | pages = 127–144 | publisher = Humana Press |doi=10.1007/978-1-59259-109-1 |isbn=1-59259-109-4 |chapter-url = https://link.springer.com/chapter/10.1007/978-1-59259-109-1_7}}</ref>

====Drug-facilitated robbery====
In the United Kingdom, the use of flunitrazepam and other "date rape" drugs have also been connected to stealing from sedated victims. An activist quoted by a British newspaper estimated that up to 2,000 individuals are robbed each year after being spiked with powerful sedatives,<ref>{{cite news| url=https://www.theguardian.com/crime/article/0,2763,1376956,00.html |work=The Guardian |location=London |title='Rape drug' used to rob thousands | vauthors = Thompson T |date=December 19, 2004 |access-date=May 2, 2010}}</ref> making drug-assisted robbery a more commonly reported problem than drug-assisted rape.

===Regional use===
Flunitrazepam is a [[Convention on Psychotropic Substances#Schedules of Controlled Substances|Schedule III]] drug under the international [[Convention on Psychotropic Substances]] of 1971.<ref>{{cite web | publisher = International Narcotics Control Board | url = http://www.incb.org/documents/Psychotropics/greenlist/Green_list_ENG_2015_new.pdf | title = List of Psychotropic Substances under International Control | archive-url = https://web.archive.org/web/20170713091834/http://www.incb.org/documents/Psychotropics/greenlist/Green_list_ENG_2015_new.pdf | archive-date= 13 July 2017 | work = Green List | edition = 26th | date = 2015 }}</ref>
* In Australia, as of 2013 the drug was authorized for prescribing for severe cases of insomnia but was restricted as a [[Standard for the Uniform Scheduling of Drugs and Poisons|Schedule 8]] medicine.<ref name="NSW-PSB"/><ref name="DoHWesternAustralia">{{cite web| date= August 13, 2004| url= http://www.health.wa.gov.au/notifications/authorisations/drugs/flunitrazepam.cfm| title= Authorisation to Supply or Prescribe Drugs of Addiction: Flunitrazepam| work= Statutory Medical Notifications| publisher= Department of Health, Government of Western Australia| access-date= 2006-03-13| archive-url = https://web.archive.org/web/20060828184311/http://www.health.wa.gov.au/notifications/authorisations/drugs/flunitrazepam.cfm <!-- Bot retrieved archive --> |archive-date = August 28, 2006}}</ref>
* In France, as of 2016 flunitrazepam was not marketed.<ref name=Kiss2016/>
* In Germany, as of 2016 flunitrazepam is an ''[[Anlage III]] Betäubungsmittel'' (controlled substance which is allowed to be marketed and prescribed by physicians under specific provisions) and is available on a special narcotic drug prescription as the Rohypnol 1&nbsp;mg film-coated tablets and several generic preparations (November 2016).<ref>{{Cite web|url=https://www.gelbe-liste.de/wirkstoffe/flunitrazepam_2624|title = Flunitrazepam - Anwendung, Wirkung, Nebenwirkungen | work = Gelbe Liste | publisher = Vidal MMI Germany GmbH |last1 = Online |first1 = Gelbe Liste }}</ref>
* In Ireland, flunitrazepam is a Schedule 3 controlled substance with strict restrictions.<ref>{{cite web | url = http://www.irishstatutebook.ie/1993/en/si/0342.html | work = Irish Statute Book, Statutory Instruments | title = S.I. No. 342/1993 — Misuse of Drugs (Amendment) Regulations | date = 1993 }}</ref>
* In Japan, flunitrazepam is marketed by Japanese pharmaceutical company [[Chugai Pharmaceutical Co.|Chugai]] under the trade name Rohypnol and is indicated for the treatment of insomnia as well as used for preanesthetic medication.<ref name=Japan>{{cite web |url=http://www.rad-ar.or.jp/siori/english/kekka.cgi?n=1051 |title=Kusuri-no-Shiori Drug Information Sheet |date=October 2015 |publisher=RAD-AR Council, Japan |access-date=2016-06-13 |archive-date=March 3, 2016 |archive-url=https://web.archive.org/web/20160303232158/http://www.rad-ar.or.jp/siori/english/kekka.cgi?n=1051 |url-status=dead }}</ref>
* In Mexico, Rohypnol is legally available.<ref>{{cite web |title=What is Rohypnol? |url=https://www.12southrecovery.us/post/what-is-rohypnol |website=12 South Recovery |date=May 27, 2019 |access-date=24 January 2021}}</ref>
* In Norway, on January 1, 2003, flunitrazepam was moved up one level in the schedule of controlled drugs and, on August 1, 2004, the manufacturer Roche removed Rohypnol from the market there altogether.<ref>{{cite journal | vauthors = Bramness JG, Skurtveit S, Furu K, Engeland A, Sakshaug S, Rønning M | title = [Changes in the sale and use of flunitrazepam in Norway after 1999] | journal = Tidsskrift for den Norske Laegeforening | volume = 126 | issue = 5 | pages = 589–590 | date = February 2006 | pmid = 16505866 }}</ref>
*In South Africa, Rohypnol is classified as a Schedule 6 drug.<ref name="RohypnolSA">{{cite web| date= October 11, 2006| url= http://www.drugaware.co.za/rohypnol.html | title = Rohypnol | work = Drug Wars – About Drugs}}</ref> It is available by prescription only, and restricted to 1&nbsp;mg doses.

[[File:Iceland Flunitrazepam Mylan 1mg.png|thumb|155x155px|Icelandic Flunitrazepam]]

* In Iceland, flunitrazepam is a controlled substance available from [[Mylan]]. It is prescribed for severe insomnia and is sometimes used before surgery to induce a calm, relaxed state of mind for the patient.<ref>{{Cite web|url=https://www.lyfja.is/lyfjabokin/lyf/FlunitrazepamMylan|title=Flunitrazepam Mylan|website=Lyfja - Lifið heil|language=is|access-date=2020-02-27}}</ref>
* In Sweden, flunitrazepam is a List II drug (substances with medicinal uses) under the Narcotics Control Act (1968).<ref>{{cite web |url=https://www.lakemedelsverket.se/sv/sok-lakemedelsfakta/substans?id=E4POCOU9OKGVERT1 |title=Flunitrazepam |publisher=Medical Products Agency |access-date=February 17, 2022 |location=Sweden |language=Swedish}}</ref> It was previously available from Mylan,<ref>{{Cite web|url=http://www.fass.se/LIF/produktfakta/substance_products.jsp?substanceId=IDE4POCOU9OKGVERT1|title = Substans | work = Farmaceutiska Specialiteter i Sverige (FASS) Allmänhet}}</ref> but has been removed from the market in January 2020.<ref>{{Cite web |url= https://janusinfo.se/nyheter/nyheter/2019/flunitrazepamutgar.5.1902def216e9304699285304.html |title=Flunitrazepam utgår | trans-title = Flunitrazepam is discontinued | work = Janusinfo | location = Stockholm | language = Swedish }}</ref>
* In the United Kingdom, flunitrazepam is not licensed for medical use<ref name="UKdrivingregs2014" /><ref name="Kiss2016" /> and is a controlled drug under [[Controlled Drug in United Kingdom#Schedule 3 - CD No Reg|Schedule 3]] and [[Drugs controlled by the UK Misuse of Drugs Act#Class C drugs|Class C]].<ref>{{cite web | url = https://www.gov.uk/government/publications/controlled-drugs-list--2/list-of-most-commonly-encountered-drugs-currently-controlled-under-the-misuse-of-drugs-legislation | title = List of most commonly encountered drugs currently controlled under the misuse of drugs legislation | date = 8 August 2022 | work = Gov.uk }}</ref>
* In the United States, the drug has not been approved by the [[Food and Drug Administration (United States)|Food and Drug Administration]] and is considered to be an [[illegal drug]]; as of 2016 it is [[Controlled Substances Act#Schedule IV controlled substances|Schedule IV]].<ref name="Kiss2016" /><ref>DEA [Lists of Scheduling Actions Controlled Substances Regulated Chemicals May 2016]</ref> {{UnitedStatesCode|21|841}} and {{UnitedStatesCode|21|952}} provide for punishment for the importation and distribution of up to 20 years in prison and a fine; possession is punishable by three years and a fine.<ref name="CESAR">{{cite web | work = Center for Substance Abuse Research | publisher = University of Maryland | url = http://www.cesar.umd.edu/cesar/drugs/rohypnol.asp | title = Flunitrazepam (Rohypnol) | archive-url = https://web.archive.org/web/20160109205146/http://www.cesar.umd.edu/cesar/drugs/rohypnol.asp | archive-date= January 9, 2016 | date = 29 October 2013 }}</ref> Travelers travelling into the United States are limited to a 30-day supply. The drug must be declared to [[US Customs]] upon arrival. If a valid prescription cannot be produced, the drug may be subject to Customs [[search and seizure]], and the traveler may face criminal charges or deportation.

===Names===
Flunitrazepam is marketed under many brand names in the countries where it is legal.<ref name=generics>{{cite web | work = Drugs.com  | url = https://www.drugs.com/international/flunitrazepam.html | title = International brands for Flunitrazepam | access-date = 13 April 2016 }}</ref> It also has many street names, including "roofie" and "ruffie".<ref name=CESAR/> It is also known as Circles, Forget Me Pill, La Rocha, Lunch Money Drug, Mexican Valium, Pingus, R2, and Roach 2.<ref>{{cite web |title=Rohypnol |url=https://www.dea.gov/factsheets/rohypnol |website=United States Drug Enforcement Administration |access-date=October 18, 2020}}</ref>