Benzodiazepines in Miami-Dade County, Florida Driving Under the Influence (DUI) Cases (1995-1998) with Emphasis on Rohypnol(R): GC-MS Confirmation, Patterns of Use Psychomotor Impairment, and Results of Florida Legislation

Abstract

Benzodiazepines are central nervous system depressant drugs often detected in biological samples from driving under the influence (DUI) offenders. They are associated with marked psychomotor impairment and represent up to 20% of all Miami-Dade County, Florida DUI urine samples analyzed in our laboratory annually. Flunitrazepam emerged in the mid-1990s as an illegal drug in the U.S. that was predominantly abused recreationally and associated with sexual assaults. Immunoassays for benzodiazepines do not discriminate between different benzodiazepines, and certain metabolites, such as 7-aminoflunitrazepam, react poorly with immunoassay reagents. A simple and sensitive method for the detection and quantitation of major benzodiazepines and metabolites by gas chromatography with mass selective detection is presented. This method was used to confirm benzodiazepines in general and flunitrazepam in particular. Data collected over a three-and-a-half-year period are summarized. Whereas flunitrazepam was present in up to 10% of DUI cases in 1995 and 1996 and had fast become the most frequently encountered benzodiazepine in Miami-Dade County DUI-related urine samples, a dramatic drop in case numbers followed the legal reclassification of the drug as a Schedule I substance in Florida in February 1997. Flunitrazepam was often used alone or in combination with cannabis and cocaine. A recent rise in clonazepam cases coincides with the decrease in flunitrazepam confirmation and may indicate a new trend in the abuse of benzodiazepines in South Florida.

Analytical developments in toxicological investigation of drug-facilitated sexual assault

“…It is available in tablets containing 0.5 mg, 1 mg, and 2 mg clonazepam under the trade names Klonopin, Clonex, Iktorivil, and Rivotril. In a previously mentioned paper, Raymon et al reported a significant rise in clonazepam involvement in DUI cases in Florida after 1998 [16].…”

“…The authors of this study noted that 10% of voluntary users reported subsequent physical or sexual victimization. In another paper, Raymon et al reported significant involvement of flunitrazepam (among other benzodiazepines) in driving under the influence cases in South Florida between 1995 and 1998 [16]. Rohypnol tablets are smuggled into the US (mainly from Mexico) and sold with street names like roofies, rophies, roopies, rib, rope, pappas, peanuts, pastas, forget pills, ro-shays, roaches, and roche 2 [15].…”

Challenges in Drugs of Abuse Testing

“…Immunoassays for benzodiazepines do not discriminate between individual drugs, and the metabolite of fl unitrazepam (7 -aminofl unitrazepam) may react poorly with certain immunoassay reagents causing false -negative result (20) . Flunitrazepam (Rohypnol) is a benzodiazepine drug not approved for use in the United States.…”

Drug-Facilitated Sexual Assault

“…32 In the United States importation of flunitrazepam was banned 1996, but it is still available and popular in Europe and Latin America. 37 Clonazepam also is sold under the street name of "roofies" with clinical effects quite similar to flunitrazepam. The manufacturer has recently reformulated the drug to give a blue color when dissolved in clear drinks and to cause haziness in colored beverages.…”