Roche Pills (Rohypnol)What are they, how do they affect the brain and memory, and why are they linked to assaults?

13What are Roche pills?

"Roche pills" is the name in circulation in a number of Arab countries for Rohypnol tablets. Rohypnol is the original brand name of the medicine flunitrazepam, one of the strongest sleeping pills in the benzodiazepine family in effect.

The popular name came from the name of the company that produced the original medicine, which is why on the street it is sometimes applied to other sedative tablets that are not flunitrazepam at all, such as Valium. Tablets circulating outside pharmacies may be counterfeit or of unknown composition, so the person taking them cannot know what they are really taking.

The World Health Organization describes flunitrazepam as having the usual effects of benzodiazepines, but with greater hypnotic and sedative potency than diazepam, a rapid onset, and a longer duration of effect, characteristics that partly explain why it is misused more than others.

14Do Roche pills have a medical use?

Yes, in some countries. According to the World Health Organization's Expert Committee on Drug Dependence, flunitrazepam is used to treat insomnia and as a pre-anesthetic medicine to help start and maintain anesthesia. In the United States it is not approved for medical use, according to the US National Institute on Drug Abuse (NIDA), yet the World Health Organization has recorded its misuse there.

15How do Roche pills affect the brain?

Flunitrazepam acts on type A GABA receptors, the natural brakes of the nervous system, strengthening their effect and slowing brain activity. The World Health Organization states that it binds to these receptors with high potency and is absorbed quickly after it is taken, which explains the strength and speed of its effect. The result:

• Deep drowsiness and sedation that can turn into sleep that is hard to wake from.
• Anterograde amnesia: The brain cannot record what happens while it is active, so the person wakes up not remembering whole hours.
• Impaired movement and balance and slow reaction.
• Respiratory depression with large amounts or when mixed with other depressants.

In a clinical trial published in 2007 on recreational drug users, flunitrazepam caused clear sedation and impaired motor performance and balance, and the researchers concluded that its potential for misuse is high.

16Forms and names of Roche pills

Flunitrazepam comes in tablets, and NIDA notes that some people swallow them or dissolve them in a liquid. Among its slang names worldwide are "roofies" and the "forget pill". The World Health Organization lists multiple brand names for it in different countries, which makes the name written on the box alone not enough to know what is inside if its source is not trustworthy.

17Why are Roche pills misused?

The World Health Organization summarizes the most common patterns of misuse, and notes that in many cities flunitrazepam was the benzodiazepine most used among people who use opioids. Motives it listed include:

• Strengthening the effect of opioids such as heroin, or using it as a substitute when they are hard to obtain.
• Self-treating opioid withdrawal symptoms without a doctor.
• The organization also notes the spread of its misuse among young people and people who use cocaine.

Dependence may sometimes begin with the intention of treating: seeking sleep or escape from anxiety without medical supervision, and then it becomes hard to stop. The problem is that most of these patterns involve mixing more than one substance, which raises the risk of respiratory depression and complicates dependence, withdrawal, and treatment together.

18Roche pills compared with other depressants

Despite the differences, all three slow the nervous system, and mixing any of them with alcohol or opioids is the most dangerous thing that can happen. You can find the details of each in the guide to GHB and the guide to barbiturates.

19Roche pills and being drugged without your knowledge: what you should know

NIDA states that flunitrazepam has been used in sexual assaults because of the strength of its sedative effect, and GHB is often mentioned with it in this context. But it is also important to know that a recent review of drug-facilitated crime cases in the United States between 2019 and 2023 found that alcohol, cannabis, and stimulants appeared most often, while flunitrazepam and GHB appeared less. That is, caution should extend to any drink or substance, not to one particular pill.

If you or a friend feel sudden drowsiness or dizziness out of proportion to what you consumed, ask for help immediately from someone you trust and do not stay alone. We explain the signs in detail, and what to do afterward, on the page Symptoms of Roche pill use and signs of use.

20Legal status of Roche pills

According to the World Health Organization, flunitrazepam was placed in Schedule IV of the 1971 United Nations Convention on Psychotropic Substances in 1984, and its Expert Committee recommended in 1995 moving it to the more strictly controlled Schedule III because of the spread of its misuse, which is its current international classification. In Egypt, circulating or possessing it outside the medical framework is an offense that exposes a person to legal liability. The Fund for Drug Control and Treatment of Addiction offers free, confidential consultation and treatment through hotline 16023.

This is general educational information and not legal advice.

21Roche pills in numbers

Sources: a study by Druid and colleagues on forensic cases in Sweden (2001), and the review by the World Health Organization's Expert Committee on Drug Dependence.

22Roche pills guide: everything you need to know

We have gathered everything about Roche pills into 5 pages, each answering one question in detail. Choose what you are looking for:

23Found out your son is taking Roche pills? Start here

1. Do not start the conversation while he is under the influence; first make sure he is breathing normally and responding to you.
2. Ask calmly about the context: Is he taking it to sleep? Is he mixing it with something else? Did it begin with a prescription or from friends?
3. Watch for any mixing with alcohol, opioids, or pregabalin; this is the most dangerous part.
4. Do not ask him to stop suddenly if he has been using it daily for some time, because stopping suddenly can be dangerous.
5. Ask for a confidential specialist assessment that determines the degree of dependence and a plan to stop it safely.
6. Save the ambulance number, 123, and learn the danger signs shown at the bottom of this page.

24Harms, symptoms, withdrawal and treatment in brief

Harms: The main ones are memory loss, impaired balance, and accidents, respiratory depression when mixed, then dependence with repeated use. Details are in Harms of Roche pills.

Symptoms: Unusual drowsiness, slurred speech, unsteadiness, gaps in memory, and with addiction, preoccupation with getting the pills. See Signs of Roche pill use.

Withdrawal: It includes rebound insomnia, anxiety, and tension, and with long use may reach seizures, so it should not be stopped suddenly. Details are in Roche pill withdrawal symptoms.

Treatment: Gradual reduction under medical supervision, then psychological and behavioral therapy that addresses the insomnia, anxiety, or trauma behind the use. Read Stages of Roche pill addiction treatment.