Flunitrazepam: More than a date rape drug

Study Objective: To evaluate the independent relationship between depressive symptoms, self-esteem, and drug resistance self-efficacy, and future intentions to use flunitrazepam. Design: Cross-sectional survey. Setting: Community-based family planning clinics. Participants: 865 sexually active women who self-identified as Caucasian, African-American, or Mexican American, denied using flunitrazepam in the last 12 months and reported intentions to use or not use this substance in the next 12 months. Interventions: None. Main Outcome Measure: An anonymous self-report measure assessed the patient's intentions to use flunitrazepam in the next 12 months; other lifetime drug use; and standardized measures of depression, self-esteem, and drug resistance self-efficacy. We hypothesized that future potential users of flunitrazepam would exhibit an increased number of depressive symptoms, lowered self-esteem, and limited drug resistance self-efficacy. Results: Of the 865 subjects, 16 (1.8%) reported using flunitrazepam in their lifetime but not in the last 12 months, and 46 (5.3%) were identified as potential users. Logistic regression analyses controlling for confounding factors found that potential to use flunitrazepam was significantly associated with limited drug resistance self-efficacy (adjusted odds ratio [AOR] = 9.3) and the presence of both severe depressive symptoms and lowered self-esteem (AOR = 3.2). Conclusions: These data suggest that young women with severe depressive symptoms and diminished self-esteem are at high risk for future flunitrazepam use and may use this drug to self-medicate psychological distress.