Assessment of the Availability, Cost, and Motivations for Use over Time of the New Psychoactive Substances—Benzodiazepines Diclazepam, Flubromazepam, and Pyrazolam—in the UK

Abouchedid, Rachelle; Gilks, Thea; Dargan, Paul I.; Archer, John R. H.; Wood, David M.

doi:10.1007/s13181-018-0659-3

Cited by 30 publications

(33 citation statements)

References 19 publications

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“…Furthermore, some NPSs are more potent than the original drugs they have been designed to mimic (King and Kicman, 2011). Clinicians and toxicologists should be aware of the substances used in their environment (Abouchedid et al, 2018) and need to be aware of their pharmacological and toxic effects. This information is needed to deal with intoxication cases, to warn potential users about the actual risks of these substances and to develop analytical methods able to detect the molecules of interest (El Balkhi et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Designer benzodiazepines’ pharmacological effects and potencies: How to find the information

et al. 2020

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Background: Scientific data on the psychopharmacological effects of new psychoactive substances (NPSs) are scarce. Web fora contain a wealth of information posted by users as trip reports (TRs), but the reliability of the reports remains questionable because of the nature of the used molecule and the potential for dose inaccuracies. We focused on the TRs of designer benzodiazepine (DBZD) users since their psychopharmacological effects are similar to prescription benzodiazepines (BZDs). Moreover, the impact of functional groups on the BZD rings with regards to the potency has been fairly/quite studied, allowing structural analysis. Methods: DBZDs offering more than 15 TRs with at least two accounts on experienced effects were included. Data were analyzed with the empirical phenomenological psychological method. Reported effects were analyzed and the pharmacological potencies of DBZDs were compared by calculating a ‘potency score’. Results: In total, 197 TRs for clonazolam, deschloroetizolam, diclazepam, etizolam, flubromazepam, flubromazolam, meclonazepam, metizolam, nifoxipam and pyrazolam were analyzed. Effects similar to prescription BZDs were reported for all the selected DBZDs. Pyrazolam was reported to be the most anxiolytic DBZD, flubromazolam the most hypnotic, etizolam the most euphoric and flubromazolam and clonazolam as the most amnesic DBZDs. Diclazepam and pyrazolam were not reported to induce euphoria. Flubromazepam, flubromazolam, clonazolam and meclonazepam were the most potent and deschloroetizolam, nifoxipam, metizolam and pyrazolam the least potent. The chemical structure of the different DBZDs and the functional groups on the BZD rings confirmed this ranking, except for nifoxipam. Conclusions: When information on NPSs obtained from Internet fora are abundant, it could be considered as an appreciable data source.

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Section: Introductionmentioning

confidence: 99%

Designer benzodiazepines’ pharmacological effects and potencies: How to find the information

et al. 2020

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“…In recent years designer benzodiazepines (such as etizolam) have emerged onto the UK illicit drug market and have become available to purchase online. 52,53 In Scotland especially, these drugs have been associated with a high number of drug‐related deaths. 42 Designer benzodiazepines, not available as prescription products in the UK, while outside the scope of the current study should be included in future research.…”

Section: Discussionmentioning

confidence: 99%

Nonmedical use of benzodiazepines and Z‐drugs in the UK

Hockenhull

Black

Haynes

et al. 2020

Brit J Clinical Pharma

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To estimate prevalence of last 12-month nonmedical use (NMU) of benzodiazepines and Z-drugs (the nonbenzodiazepine hypnotics zaleplon, zolpidem and zopiclone) in the UK. Methods: Data were collected using the Non-Medical Use of Prescription Drugs survey with poststratification weighting applied to be representative of the UK population (≥16 years). Participants were questioned about whether they had nonmedically used benzodiazepines and/or Z-drugs in the last 12-months and from where they had obtained the drug (including via a prescription, or illicitly from a friend/family member, a dealer or via the internet). Additional questions were asked about last 12-month use of illicit drugs (cannabis, cocaine, 3,4-methylenedioxymethylamphetamine [MDMA], non-pharmaceutical amphetamine, crack cocaine and/or heroin). Results: The study included 10 006 eligible participants representing approximately 52 927 000 UK adults. The estimated prevalence of past 12-month NMU of any benzodiazepine and/or Z-drug was 1.2% (95% confidence interval: 1.0-1.5) corresponding to approximately 635 000 adults; amongst this group only an estimated 4.6% (1.2-8.0) had NMU of both a benzodiazepine and a Z-drug. The highest prevalence of NMU for only Z-drugs was among those who had used heroin in the last 12-months (5.4%, 2.7-10.5), whilst the highest prevalence of NMU for only benzodiazepines was among those who had used illicit stimulants in the last 12-months: cocaine (5.9%, 3.8-8.9), amphetamine (5.6%, 3.1-10.0) and MDMA (5.2%, 3.1-8.8). The drug non-medically used was more commonly acquired without than with a prescription for both only benzodiazepines (70.2%, 59.4-81.1 compared to 51.3%, 41.5-64.6) and only Z-drugs (75.6%, 61.6-89.7 compared to 33.9%, 16.9-51.0). Conclusion: There is little overlap between benzodiazepine and Z-drug NMU suggesting distinct nonmedical use of the drugs; future studies need to explore whether this relates to personal preference, drug availability or other factors. A significant proportion are acquiring these drugs for NMU without a prescription, so without guidance and monitoring from a medical practitioner. While the dangers of mixing benzodiazepines and heroin/other opioids are well documented, there is a The authors confirm that the PI for this paper is Paul I. Dargan and that he had direct clinical responsibility for patients.

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“…Whatever the reasons are, this market seems to be quite small. According to (Abouchedid, Gilks, Dargan, Archer, & Wood, 2018), there has been an increase of websites selling non-registered benzodiazepines drug (i.e. diclazepam, flubromazepam and pyrazolam) between 2014 and 2016 in the UK/Europe.…”

Section: General Discussion and Conclusionmentioning

confidence: 99%

“…Whatever the reasons are, this market seems to be quite small. According to Abouchedid, Gilks, Dargan, Archer, and Wood (2018), there has been an increase of websites selling the nonregistered benzodiazepines drug (i.e., diclazepam, flubromazepam, and pyrazolam) between 2014 and 2016 in the United Kingdom/Europe. They reported that the most prominent themes regarding the motivations behind the use of these substances were the treatment of anxiety, sedation/sleep aid, to avoid benzodiazepines withdrawals, and “come down” after the use of stimulants such as amphetamines or cocaine.…”

Section: General Discussion and Conclusionmentioning

confidence: 99%

An insight into the sale of prescription drugs and medicine on the AlphaBay cryptomarket

Morelato

Bozic

Rhumorbarbe

et al. 2019

Journal of Drug Issues

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Internet access has provided new ways to trade goods. Unlike conventional legal sale sites, cryptomarkets facilitate exchanges in a context where the anonymity of participants is warranted. The aim of this article was to obtain a better understanding of the trafficking of prescription drugs and medicine on the AlphaBay cryptomarket. The results showed that alprazolam, oxycodone, and Adderall were the most offered prescription drugs while alprazolam, diazepam, and oxycodone were the most sold substances. The sale was dominated by North America, Australia, and Western European countries. The revenue of prescription drugs was estimated to be more than US$65 million since the creation of AlphaBay, a small market in comparison with offer a complementary way to understand the trafficking of prescription drugs and medicine and to identify the most prolific vendors and their implication in this trafficking.

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Assessment of the Availability, Cost, and Motivations for Use over Time of the New Psychoactive Substances—Benzodiazepines Diclazepam, Flubromazepam, and Pyrazolam—in the UK

Abstract: These three benzodiazepines are widely available online, most commonly as pellets, and are (mis)used for a number of reasons. This study could be used to support triangulation of data from other sources to inform harm minimisation strategies.

Cited by 30 publications

References 19 publications

Designer benzodiazepines’ pharmacological effects and potencies: How to find the information

Designer benzodiazepines’ pharmacological effects and potencies: How to find the information

Nonmedical use of benzodiazepines and Z‐drugs in the UK

An insight into the sale of prescription drugs and medicine on the AlphaBay cryptomarket

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