Femoral blood concentrations of flualprazolam in 33 postmortem cases

Kriikku, Pirkko; Rasanen, Ilpo; Ojanperä, Ilkka; Thelander, Gunilla; Kronstrand, Robert; Vikingsson, Svante

doi:10.1016/j.forsciint.2019.110101

Cited by 29 publications

(28 citation statements)

References 8 publications

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“…The flualprazolam concentration range in blood samples was 3.0-68.0 ng/g, with a median concentration of 18.0 ng/g. Both medicinal and illegal drugs were also detected in blood samples, with buprenorphine being the most common finding, followed by alcohol, pregabalin and gabapentin, or psychoactive substances such as amphetamine and morphine [28]. A single femoral blood concentration of 1.94 ng/mL has also been reported by Mei et al [40], when a newly developed method including flualprazolam was applied for the investigation of forensic cases.…”

Section: Intoxications and Fatal Cases Related To Flualprazolammentioning

confidence: 70%

“…The abuse of flualprazolam is often combined with that of other psychoactive substances as described above. Toxicological analysis of biological samples of flualprazolam users showed that prescribed drugs such as buprenorphine, or other opioids, as well as pregabalin and gabapentin were also detected [28]. The concurrent use of flualprazolam with other NPS benzodiazepines, such as flubromazolam and phenazepam has also been reported [29].…”

Section: Prevalence and Usementioning

confidence: 99%

“…In Europe, flualprazolam was first seized in Sweden in November 2017, while in Finland in February 2018. Kriikku et al [28] reported 33 postmortem and DUID cases, in Sweden and Finland, where flualprazolam was involved, until December 2019. According to European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) publishing a report on flualprazolam in March 2019, flualprazolam had been seized in Denmark, Finland, Germany, Slovenia, Sweden and Norway mainly as tablets [35].…”

Section: Prevalence and Usementioning

confidence: 99%

“…Flualprazolam has been identified in numerous postmortem blood samples collected from drug addicts [3,21,28,40]. The analysis of 171 samples found positive for flualprazolam in USA was conducted by Papsun et al [21], between August 2019 and February 2020.…”

Section: Intoxications and Fatal Cases Related To Flualprazolammentioning

confidence: 99%

“…The isolation of flualprazolam from blood or urine samples has been performed by liquid-liquid extraction with butyl acetate [28], a mixture of methyl tert-butyl ether/1-chlorobutane (60:40, v/v) [21], ethyl acetate/heptane (4:1, v/v) or with methyl tert-butyl ether [29] after alkalinization. For the solid-phase extraction (SPE) of flualprazolam, mixed-mode (strong cation exchange and hydrophobic) [16] and Preconditioned Clean Screen XCEL I columns [40] have been used.…”

Section: Analysis Of Flualprazolam In Biological Samplesmentioning

confidence: 99%

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A fluorine turns a medicinal benzodiazepine into NPS: the case of flualprazolam

et al. 2021

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Purpose The purpose of this review is to summarize the existing knowledge on flualprazolam, a novel ‘designer’ benzodiazepine that derives from the fluorination of the phenyl moiety in the ortho-position of alprazolam. Methods An extensive literature search was carried out in PubMed, Google Scholar and World Wide Web using relevant keywords. All articles found were gathered, and the available information is presented. Results This article reviews the existing knowledge on chemistry, pharmacology, toxicology, prevalence and current legal status of flualprazolam. Moreover, forensic and clinical cases where flualprazolam was involved worldwide, as well as flualprazolam seizures, along with the methods for its determination in biological samples are presented. Conclusions The recent flualprazolam-related cases have raised concerns to regulatory authorities and international stakeholders suggesting that flualprazolam should be under international control. The urgent international control of flualprazolam, despite the limited information on clinical effects and pharmacologic characteristics available, is an important measure for the prevention of its increasing abuse worldwide.

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Section: Intoxications and Fatal Cases Related To Flualprazolammentioning

confidence: 70%

Section: Prevalence and Usementioning

confidence: 99%

Section: Prevalence and Usementioning

confidence: 99%

Section: Intoxications and Fatal Cases Related To Flualprazolammentioning

confidence: 99%

Section: Analysis Of Flualprazolam In Biological Samplesmentioning

confidence: 99%

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A fluorine turns a medicinal benzodiazepine into NPS: the case of flualprazolam

et al. 2021

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What's in fake ‘Xanax’?: A dosage survey of designer benzodiazepines in counterfeit pharmaceutical tablets

Blakey

Thompson

Matheson

et al. 2021

Drug Testing and Analysis

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The identification of a range of different drugs within counterfeit benzodiazepine tablets has been widely reported; however, limited information is available on the dosage of these products. A rapid dosage survey of 46 counterfeit benzodiazepine tablets from 20 seizures was conducted over a 6-month period between April and September 2020. Existing methods utilised for the determination of benzodiazepines in toxicology specimens were applied to assess the dosage of four benzodiazepines detected across five different counterfeit benzodiazepine presentations. The highest dosage variation was observed for etizolam with a range of 0.7-8.3 mg per tablet. This report demonstrates the variability in drug content and dosage that can occur between visually similar counterfeit tablets, even when co-packaged within the same seizure, highlighting the potential public harm posed by these counterfeit medications.

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New psychoactive substances—Designer benzodiazepines

Wilde

Auwärter

Moosmann

2021

WIREs Forensic Science

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Designer benzodiazepines are a rather new class of new psychoactive substances counting 26 compounds by the end of 2019. However, due to their high habit‐forming potential, the easy availability of these drugs in online shops is rather alarming. While the risk of acute health effects or intoxications after the sole consumption of benzodiazepines is low, combined consumption with other central nervous system depressant drugs such as opioids or alcohol can lead to life‐threating conditions. Furthermore, long term use can lead to tolerance and addiction. In this review article the emergence of this drug class is described and the literature on pharmacokinetics and the various methods of detection is discussed. Furthermore, the structure activity relationships of benzodiazepines are summarized in order to predict the potency of newly emerging compounds. This article is categorized under: Toxicology > New Psychoactive Substances

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Femoral blood concentrations of flualprazolam in 33 postmortem cases

Cited by 29 publications

References 8 publications

A fluorine turns a medicinal benzodiazepine into NPS: the case of flualprazolam

A fluorine turns a medicinal benzodiazepine into NPS: the case of flualprazolam

What's in fake ‘Xanax’?: A dosage survey of designer benzodiazepines in counterfeit pharmaceutical tablets

New psychoactive substances—Designer benzodiazepines

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