INTRODUCTION. Many crimes, especially of a sexual nature, are committed using sedative substances to reduce the victim's state of consciousness and reactivity and are defined as "drugs facilitated crimes". Among these, benzodiazepines (BDZ) and some new designer derivatives are widely used especially in liquid formulations added to other drinks. The purpose of this article is to analyze the chemical, toxicological and analytical characteristics starting from the alteration data and through in-depth analysis on dedicated databases. MATERIALS AND METHODS. We conducted searches in PUBMED, PUBCHEM, CHEMID PLUS and GOOGLE SCHOLAR for papers and documents done on qualitative characteristics of the BDZ most commonly used as facilitating crimes. We have selected research articles and reviews from 2012 to 2022, with the primary endpoint relative to the typology of BDZ found in the samples examined in the various studies. We also researched their chemical and toxicological characteristics on the PUBCHEM and CHEMID PLUS international databases. DISCUSSION AND CONCLUSIONS. Benzodiazepines (BDZs) are among the most commonly used sedatives for illicit purposes, including their use to facilitate sexual crimes or robbery, alone or in co-administration with other substances, especially alcohol. In recent years there have been recorded cases of both classic BDZ intoxication, marketed as medicinal specialties, but also of new designer BDZs such as cinazepam, flualprazolam or phenazepam, less easily detectable in first-level toxicological tests and often much more potent than other more commonly used compounds. The analytical techniques in use, especially the first-level assays used in triages, can sometimes fail to cross-react and make these molecules invisible which, even in the most sophisticated confirmation tests such as techniques combined with mass spectrometry, do not always make these new psychoactive substances detectable.

Introduction: The use of benzodiazepines (BDZ) is notoriously associated with significant long-term problems and it is estimated that the long-term users (LTU) in Italy are over 3 million people, including many elderly people. Unfortunately, 40 to 80% of the LTUs develop dependence and many also have tolerance, with the need for a progressive increase in the daily dosage up to the point of tolerating daily megadoses. In recent years, the off-label use of continuous infusion subcutaneous flumazenil has established itself as a viable approach for rapid hospital detoxification of these sometimes very complex clinical cases. The purpose of the article is, starting from the pharmacological and biochemical bases, to describe the mechanism of action, the areas of applicability and the possible criticalities by analyzing the Italian data. Materials and Methods: A computerized research was carried out for the articles to be inserted through use of international databases PUBMED and RESEARCHGATE by typing in keywords such as “flumazenil, high dose benzodiazepine users, use of flumazenil for benzo detoxification” and related articles. We also used the PUBCHEM database to describe some chemical and pharmacological characteristics of flumazenil. Both Italian and international research articles have been selected, starting from 1980 to today. Discussion and Conclusions: The use of flumazenil in slow infusion remains off-label but, for almost 20 years, it has been in use (in Italy and beyond) to detoxify, in about a week of hospitalization, patients with equivalent daily doses of diazepam greater than 50 mg / day for more than 6 months (with a description of cases up to 350 mg / day of diazepam-equivalent). This would allow the GABA-Argic receptor resensitization in a short time and with minimal or absent withdrawal symptoms, being able to suspend megadoses of BDZ in a very short time. In Italy this approach is still used to a limited extent and it cannot be said that it is absolutely the best method but the analysis of various endpoints in published studies, such as acute withdrawal discomfort, discharge without prescription of benzodiazepines and relapses in the first 6-12 months of discharge, certainly makes us reflect on the possibility of extending this approach to various territorial hospitals.