Adverse Effects From Counterfeit Alprazolam Tablets

Arens, Ann M.; Wijk, Xander M R van; Vo, Kathy T.; Lynch, Kara L.; Wu, Alan H.B.; Smollin, Craig G.

doi:10.1001/jamainternmed.2016.4306

Cited by 98 publications

(41 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This rise in NPF has created a significant public health crisis since those exposed are unaware of the adulteration, but rather assume they were using standard heroin, cocaine, or prescription strength opioid pills. Street-purchased counterfeit Xanax and Norco pills containing fentanyl were responsible for two overdose outbreaks in northern California from late 2015-2016 (Arens et al, 2016;Vo et al, 2016;Sutter et al, 2016). NPFadulteration is not limited to heroin and other illicitly produced opioid analgesics, but has also been found in cocaine.…”

Section: Study Selectionmentioning

confidence: 99%

Fentanyl, fentanyl analogs and novel synthetic opioids: A comprehensive review

et al. 2018

Self Cite

View full text Add to dashboard Cite

Section: Study Selectionmentioning

confidence: 99%

Fentanyl, fentanyl analogs and novel synthetic opioids: A comprehensive review

et al. 2018

Self Cite

View full text Add to dashboard Cite

“…A similar episode was reported in New Haven, CT, with fentanyl distributed as white powder cocaine resulting in 9 non-fatal and 3 fatal overdoses in a 6-hour period (Tomassoni et al, 2017). An outbreak of poisoning due to counterfeit alprazolam (labeled as Xanax) tablets containing fentanyl occurred in 2015 in San Francisco (Arens et al, 2016), resulting in 8 deaths and no related reports of lay naloxone use.…”

Section: Overdose Response In the Synthetic Opioid Eramentioning

confidence: 99%

Naloxone for heroin, prescription opioid, and illicitly made fentanyl overdoses: Challenges and innovations responding to a dynamic epidemic

Fairbairn

Coffin

Walley

2017

International Journal of Drug Policy

250

192

View full text Add to dashboard Cite

Community-based overdose prevention programs first emerged in the 1990's and are now the leading public health intervention for overdose. Key elements of these programs are overdose education and naloxone distribution to people who use opioids and their social networks. We review the evolution of naloxone programming through the heroin overdose era of the 1990's, the prescription opioid era of the 2000's, and the current overdose crisis stemming from the synthetic opioid era of illicitly manufactured fentanyl and its analogues in the 2010's. We present current challenges arising in this new era of synthetic opioids, including variable potency of illicit drugs due to erratic adulteration of the drug supply with synthetic opioids, potentially changing efficacy of standard naloxone formulations for overdose rescue, potentially shorter overdose response time, and reports of fentanyl exposure among people who use drugs but are opioid naïve. Future directions for adapting naloxone programming to the dynamic opioid epidemic are proposed, including scale-up to new venues and social networks, new standards for post-overdose care, expansion of supervised drug consumption services, and integration of novel technologies to detect overdose and deliver naloxone.

show abstract

“…Dependence potential, both physiological and behavioural, is documented in case reports . Few signs of harm were identified until recent years when etizolam has been involved in rapidly increasing numbers of drug‐related deaths in Scotland , and recent alerts in Australia and the USA have identified that etizolam is appearing in counterfeit benzodiazepine tablets .…”

Section: Introductionmentioning

confidence: 99%

Etizolam: A rapid review on pharmacology, non‐medical use and harms

Nielsen

McAuley

2020

Drug and Alcohol Review

View full text Add to dashboard Cite

Issues. Etizolam is a thienodiazepine derivative, with high affinity for the benzodiazepine site of GABA A receptors. It is often referred to as a new (or novel) psychoactive substance, a 'designer' benzodiazepine or a 'street benzodiazepine'. Increasing reports of non-medical use, identification of etizolam as an ingredient in counterfeit medications and the common identification of etizolam in drug-related deaths, highlight the need for a greater understanding of etizolam. Approach. A rapid narrative review was conducted using PubMed and Google Scholar to synthesise what is known about etizolam to answer two research questions: (i) Does the pharmacological or toxicological profile of etizolam differ from other benzodiazepines?; and (ii) What is the nature and context of non-medical use and harms related to etizolam? Key Findings. Etizolam has a higher potency as an anxiolytic but lower lethality compared with diazepam. Few harms are documented with the therapeutic use of pharmaceutical products. Harms appear to be predominantly related to the use of etizolam in illicitly manufactured pills and occur almost exclusively in the context of mixed-drug toxicity. Conclusion. In therapeutic doses, there is little to suggest that etizolam is more harmful than other benzodiazepines. Most harms with etizolam appear to be related to the wide availability of illicitly manufactured pills, which are taken in unknown doses and combined with other substances. Current harm reduction advice, including avoiding combining opioids and benzodiazepines, remains relevant and increasingly important within an emerging culture of non-medical use. [Nielsen S, McAuley A. Etizolam: A rapid review on pharmacology, non-medical use and harms. Drug Alcohol Rev 2020;39: [330][331][332][333][334][335][336]

show abstract

Adverse Effects From Counterfeit Alprazolam Tablets

Cited by 98 publications

References 4 publications

Fentanyl, fentanyl analogs and novel synthetic opioids: A comprehensive review

Fentanyl, fentanyl analogs and novel synthetic opioids: A comprehensive review

Naloxone for heroin, prescription opioid, and illicitly made fentanyl overdoses: Challenges and innovations responding to a dynamic epidemic

Etizolam: A rapid review on pharmacology, non‐medical use and harms

Contact Info

Product

Resources

About