Changing trends in novel benzodiazepine use within Scottish prisons: detection, quantitation, prevalence, and modes of use

Abstract

Drug use within prisons is increasingly complex and unpredictable. Benzodiazepines are currently one of the most common drugs detected in individuals leaving Scottish prisons; however, understanding illicit benzodiazepine use within prisons and assessing the potential harm to individuals is challenging due to the lack of available analytical data on the substances circulating. Increasingly, materials, such as paper and clothing, infused with novel benzodiazepines have been identified as a smuggling route into Scottish prisons. Methods were developed for the qualitative and quantitative analysis of benzodiazepines using gas chromatography–mass spectrometry (GC–MS) and applied to 495 seized samples from 11 Scottish prisons, including papers, cards, blotters, powders, tablets, and clothing. Evolution in the benzodiazepines being detected was demonstrated, with etizolam being the most prevalent throughout 2020/2021 following which flubromazepam and bromazolam detections increased. Additionally, significant changes in the smuggling methods and drug formats detected occurred over time following policy changes within prisons. These data represent the first reported widescale etizolam quantitation data and demonstrate high levels of variability across all sample types, most notably within tablets (0.34–2.33 mg per tablet). Additionally, concentration mapping of a whole seized card sample revealed the total concentration of drug present (312.5 mg) and demonstrated variability across the surface of the card (1.16–1.87 mg/cm2). These data highlight the challenges of consistent dosing for individuals and the high risks of unintentional overdose. Increased understanding of the challenge of such drug smuggling and benzodiazepine use will aid in the development of strategies to reduce supply and mitigate harm.

Benzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniques

“…We acknowledge, in this study, that the tested samples were purchased prior to the introduction of the PSA (2016); yet in the more recent literature, the quantitative analysis of street purchased etizolam also suggests similar degrees of product purity and inter/intra batch variability. This demonstrates that DBZDs remain a serious cause of concerns, given the mortality statistics across Scotland and some European countries [ 80 , 81 , 82 ]. Thus, it can be inferred that either these drugs potentially remain under similar manufacturing controls as witnessed pre-2016, or there is a residual drug supply circulating among the various PWUD communities and supply chains.…”