Law

From the clinic to the street: the changing role of benzodiazepines in the Scottish overdose epidemic

“…midazolam). People who use drugs may also seek illicit benzodiazepines to reduce and self-manage anxiety, insomnia and withdrawal symptoms (Ford & Law, 2014). They also report using supra-therapeutic ['mega'] doses of benzodiazepines to enhance the effects of opioids (Jones et al, 2012).…”

“…As prescribing of diazepam increased in the general population, so too did diversion into the illicit market. Diazepam was mainly consumed alongside other depressant drugs, typically opioids and alcohol, thus increasing risk of heavy sedation and respiratory depression (Ford & Law, 2014). As Scotland's drug-related death numbers continued to increase throughout the 2000s the role of diazepam came under scrutiny and the long term trend of increased prescribing peaked around 2006/07 followed by a steady reduction which has persisted to the present day.…”

“…Mortality data confirm this, with only 8/806 (1%) etizolam-related deaths in 2020 involving etizolam alone (National Records of Scotland, 2021a). Although etizolam specific studies are lacking, the risks associated with consuming multiple depressant drugs in combination are well established (Ford & Law, 2014;Gudin et al, 2013). In addition, the illicit production of such drugs where contents are unknown and their appearance is designed to mimic other drugs leaves people who use drugs in a perpetual cycle of consumption roulette where they are unsure of the effect they may experience between different sessions or even pills.…”