Health officials in the United States are sounding the alarm over ‘designer’ Xanax that is increasingly behind more overdose deaths.
Bromazolam is a benzodiazepine – a class of drugs used to treat anxiety – that has been enhanced in the lab to be more potent than approved sedatives like Xanax and Valium.
The Centers for Disease Control and Prevention said in 2021, just one percent of toxicology cases submitted to National Medical Services Labs tested positive for Bromazolam. By mid-2022 this number rose to 13 percent.
Benzodiazepines, or benzos, are depressants that cause sedation, slowing the body and brain down. However, high potency benzos like Bromazolam can cause loss of coordination, drowsiness, dizziness, respiratory depression, coma and death.
Bromazolam can be sold as tablets, in a powder form and gummies and is often found mixed with opioids like fentanyl
The Center for Forensic Science Research and Education (CFSRE) reported the first positive blood test result for the drug in September 2020.
Between then and June 2023, there were a total of 1,791 postmortem blood samples supplied to the organization from coroners and medical examiners that tested positive for Bromazolam.
The CFSRE reports Bromazolam once made up just four percent of novel benzos in circulation in 2021, but estimates its presence rose to 73 percent of the supply in the first six months of 2023.
And it is increasingly being mixed with the deadly opioid fentanyl. The CFSRE reported that 83 percent of its samples tested positive for fentanyl.
It is sold under names such as ‘XLI-268,’ ‘Xanax,’ ‘Fake Xanax,’ and ‘Dope.’
The drug can be sold as tablets, in a powder form or as gummies. On several websites selling the drug based in China, Europe and the US, prices range from $20 for two dozen 3mg tablets, $8 for a single 1mg tablet and $356 for an unspecified amount of 5mg tablets.
Effects of Bromazolam occur within 15 to 45 minutes after ingestion and can last five to eight hours.
A case study of three people detailed in the CDC’s Morbidity and Mortality Weekly Report describe ‘previously healthy young adults’ who took pills they believed were alprazolam – the generic version of Xanax – but were actually Bromazolam.
The three subjects were found February 1, 2023 in a suburb of Chicago.
The two 25-year-old men and one 20-year-old woman were found unresponsive and could not be revived using naloxone, the antidote to quickly reverse opioid overdoses.
One of the men found had elevated blood pressure, a high heart rate and a fever.
He experienced multiple seizures, was intubated and admitted to the ICU for 11 days. upon discharge, the man was reported to be experiencing persistent neurological deficits.
The other man had a slightly elevated temperature, was intubated and admitted to the ICU.
The man also experienced seizures. He was released from the hospital on the fourth day and reported some hearing loss.
The woman was unresponsive and having multiple seizures, eventually leading to intubation. She suffered prolonged and multiple seizures that did not respond to medication and was in a persistent coma. After 11 days she was transferred to another hospital but no follow-up information was available.
All three patients were found to have elevated levels of a protein in their blood that is observed in people having heart attacks.
Biological samples from all three people confirmed the presence of Bromazolam but did not detect fentanyl or any other opioid.
The CDC said the symptoms of these patients were unusual for an expected benzo overdose, which indicate Bromazolam has unknown properties from other benzos that cause more serious health impacts.
The health agency said ‘the constellation of findings reported should prompt close involvement with public health officials and regional poison centers, given the more severe findings in these reported cases compared with those expected from routine benzodiazepine overdoses.’
In August, the Indiana Department of Health issued an emerging drug threat in the state after doctors and first responders reported an uptick in people using the drug.
In the first six months of 2023, 35 who overdosed in Indiana tested positive for the drug.
Illinois has seen an increased use of the drug and Canadian provinces warned in May that the drug had been detected in the country’s drug supply.
And law enforcement is increasingly confiscating more quantities of Bromazolam. The CDC reported that seizures in the US increased from zero to three per year from 2016 to 2018, to 2,140 in 2022 and nearly 3,000 last year.
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