‘Fake Xanax’ Tied to Seizures, Coma; Naloxone Ineffective

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buy Adderall Xr 30mg online overnight without prescription. Alicia Ault

DISCLOSURES | January 09, 2024

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Bromazolam, a street drug that has been detect with increasing frequency

in the United States, has reportedly cause protracted seizures,

myocardial injury, comas, and multiday intensive care stays in three individuals,

new data from the US Centers for Disease Control and Prevention (CDC) showed.

The substance is one of at least a dozen designer benzodiazepines,

created in the lab, but not approved for any therapeutic use.

The Center for Forensic Science Research and Education (CFSRE) report

that bromazolam was first detected in 2016 in recreational drugs

in Europe and subsequently appeared in the United States.

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It is sold under names such as “XLI-268,” “Xanax,” “Fake Xanax,” and “Dope.

” Bromazolam may be sold in tablet or powder form, or sometimes

as gummies, and is often taken with fentanyl by users.

The CDC report, publish in the Morbidity and Mortality Weekly Report (MMWR),

describe three cases of “previously healthy young adults,” two 25-year-old men and a 20-year-old woman, who took tablets believing it was alprazolam, when it was actually bromazolam and were found unresponsive.

They could not be revive with naloxone and continue to be unresponsive upon arrival at the emergency department. One of the men was hypertensive (152/100 mmHg),

tachycardic (heart rate of 124 beats per minute), and hyperthermic (101.7 °F [38.7 °C]) and experienced multiple generalized seizures. He was intubate and admit to intensive care.

The other man also had an elevate temperature (100.4 °F) and was intubate and admitted to the ICU because of unresponsiveness and multiple generalized seizures.

The woman was also intubate and nonresponsive with focal seizures.

All three had elevated troponin levels and had urine tests positive for benzodiazepines.

The first man was intubated for 5 days and discharge after 11 days, while the second man was discharge on the fourth day with mild hearing difficulty.

The woman progressed to status epilepticus despite administration of multiple antiepileptic medications and was in a persistent coma. She was transfer to a second hospital after 11 days and was subsequently lost to follow-up.

Toxicology testing by the Drug Enforcement Administration confirmed the presence of bromazolam (range = 31.1-207 ng/mL), without the presence of fentanyl or any other opioid.

The CDC said that “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 addition, it noted that clinicians and first responders should “consider bromazolam in cases of patients requiring treatment for seizures, myocardial injury, or hyperthermia after illicit drug use.”

Surging Supply, Increased Warnings

In 2022, the CDC warn that the drug was surging in the United States, noting that as of mid-2022, bromazolam was identify in more than 250 toxicology cases submit to NMS Labs, and that it had been identify in more than 190 toxicology samples test at CFSRE.

In early 2021, only 1% of samples were positive for bromazolam. By mid-2022, 13% of samples were positive for bromazolam, and 75% of the bromazolam samples were positive for fentanyl.

The combination is sold on the street as benzo-dope.

Health authorities across the globe have been warning about the dangers of designer benzodiazepines, and bromazolam in particular. They’ve noted that the overdose reversal agent naloxone does not combat the effects of a benzodiazepine overdose.

In December 2022, the Canadian province of New Brunswick

said that bromazolam had been detected in nine sudden death investigations, and that fentanyl was detect in some of those cases. The provincial government of the Northwest Territories warned in May 2023 that bromazolam had been detect in the region’s drug supply and caution against combining it with opioids.

The Indiana Department of Health notified the public, first responders, law enforcement, and clinicians in August 2023 that the drug was increasingly being detect in the state. In the first half of the year, 35 people who had overdosed in Indiana tested positive for bromazolam. The state did not test for the presence of bromazolam before 2023.

According to the MMWR, the law enforcement seizures in the United States of bromazolam increased from no more than three per year during 2016-2018 to 2142 in 2022 and 2913 in 2023.

Illinois has been an area of increased use. Bromazolam-involved deaths increased from 10 in 2021 to 51 in 2022, the CDC researchers reported.

The findings were publish online on January 4, 2024, in the MMWR.

Alicia Ault is a Saint Petersburg, Florida-based freelance journalist whose work has appeared in publications including JAMA and Smithsonian.com. You can find her on X (formerly known as Twitter): @aliciaault.

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