Public health alert: New benzodiazepines – Bromazolam

Alert area

Scotland

Action required by

people working and volunteering in drug and alcohol services, emergency services, healthcare and medical settings, and high-risk settings such as prisons and hostels.

Action required

provide harm reduction interventions for benzodiazepines and polydrug use – see sections marked for specific actions.

Alert number

2023/13

Version number

1.1

Release date

5 July 2023

Updated

13 October 2023

Valid until

31 March 2024

Update

This alert was updated on 13 October 2023 to include recent detection data and new information on effects.

Summary

Between 2016 and 2022, etizolam was the primary drug detected in street benzodiazepines (benzos) in Scotland. Data shows the market is significantly changing, etizolam detections are decreasing and detections of new benzodiazepines are increasing.

Bromazolam is now the most common drug detected in ‘street benzos’.

Bromazolam has been seized in both community and custodial settings and implicated in hospitalisations and deaths in different areas of the country.

Reports to RADAR indicate that bromazolam produces strong sedative and sleep-inducing effects. As a result, there is a substantial risk of overdose.

The harm associated with bromazolam and other new benzos should be considered in the context of polysubstance use (mixing drugs), which is a common feature of drug use in Scotland. 

Services should promote and discuss realistic harm reduction and support measures. Overdose signs and response actions for bromazolam are the same as for any other overdose involving depressants.

New drugs may not always be picked up in clinical testing but that does not mean that they are not present. Consider the person’s presentation and clinical history to determine appropriate interventions. Guidance on psychological and prescribing interventions to address benzodiazepine harms is available from the Scottish Drug Deaths Taskforce.

Last updated: 20 November 2023
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