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Death investigation, expanded toxicology and medical investigation information were included for contextualization of etizolam in death. Etizolam was detected and confirmed within peripheral and cardiac blood, urine, vitreous humor and, in one case, gastric fluid, by liquid chromatography\u2013tandem mass spectrometry and liquid chromatography\u2013quadrupole time of flight mass spectrometry methodologies. Death investigation indicated nonmedical use of most drugs. Medical investigation commonly noted pulmonary edema, cardiomegaly and cerebral swelling. The majority of the decedents appeared to be unaware of the presence of etizolam and succumbed to the mixed drug toxicity of their routine depressant and narcotic analgesic drug of abuse in combination with etizolam. Etizolam use continues to be observed and poses as a potentially lethal contribution to multiple drug toxicity, especially in the age of the opioid crisis. Assessment of analytes like etizolam requires up-to-date methodologies and vigilance in testing to better characterize the toxicology and interpret the contribution to death.<\/jats:p>","DOI":"10.1093\/jat\/bkaa146","type":"journal-article","created":{"date-parts":[[2020,10,4]],"date-time":"2020-10-04T11:07:20Z","timestamp":1601809640000},"page":"e4-e17","source":"Crossref","is-referenced-by-count":28,"title":["A Case Series of Etizolam in Opioid-Related Deaths"],"prefix":"10.1093","volume":"45","author":[{"given":"Jirair","family":"Gevorkyan","sequence":"first","affiliation":[{"name":"Forensic Laboratory Division, Office of the Chief Medical Examiner, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliet","family":"Kinyua","sequence":"additional","affiliation":[{"name":"Forensic Laboratory Division, Office of the Chief Medical Examiner, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1501-112X","authenticated-orcid":false,"given":"Sue","family":"Pearring","sequence":"additional","affiliation":[{"name":"Forensic Laboratory Division, Office of the Chief Medical Examiner, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luke N","family":"Rodda","sequence":"additional","affiliation":[{"name":"Forensic Laboratory Division, Office of the Chief Medical Examiner, San Francisco, California, USA"},{"name":"Department of Laboratory Medicine, University of California, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,24]]},"reference":[{"key":"2021081406204300600_R1","first-page":"88","article-title":"Molecular and neurochemical evaluation of the effects of etizolam on GABAA receptors under normal and stress conditions","volume":"49","author":"Sanna","year":"1999","journal-title":"Arzneimittelforschung"},{"key":"2021081406204300600_R2","article-title":"National Forensic Laboratory Information sSystem: 2017 Annual Report","volume-title":"U.S. Drug Enforcement Administration, Diversion Control Division","year":"2017"},{"key":"2021081406204300600_R3","article-title":"National Forensic Laboratory Information System: 2018 Annual Report","volume-title":"U.S. Drug Enforcement Administration, Diversion Control Division","year":"2018"},{"key":"2021081406204300600_R4","article-title":"National Forensic Laboratory Information System: 2019 Midyear Report","volume-title":"U.S. Drug Enforcement Administration, Diversion Control Division","year":"2019"},{"key":"2021081406204300600_R5","article-title":"2020 Q1 NPS benzodiazepines trend report","author":"Center for Forensic Science Research and Education","year":"2020"},{"key":"2021081406204300600_R6","volume-title":"New South Wales Ministry of Health. 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