{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:17:00Z","timestamp":1792725420269,"version":"4.5.0"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T00:00:00Z","timestamp":1674777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,14]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Bromazolam is a designer benzodiazepine that was first detected in British Columbia in January 2021. Postmortem cases were analyzed using a comprehensive blood drug screening procedure by liquid chromatography\u2013high-resolution mass spectrometry before being retrospectively analyzed using an in-house novel psychoactive substances data processing method. Bromazolam was detected in 41 postmortem cases in 2021 and quantitatively confirmed by standard addition, using liquid chromatography\u2013tandem mass spectrometry. The mean bromazolam concentration observed was 11.4\u2009\u00b1\u200953.7\u2009ng\/mL (median concentration: 1.6\u2009ng\/mL), with a range from 0.5 to 319.3\u2009ng\/mL and the majority of cases co-occurring with fentanyl. These low concentrations may be indicative of a presumed enhancement of opioid effects, rather than being used as a stand-alone drug. Bromazolam was always detected with opioids (fentanyl and carfentanil), stimulants (methamphetamine) and\/or other benzodiazepines (etizolam and flualprazolam). To our knowledge, this is the first report to provide concentrations of bromazolam in postmortem blood samples in Canada.<\/jats:p>","DOI":"10.1093\/jat\/bkad005","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T10:49:27Z","timestamp":1675075767000},"page":"385-392","source":"Crossref","is-referenced-by-count":39,"title":["Bromazolam Blood Concentrations in Postmortem Cases\u2014A British Columbia Perspective"],"prefix":"10.1093","volume":"47","author":[{"given":"Sandrine A M","family":"M\u00e9rette","sequence":"first","affiliation":[{"name":"Provincial Toxicology Centre, Provincial Health Services Authority , 655 West 12th Avenue, Vancouver, British Columbia V5Z 4R4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Th\u00e9riault","sequence":"additional","affiliation":[{"name":"Provincial Toxicology Centre, Provincial Health Services Authority , 655 West 12th Avenue, Vancouver, British Columbia V5Z 4R4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei E C","family":"Piramide","sequence":"additional","affiliation":[{"name":"Provincial Toxicology Centre, Provincial Health Services Authority , 655 West 12th Avenue, Vancouver, British Columbia V5Z 4R4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael D","family":"Davis","sequence":"additional","affiliation":[{"name":"British Columbia Coroner Services, Metrotown II Suite 800 , 4720 Kingsway, Burnaby, British Columbia V5H 4N2, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron M","family":"Shapiro","sequence":"additional","affiliation":[{"name":"Provincial Toxicology Centre, Provincial Health Services Authority , 655 West 12th Avenue, Vancouver, British Columbia V5Z 4R4, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,1,27]]},"reference":[{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1097\/01.yco.0000165594.60434.84","article-title":"The diagnosis and management of benzodiazepine dependence","volume":"18","author":"Ashton","year":"2005","journal-title":"Current Opinion in Psychiatry"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1177\/0033354919887741","article-title":"The emerging role of toxic adulterants in street drugs in the US illicit opioid crisis","volume":"135","author":"Singh","year":"2020","journal-title":"Public Health Reports"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1177\/003335491613100315","article-title":"The impact of benzodiazepine use on mortality among polysubstance users in Vancouver, Canada","volume":"131","author":"Walton","year":"2016","journal-title":"Public Health Reports"},{"key":"2023041410543887200_","article-title":"New Benzodiazepines in Europe \u2013 A Review","volume-title":"EMCDDA","author":"EMCDDA","year":"2021"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"809","DOI":"10.2174\/1570159X18666200110121333","article-title":"\u2018New\/Designer Benzodiazepines\u2019: an analysis of the literature and psychonauts\u2019 trip reports","volume":"18","author":"Orsolini","year":"2020","journal-title":"Current Neuropharmacology"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.1093\/jat\/bkaa146","article-title":"A case series of etizolam in opioid-related deaths","volume":"45","author":"Gevorkyan","year":"2021","journal-title":"Journal of Analytical Toxicology"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"399","DOI":"10.1159\/000516165","article-title":"Explaining the differences in opioid overdose deaths between Scotland and England\/Wales: implications for European opioid policies","volume":"27","author":"Van Amsterdam","year":"2021","journal-title":"European Addiction Research"},{"key":"2023041410543887200_","article-title":"Illicit Drug Toxicity Type of Drug Data to December 31","author":"BC Coroners Service","year":"2021"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1002\/dta.2211","article-title":"The emergence of new psychoactive substance (NPS) benzodiazepines: A review","volume":"10","author":"Manchester","year":"2018","journal-title":"Drug Testing and Analysis"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1111\/j.1365-2125.2004.02089.x","article-title":"Alprazolam is relatively more toxic than other benzodiazepines in overdose","volume":"58","author":"Isbister","year":"2004","journal-title":"British Journal of Clinical Pharmacology"},{"key":"2023041410543887200_","article-title":"Controlled Drugs and Substances Act (S.C. 1996, c. 19)"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1021\/jm00197a021","article-title":"6-Aryl-4-H-s-triazolo [4,3-a][1,4] benzodiazepines. Influence of 1-Substitution on Pharmacological Activity.","volume":"22","author":"Hester","year":"1979","journal-title":"Journal of Medicinal Chemistry"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2015\/430248","article-title":"A review of the updated pharmacophore for the alpha 5 GABA(A) benzodiazepine receptor model","author":"Clayton","year":"2015","journal-title":"International Journal of Medicinal Chemistry"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1111\/j.1527-3458.2004.tb00003.x","article-title":"Clinical pharmacology, clinical efficacy, and behavioral toxicity of alprazolam: a review of the literature","volume":"10","author":"Verster","year":"2004","journal-title":"CNS Drug Reviews"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1097\/ADM.0000000000000350","article-title":"A review of alprazolam use, misuse, and withdrawal","volume":"12","author":"Ait-Daoud","year":"2018","journal-title":"Journal of Addiction Medicine"},{"key":"2023041410543887200_","article-title":"New drugs on the block: spring 2022 line-up","volume-title":"ToxTalk","author":"Ellefsen","year":"2022"},{"key":"2023041410543887200_","author":"Drugsdata.org","year":"2021"},{"key":"2023041410543887200_","article-title":"Illicit Drug Toxicity Deaths in B.C. January 1, 2011 - December 31, 2021","author":"BC Coroners Service","year":"2021"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1093\/jat\/bkaa016","article-title":"Isotonitazene quantitation and metabolite discovery in authentic forensic casework","volume":"44","author":"Krotulski","year":"2020","journal-title":"Journal of Analytical Toxicology"},{"key":"2023041410543887200_","first-page":"1","article-title":"Drug overdose deaths in the United States, 1999-2020","volume":"426","author":"Hedegaard","year":"2021","journal-title":"NCHS Data Brief"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1016\/j.drugpo.2017.06.004","article-title":"Heroin uncertainties: exploring users\u2019 perceptions of fentanyl-adulterated and -substituted \u2018heroin\u2019","volume":"46","author":"Ciccarone","year":"2017","journal-title":"International Journal of Drug Policy"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"532","DOI":"10.1111\/bph.12696","article-title":"In vivo profiling of seven common opioids for antinociception, constipation and respiratory depression: no two opioids have the same profile","volume":"172","author":"Kuo","year":"2015","journal-title":"British Journal of Pharmacology"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/j.drugpo.2017.05.016","article-title":"High enhancer, downer, withdrawal helper: Multifunctional nonmedical benzodiazepine use among young adult opioid users in New York City","volume":"46","author":"Mateu-Gelabert","year":"2017","journal-title":"International Journal of Drug Policy"},{"key":"2023041410543887200_","article-title":"Bromazolam: Monitoring the Increasing Prevalence of an Emergent Designer Benzodiazepine","author":"Papsun","year":"2021"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.drugpo.2021.103169","article-title":"An outbreak of novel psychoactive substance benzodiazepines in the unregulated drug supply: Preliminary results from a community drug checking program using point-of-care and confirmatory methods","volume":"93","author":"Laing","year":"2021","journal-title":"International Journal of Drug Policy"},{"key":"2023041410543887200_","article-title":"Harm Reduction Program, B.C. for D.C. Naloxone | Toward the Heart"},{"key":"2023041410543887200_","article-title":"Naloxone Hydrochloride","author":"Prescribers\u2019 Digital Reference","year":"2020"},{"key":"2023041410543887200_","first-page":"177","article-title":"Potent sedatives in opioids in bc: Implications for resuscitation, and benzodiazepine and etizolam withdrawal","volume":"63","author":"Purssell","year":"2021","journal-title":"British Columbia Medical Journal"},{"key":"2023041410543887200_","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13011-019-0195-4","article-title":"Higher doses of naloxone are needed in the synthetic opioid era","volume":"14","author":"Moss","year":"2019","journal-title":"Substance Abuse Treatment, Prevention, and Policy"}],"container-title":["Journal of Analytical Toxicology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jat\/advance-article-pdf\/doi\/10.1093\/jat\/bkad005\/49422898\/bkad005.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jat\/article-pdf\/47\/4\/385\/49897440\/bkad005.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jat\/article-pdf\/47\/4\/385\/49897440\/bkad005.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T17:56:36Z","timestamp":1701798996000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jat\/article\/47\/4\/385\/7008721"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,27]]},"references-count":29,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,1,27]]},"published-print":{"date-parts":[[2023,4,14]]}},"URL":"https:\/\/doi.org\/10.1093\/jat\/bkad005","relation":{},"ISSN":["0146-4760","1945-2403"],"issn-type":[{"value":"0146-4760","type":"print"},{"value":"1945-2403","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,5,1]]},"published":{"date-parts":[[2023,1,27]]}}}