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In this study we investigated how street BZDs contribute to overall BZD use and death prevalences in England, Wales and Northern Ireland.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were analysed from deaths reported to the National Programme on Substance Use Mortality with post\u2010mortem BZD detections (1999\u20132021), BZDs seized from music festivals (2017\u20132021) and drug samples with BZD detections submitted to Welsh Emerging Drugs and Identification of Novel Substances (WEDINOS) (2017\u20132021).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>About 14,837 deaths with BZD detections were identified, with polydrug use evident in 99.3% of cases (<jats:italic>n<\/jats:italic>\u2009=\u200914,733\/14,837). Deaths following BZD use increased by over 200% from 2010 (<jats:italic>n<\/jats:italic>\u2009=\u2009556) to 2020 (<jats:italic>n<\/jats:italic>\u2009=\u20091245). Most BZD detections were of those available via NHS prescription (96.2%), although in most cases (61.9%) the BZD\u2014majority diazepam (77.3% of detections)\u2014had been illicitly sourced. While street BZD deaths represented only 8.5% of overall BZD deaths, street BZD deaths increased by over 1200% between 2015 (<jats:italic>n<\/jats:italic>\u2009=\u200926) and 2020 (<jats:italic>n<\/jats:italic>\u2009=\u2009326). There were increasing proportions of street BZD deaths in each geographical region but was more marked in Northern Ireland. The proportion of individual BZDs seized at music festivals and submitted to WEDINOS largely reflected that of individual BZDs detected in deaths.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>While deaths following street BZD use are increasing, most BZDs detected in deaths were prescribable BZDs that were often illicitly sourced. The types of BZD detected in post\u2010mortem samples, festival seizures and WEDINOS submissions has evolved over time to reflect changes in BZD prevalence on the illicit drug market.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.13979","type":"journal-article","created":{"date-parts":[[2024,11,29]],"date-time":"2024-11-29T06:24:02Z","timestamp":1732861442000},"page":"355-365","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Impact of \u2018street\u2019 benzodiazepines on drug\u2010related deaths in England, Wales and Northern Ireland"],"prefix":"10.1111","volume":"44","author":[{"given":"Kirsten L.","family":"Rock","sequence":"first","affiliation":[{"name":"Institute of Pharmaceutical Science, King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anca","family":"Frinculescu","sequence":"additional","affiliation":[{"name":"TICTAC Communications Limited  London UK"},{"name":"Department of Analytical, Environmental and Forensic Sciences King's College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trevor","family":"Shine","sequence":"additional","affiliation":[{"name":"TICTAC Communications Limited  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola J.","family":"Kalk","sequence":"additional","affiliation":[{"name":"South London and Maudsley NHS Foundation Trust  London UK"},{"name":"Addictions Department Institute of Psychology, Psychiatry and Neuroscience, King's College London  London UK"},{"name":"National Programme on Substance Abuse Deaths  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4462-1402","authenticated-orcid":false,"given":"Caroline S.","family":"Copeland","sequence":"additional","affiliation":[{"name":"Institute of Pharmaceutical Science, King's College London  London UK"},{"name":"National Programme on Substance Abuse Deaths  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,11,28]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/2045125320967197"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/dar.13052"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/dta.2211"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0741-8329(90)90017-7"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/164_2018_154"},{"key":"e_1_2_11_7_1","first-page":"463","article-title":"Pharmacokinetics, pharmacodynamics, and treatment issues of benzodiazepines: alprazolam, adinazolam, and clonazepam","volume":"27","author":"DeVane CL","year":"1991","journal-title":"Psychopharmacol Bull"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00280074"},{"key":"e_1_2_11_9_1","unstructured":"ACMD.Novel benzodiazepines: a review of the evidence of use and harms of novel benzodiazepines.2020."},{"key":"e_1_2_11_10_1","volume-title":"Rang and Dale's pharmacology","author":"Ritter J","year":"2019"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000350"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11419-020-00565-4"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/dta.2203"},{"key":"e_1_2_11_14_1","unstructured":"Deaths related to drug poisoning in England and Wales: 2022 registrations. 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