{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T19:59:57Z","timestamp":1792699197839,"version":"4.5.0"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Drug and Alcohol Review"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Falsified alprazolam tablets (sometimes called \u2018counterfeit alprazolam\u2019) typically do not contain alprazolam and instead contain novel benzodiazepines or other drugs. We describe temporal changes in the number and contents of falsified alprazolam tablets in New South Wales, Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched a database of analysed police seizures between January 2012 and March 2024 for falsified alprazolam (tablet presenting as Kalma, Mylan, Xanax, Sandoz or Alprax brands, but not containing alprazolam and\/or contained other drugs). Falsified alprazolam tablets taken by patients presenting to NSW Health services for 5\u2009months in 2020 were also tested.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 809 falsified alprazolam tablet seizures, mostly Xanax (<jats:italic>n<\/jats:italic>\u2009=\u2009406, 50%) or Mylan (<jats:italic>n<\/jats:italic>\u2009=\u2009322, 40%) brands. The three most common drugs detected in falsified alprazolam tablets were the novel benzodiazepines etizolam (present in <jats:italic>n<\/jats:italic>\u2009=\u2009228 samples, 28%), clonazolam (<jats:italic>n<\/jats:italic>\u2009=\u2009224, 28%) and bromazolam (<jats:italic>n<\/jats:italic>\u2009=\u2009178, 22%). Of all falsified alprazolam tablets, only 70 (8.7%) contained alprazolam. There were rare detections of non\u2010benzodiazepine drugs including the opioids etodesnitazene and ortho\u2010desmethyltramadol.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion and Conclusions<\/jats:title><jats:p>Our analysis highlights the variability in contents of falsified alprazolam tablets over time. This report highlights the potential value of surveillance systems involving analysis of police seizure data as part of a drug early warning system. Our results are of interest to the community who take falsified alprazolam tablets, and to health care workers managing cases of poisoning or dependence. This study highlights the need to continue developing the ability to detect, assess and respond to emerging falsified products, to facilitate clinical and public health responses.<\/jats:p><\/jats:sec>","DOI":"10.1111\/dar.14068","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T12:44:13Z","timestamp":1748004253000},"page":"1449-1458","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Contents and Time\u2010Course of Falsified Alprazolam Detections in New South Wales, Australia"],"prefix":"10.1111","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8896-1188","authenticated-orcid":false,"given":"Janette L.","family":"Smith","sequence":"first","affiliation":[{"name":"Centre for Alcohol and Other Drugs NSW Ministry of Health  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thanjira","family":"Jiranantakan","sequence":"additional","affiliation":[{"name":"Centre for Alcohol and Other Drugs NSW Ministry of Health  Sydney Australia"},{"name":"NSW Poisons Information Centre Sydney Children's Hospitals Network  Sydney Australia"},{"name":"Edith Collins Centre Central Clinical School, Faculty of Medicine and Health, The University of Sydney  Sydney Australia"},{"name":"Faculty of Medicine and Health The University of Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Una","family":"Cullinan","sequence":"additional","affiliation":[{"name":"NSW Health Pathology, Forensic &amp; Analytical Science Service, Illicit Drug Analysis Unit  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Ewers","sequence":"additional","affiliation":[{"name":"NSW Health Pathology, Forensic &amp; Analytical Science Service, Illicit Drug Analysis Unit  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren M.","family":"Roberts","sequence":"additional","affiliation":[{"name":"NSW Poisons Information Centre Sydney Children's Hospitals Network  Sydney Australia"},{"name":"Edith Collins Centre Central Clinical School, Faculty of Medicine and Health, The University of Sydney  Sydney Australia"},{"name":"Faculty of Medicine and Health UNSW Sydney  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6855-3865","authenticated-orcid":false,"given":"Jared A.","family":"Brown","sequence":"additional","affiliation":[{"name":"Centre for Alcohol and Other Drugs NSW Ministry of Health  Sydney Australia"},{"name":"NSW Poisons Information Centre Sydney Children's Hospitals Network  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/dta.3119"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.forsciint.2022.111414"},{"key":"e_1_2_11_4_1","unstructured":"United Nations Office on Drugs and Crime \u201cFalsified Xanax Containing NPS Flualprazolam and Flubromazolam \u201d2021 https:\/\/www.unodc.org\/LSS\/Announcement\/Details\/bb1a14f0\u201075bb\u2010499e\u2010bba7\u2010984c72822370."},{"key":"e_1_2_11_5_1","unstructured":"NSW Health \u201cNon\u2010Pharmaceutical Grade (Counterfeit) Alprazolam Tablets Containing Etizolam \u201d2019 https:\/\/www.health.nsw.gov.au\/aod\/\/public\u2010drug\u2010alerts\/Pages\/counterfeit\u2010alprazolam\u2010etizolam.aspx."},{"key":"e_1_2_11_6_1","unstructured":"NSW Health \u201cPrescription Recreational and Illicit Substance Evaluation (PRISE) Program \u201d2024 https:\/\/www.health.nsw.gov.au\/aod\/programs\/Pages\/prise.aspx."},{"key":"e_1_2_11_7_1","unstructured":"NSW Ministry of Health \u201cDrug Warning \u2010 Counterfeit Alprazolam \u2010 Public Drug Warnings \u201d2020 https:\/\/www.health.nsw.gov.au\/aod\/public\u2010drug\u2010alerts\/Pages\/counterfeit\u2010alprazolam\u2010july.aspx."},{"key":"e_1_2_11_8_1","unstructured":"NSW Ministry of Health \u201cIllicit Supply of Counterfeit Alprazolam \u201d2020 https:\/\/www.health.nsw.gov.au\/sabs\/Documents\/2020\u2010sn\u2010007.pdf."},{"key":"e_1_2_11_9_1","unstructured":"NSW Ministry of Health \u201cIllicit Supply of Counterfeit Alprazolam Safety Notice 008\/20 \u201d2020 https:\/\/www.health.nsw.gov.au\/sabs\/Documents\/2020\u2010sn\u2010008.PDF."},{"key":"e_1_2_11_10_1","unstructured":"Department of Health Victoria \u201cHigh Potency Benzodiazepine Tablets \u201d2022 https:\/\/www.health.vic.gov.au\/drug\u2010alerts\/high\u2010potency\u2010benzodiazepine\u2010tablets."},{"key":"e_1_2_11_11_1","unstructured":"Therapeutic Goods Administration (TGA) \u201cCounterfeit Alprazolam 2mg and Kalma 2 Tablets \u201d2020 https:\/\/www.tga.gov.au\/news\/safety\u2010alerts\/counterfeit\u2010alprazolam\u20102mg\u2010and\u2010kalma\u20102\u2010tablets."},{"key":"e_1_2_11_12_1","unstructured":"DanceWize NSW \u201cBenzos and Fake Benzos: What do You Need to Know?\u201d2022 Factsheet https:\/\/www.dancewizensw.org.au\/latest\u2010news\/2021\/7\/15\/benzos\u2010and\u2010fake\u2010benzos\u2010factsheet."},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108300"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000001775"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2016.4306"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2019-2953"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/dta.2884"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00414-020-02352-7"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40120-024-00628-3"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2023.2183105"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000606"},{"key":"e_1_2_11_22_1","unstructured":"European Monitoring Centre for Drugs and Drug Addiction \u201cNew Benzodiazepines in Europe \u2013 A Review. 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