{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T19:26:17Z","timestamp":1783452377751,"version":"3.55.0"},"reference-count":22,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:p>Flualprazolam is a nonregistered drug in the benzodiazepine family and constitutes a new psychoactive substance (NPS). Since 2014, a growing number of designer benzodiazepines have become available over the Internet and on the counterfeit drug market. In June 2019, a cluster of patients intoxicated with flualprazolam was identified by the Oregon Poison Center. As an emerging drug of abuse, the clinical characteristics of flualprazolam have been poorly characterized thus far. Over a one-week period, 6 teenagers presented to local emergency departments after ingesting illegally obtained counterfeit alprazolam, which led to sedation. Other symptoms included slurred speech, confusion, and mild respiratory depression. All 6 patients had resolution of their symptoms within 6 hours of ingestion. Blood and urine samples, as well as a tablet fragment, were obtained from 3 patients. The tablet and biological samples were analyzed by using liquid chromatography\u2013quadrupole time-of-flight mass spectrometry and were found to contain the NPS flualprazolam without other drugs or intoxicants. With this case series, we add to the medical literature a clinical description of an emerging drug of abuse. Flualprazolam appears to share the clinical properties of other benzodiazepines. As flualprazolam and other NPSs become more common, physicians must be aware of their availability and characteristics. Sedation lasting &amp;lt;6 hours was observed in 6 of 6 patients exposed to flualprazolam. No effects that would be unexpected from benzodiazepine intoxication were seen among the patients. Specifically, none developed prolonged symptoms or required intubation and mechanical ventilation, ICU admission, or antidotal therapy.<\/jats:p>","DOI":"10.1542\/peds.2019-2953","type":"journal-article","created":{"date-parts":[[2020,6,24]],"date-time":"2020-06-24T12:25:11Z","timestamp":1593001511000},"source":"Crossref","is-referenced-by-count":27,"title":["Flualprazolam: Report of an Outbreak of a New Psychoactive Substance in Adolescents"],"prefix":"10.1542","volume":"146","author":[{"given":"Adam","family":"Blumenberg","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, School of Medicine, Oregon Health and Science University, Portland, Oregon; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne","family":"Hughes","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, School of Medicine, Oregon Health and Science University, Portland, Oregon; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Reckers","sequence":"additional","affiliation":[{"name":"Clinical Toxicology and Environmental Biomonitoring Laboratory, University of California, San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ross","family":"Ellison","sequence":"additional","affiliation":[{"name":"Clinical Toxicology and Environmental Biomonitoring Laboratory, University of California, San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Gerona","sequence":"additional","affiliation":[{"name":"Clinical Toxicology and Environmental Biomonitoring Laboratory, University of California, San Francisco, San Francisco, California"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2020,7,1]]},"reference":[{"issue":"7712","key":"2021121013151726700_B1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1038\/s41586-018-0255-3","article-title":"Structure of a human synaptic GABAA receptor","volume":"559","author":"Zhu","year":"2018","journal-title":"Nature"},{"key":"2021121013151726700_B2","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1007\/978-94-011-7238-7_3","volume-title":"Benzodiazepines: Today and Tomorrow","author":"Sternbach","year":"1980","edition":"1st ed"},{"key":"2021121013151726700_B3","volume-title":"Benzodiazepine Toxicity","author":"Kang","year":"2020"},{"issue":"3","key":"2021121013151726700_B4","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1002\/cpdd.667","article-title":"Designer benzodiazepines: a review of published data and public health significance","volume":"8","author":"Greenblatt","year":"2019","journal-title":"Clin Pharmacol Drug Dev"},{"key":"2021121013151726700_B5","unstructured":"United Nations Office on Drugs and Crime\n          . 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