{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T03:16:58Z","timestamp":1792725418689,"version":"4.5.0"},"reference-count":159,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T00:00:00Z","timestamp":1623369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>The rising use of designer benzodiazepines (DBZD) is a cat-and-mouse game between organized crime and law enforcement. Non-prohibited benzodiazepines are introduced onto the global drug market and scheduled as rapidly as possible by international authorities. In response, DBZD are continuously modified to avoid legal sanctions and drug seizures and generally to increase the abuse potential of the DBZD. This results in an unpredictable fluctuation between the appearance and disappearance of DBZD in the illicit market. Thirty-one DBZD were considered for review after consulting the international early warning database, but only 3-hydroxyphenazepam, adinazolam, clonazolam, etizolam, deschloroetizolam, diclazepam, flualprazolam, flubromazepam, flubromazolam, meclonazepam, phenazepam and pyrazolam had sufficient data to contribute to this scoping review. A total of 49 reports describing 1 drug offense, 2 self-administration studies, 3 outpatient department admissions, 44 emergency department (ED) admissions, 63 driving under the influence of drugs (DUID) and 141 deaths reported between 2008 and 2021 are included in this study. Etizolam, flualprazolam flubromazolam and phenazepam were implicated in the majority of adverse-events, drug offenses and deaths. However, due to a general lack of knowledge of DBZD pharmacokinetics and toxicity, and due to a lack of validated analytical methods, total cases are much likely higher. Between 2019 and April 2020, DBZD were identified in 48% and 83% of postmortem and DUID cases reported to the UNODC, respectively, with flualprazolam, flubromazolam and etizolam as the most frequently detected substances. DBZD toxicology, public health risks and adverse events are reported.<\/jats:p>","DOI":"10.3390\/ph14060560","type":"journal-article","created":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T12:44:37Z","timestamp":1623415477000},"page":"560","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":89,"title":["Designer Benzodiazepines: A Review of Toxicology and Public Health Risks"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5271-7773","authenticated-orcid":false,"given":"Pietro","family":"Brunetti","sequence":"first","affiliation":[{"name":"Department of Excellence of Biomedical Sciences and Public Health, Marche Polytechnic University of Ancona, Via Tronto 10, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2399-0396","authenticated-orcid":false,"given":"Raffaele","family":"Giorgetti","sequence":"additional","affiliation":[{"name":"Department of Excellence of Biomedical Sciences and Public Health, Marche Polytechnic University of Ancona, Via Tronto 10, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4434-0475","authenticated-orcid":false,"given":"Adriano","family":"Tagliabracci","sequence":"additional","affiliation":[{"name":"Department of Excellence of Biomedical Sciences and Public Health, Marche Polytechnic University of Ancona, Via Tronto 10, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2137-4645","authenticated-orcid":false,"given":"Marilyn","family":"Huestis","sequence":"additional","affiliation":[{"name":"Institute of Emerging Health Professions, Thomas Jefferson University, 1020 Walnut St., Philadelphia, PA 19144, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Busard\u00f2","sequence":"additional","affiliation":[{"name":"Department of Excellence of Biomedical Sciences and Public Health, Marche Polytechnic University of Ancona, Via Tronto 10, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1007\/s11419-015-0277-6","article-title":"Characterization of the four designer benzodiazepines clonazolam, deschloroetizolam, flubromazolam, and meclonazepam, and identification of their in vitro metabolites","volume":"33","author":"Huppertz","year":"2015","journal-title":"Forensic Toxicol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.jpba.2018.06.039","article-title":"Determination of benzodiazepines in pericardial fluid by gas chromatography\u2013mass spectrometry","volume":"159","author":"Brunetti","year":"2018","journal-title":"J. Pharm. Biomed. Anal."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1097\/FTD.0b013e31819f3328","article-title":"Pharmacokinetics and therapeutic drug monitoring of psychotropic drugs in pediatrics","volume":"31","author":"Pichini","year":"2009","journal-title":"Ther. Drug Monit."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1007\/BF00431795","article-title":"Initial study of methylclonazepam in generalized anxiety disorder\u2014Evidence for greater power in the cross-over design","volume":"87","author":"Ansseau","year":"1985","journal-title":"Psychopharmacology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11419-016-0338-5","article-title":"Metabolites replace the parent drug in the drug arena. The cases of fonazepam and nifoxipam","volume":"35","author":"Katselou","year":"2017","journal-title":"Forensic Toxicol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1007\/164_2019_260","article-title":"Newly emerging drugs of abuse","volume":"258","author":"Tamama","year":"2020","journal-title":"Handb. Exp. Pharmacol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"k3208","DOI":"10.1136\/bmj.k3208","article-title":"Tackling benzodiazepine misuse","volume":"362","author":"Hayhoe","year":"2018","journal-title":"BMJ"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1002\/ana.410250302","article-title":"Differential regulation of \u03b3-aminobutyric acid receptor channels by diazepam and phenobarbital","volume":"25","author":"Twyman","year":"1989","journal-title":"Ann. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1016\/j.tips.2018.03.006","article-title":"The Benzodiazepine Binding Sites of GABAA Receptors","volume":"39","author":"Sigel","year":"2018","journal-title":"Trends Pharmacol. Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1038\/s41586-020-2654-5","article-title":"Shared structural mechanisms of general anaesthetics and benzodiazepines","volume":"585","author":"Kim","year":"2020","journal-title":"Nature"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Guina, J., and Merrill, B. (2018). Benzodiazepines I: Upping the Care on Downers: The Evidence of Risks, Benefits and Alternatives. J. Clin. Med., 7.","DOI":"10.3390\/jcm7020017"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Va\u0161kov\u00e1, J., and Va\u0161ko, L. (2019). 1,4-Benzodiazepines and New Derivatives: Description, Analysis, and Organic Synthesis. Medicinal Chemistry, IntechOpen.","DOI":"10.5772\/intechopen.76494"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1111\/j.1600-0447.1978.tb02395.x","article-title":"The abuse potential of benzodiazepines with special reference to oxazepam","volume":"58","author":"Bliding","year":"1978","journal-title":"Acta Psychiatr. Scand."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1176\/appi.ps.201700095","article-title":"Long-term use of benzodiazepines and nonbenzodiazepine hypnotics, 1999\u20132014","volume":"69","author":"Kaufmann","year":"2018","journal-title":"Psychiatr. Serv."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1401","DOI":"10.1001\/jama.1979.03300130045021","article-title":"Benzodiazepines: Dependence and withdrawal","volume":"242","author":"Ayd","year":"1979","journal-title":"JAMA"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"S399","DOI":"10.1016\/S0924-977X(99)00051-6","article-title":"Limitations on the use of benzodiazepines in anxiety and insomnia: Are they justified?","volume":"9","author":"Lader","year":"1999","journal-title":"Eur. Neuropsychopharmacol."},{"key":"ref_17","first-page":"a501","article-title":"Benzodiazepines revisited","volume":"5","author":"Mehdi","year":"2012","journal-title":"BJMP"},{"key":"ref_18","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":"Curr. Opin. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"538","DOI":"10.4140\/TCP.n.2013.538","article-title":"The history of benzodiazepines","volume":"28","author":"Wick","year":"2013","journal-title":"Consult. Pharm."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/0278-5846(92)90003-W","article-title":"International regulation of benzodiazepine","volume":"16","author":"Khan","year":"1992","journal-title":"Prog. Neuro Psychopharmacol. Biol. Psychiatry"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1038\/clpt.1982.22","article-title":"Lack of effect of diazepam on methadone metabolism in methadone-maintained addicts","volume":"31","author":"Pond","year":"1982","journal-title":"Clin. Psychopharmacol. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"843","DOI":"10.3109\/10826087509027342","article-title":"Misuse and abuse of diazepam: An increasingly common medical problem","volume":"10","author":"Woody","year":"1975","journal-title":"Int. J. Addict."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/0740-5472(91)90027-8","article-title":"History of benzodiazepine dependence","volume":"8","author":"Lader","year":"1991","journal-title":"J. Subst. Abuse Treat."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"110A","DOI":"10.1097\/00002826-199201001-00060","article-title":"Benzodiazepines and other psychotropic drugs abused by patients in a methadone maintenance program: Familiarity and preference","volume":"15","author":"Barnas","year":"1992","journal-title":"Clin. Neuropharmacol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/0376-8716(93)90092-5","article-title":"The dual use of opioids and temazepam by drug injectors in Glasgow (Scotland)","volume":"32","author":"Forsyth","year":"1993","journal-title":"Drug Alcohol Depend."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Gautam, L., Sharratt, S.D., and Cole, M.D. (2014). Drug facilitated sexual assault: Detection and stability of benzodiazepines in spiked drinks using gas chromatography-mass spectrometry. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0089031"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e187399","DOI":"10.1001\/jamanetworkopen.2018.7399","article-title":"Patterns in Outpatient Benzodiazepine Prescribing in the United States","volume":"2","author":"Agarwal","year":"2019","journal-title":"JAMA Netw. Open"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1111\/bcpt.12655","article-title":"The Pharmacology and Toxicology of the \u2018Holy Trinity\u2019","volume":"120","author":"Horsfall","year":"2017","journal-title":"Basic Clin. Pharmacol. Toxicol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1111\/add.15095","article-title":"Benzodiazepines: The time for systematic change is now","volume":"116","author":"Schmitz","year":"2021","journal-title":"Addiction"},{"key":"ref_30","unstructured":"UNODC (2020, December 08). Global SMART Update Volume 18. Non-Medical Use of Benzodiazepines: A Growing Threat to Public Health?. Available online: https:\/\/www.unodc.org\/documents\/scientific\/Global_SMART_Update_2017_Vol_18.pdf."},{"key":"ref_31","unstructured":"EMCDDA (2020, December 01). The Misuse of Benzodiazepines among High-Risk Opioid Users in Europe. Available online: http:\/\/www.emcdda.europa.eu\/system\/files\/publications\/2733\/Misuse of benzos_POD2015.pdf."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.neuro.2019.02.015","article-title":"An expanding world of new psychoactive substances-designer benzodiazepines","volume":"73","author":"Zawilska","year":"2019","journal-title":"Neurotoxicology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"4967","DOI":"10.1007\/s00216-018-1147-y","article-title":"Rapid determination of designer benzodiazepines, benzodiazepines, and Z-hypnotics in whole blood using parallel artificial liquid membrane extraction and UHPLC-MS\/MS","volume":"410","author":"Wong","year":"2018","journal-title":"Anal. Bioanal. Chem."},{"key":"ref_34","first-page":"41","article-title":"Testing for Betel Nut Alkaloids in Hair of Papuans Abusers using UPLC-MS\/MS and UPLC-Q-Tof-MS","volume":"44","author":"Gheddar","year":"2020","journal-title":"J. Anal. Toxicol."},{"key":"ref_35","first-page":"264","article-title":"Quinazolines and 1,4-benzodiazepines XVII. Synthesis of 1,3-dihydro-5-pyridyl-2H-1,4-benzodiazepine derivatives","volume":"53","author":"Fryer","year":"1964","journal-title":"J. Pharm. Sci."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1021\/jm00339a010","article-title":"Quinazolines and 1,4-Benzodiazepines. X.\u2019 Nitro-Substituted 5-Phenyl-1,4-benzodiazepine Derivatives","volume":"6","author":"Sternbach","year":"1963","journal-title":"J. Med. Chem."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/978-3-540-74806-9_16","article-title":"Midazolam and other benzodiazepines","volume":"182","author":"Olkkola","year":"2008","journal-title":"Handb. Exp. Pharmacol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1124\/pr.117.014381","article-title":"Drugs for insomnia beyond benzodiazepines: Pharmacology, clinical applications, and discovery","volume":"70","author":"Atkin","year":"2018","journal-title":"Pharmacol. Rev."},{"key":"ref_39","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":"ref_40","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.scijus.2017.12.004","article-title":"The use of a quantitative structure-activity relationship (QSAR) model to predict GABA-A receptor binding of newly emerging benzodiazepines","volume":"58","author":"Waters","year":"2018","journal-title":"Sci. Justice"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1021","DOI":"10.1177\/0269881119901096","article-title":"Designer benzodiazepines\u2019 pharmacological effects and potencies: How to find the information","volume":"34","author":"Monchaud","year":"2020","journal-title":"J. Psychopharmacol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"794","DOI":"10.2215\/CJN.13341019","article-title":"Benzodiazepines, codispensed opioids, and mortality among patients initiating long-term in-center hemodialysis","volume":"15","author":"Muzaale","year":"2020","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"697","DOI":"10.1016\/j.mcna.2018.02.010","article-title":"New and Emerging Illicit Psychoactive Substances","volume":"102","author":"Graddy","year":"2018","journal-title":"Med. Clin. N. Am."},{"key":"ref_44","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":"Curr. Neuropharmacol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1016\/j.psym.2019.02.007","article-title":"Novel Ways to Acquire Designer Benzodiazepines: A Case Report and Discussion of the Changing Role of the Internet","volume":"60","author":"Shapiro","year":"2019","journal-title":"Psychosomatics"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"bcr2018224995","DOI":"10.1136\/bcr-2018-224995","article-title":"Novel psychoactive substances: Overdose of 3-fluorophenmetrazine (3-FPM) and etizolam in a 33-year-old man","volume":"2018","author":"Benesch","year":"2018","journal-title":"BMJ Case Rep."},{"key":"ref_47","unstructured":"UNODC (2020, September 18). World Drug Report 2019\u2014Booklet 3: Depressants. Available online: https:\/\/wdr.unodc.org\/wdr2019\/prelaunch\/WDR19_Booklet_3_DEPRESSANTS.pdf."},{"key":"ref_48","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 Test. Anal."},{"key":"ref_49","unstructured":"EMCDDA (2020, December 15). Europol 2013 Annual Report on the Implementation of Council Decision 2005\/387\/JHA. Available online: http:\/\/www.emcdda.europa.eu\/attachements.cfm\/att_229598_EN_TDAN14001ENN.pdf."},{"key":"ref_50","unstructured":"EMCDDA (2020, December 15). Europol 2014 Annual Report on the Implementation of Council Decision 2005\/387\/JHA. Available online: https:\/\/www.emcdda.europa.eu\/system\/files\/publications\/1018\/TDAN15001ENN.pdf."},{"key":"ref_51","unstructured":"EMCDDA (2020, December 15). Europol 2015 Annual Report on the Implementation of Council Decision 2005\/387\/JHA. Available online: https:\/\/www.emcdda.europa.eu\/system\/files\/publications\/2880\/TDAS16001ENN.pdf."},{"key":"ref_52","unstructured":"EMCDDA (2020, December 16). Europol 2016 Annual Report on the Implementation of Council Decision 2005\/387\/JHA. Available online: http:\/\/www.emcdda.europa.eu\/system\/files\/publications\/4724\/TDAN17001ENN_PDFWEB.pdf."},{"key":"ref_53","unstructured":"EMCDDA (2020, December 16). Europol 2017 Annual Report on the Implementation of Council Decision 2005\/387\/JHA. Available online: https:\/\/www.emcdda.europa.eu\/system\/files\/publications\/9282\/20183924_TDAN18001ENN_PDF.pdf."},{"key":"ref_54","unstructured":"UNODC (2021, January 01). Global Synthetic Drugs Assessment 2020\u2014Regional Overviews. Available online: https:\/\/www.unodc.org\/documents\/scientific\/Global_Synthetic_Drugs_Assessment_2020.pdf."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"3637","DOI":"10.1039\/D0AY00560F","article-title":"Determination of prescribed and designer benzodiazepines and metabolites in influent wastewater","volume":"12","author":"Bade","year":"2020","journal-title":"Anal. Methods"},{"key":"ref_56","unstructured":"NSW Government (2021, April 25). Public Drug Warnings 2021: Non-Pharmaceutical Grade (Counterfeit) Alprazolam Tablets Containing Etizolam, Available online: https:\/\/www.health.nsw.gov.au\/aod\/\/public-drug-alerts\/Pages\/drug-warning-counterfeit-alprazolam.aspx."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.pbb.2008.01.001","article-title":"Abuse and dependence liability of benzodiazepine-type drugs: GABAA receptor modulation and beyond","volume":"90","author":"Licata","year":"2008","journal-title":"Pharmacol. Biochem. Behav."},{"key":"ref_58","unstructured":"EMCDDA (2021, February 15). Euroean Drug Report 2020: Key Issues. Available online: https:\/\/www.emcdda.europa.eu\/system\/files\/publications\/13238\/TD0420439ENN.pdf."},{"key":"ref_59","unstructured":"NFLIS (2021, February 24). Drug 2018 Annual Report, Available online: https:\/\/www.nflis.deadiversion.usdoj.gov\/DesktopModules\/ReportDownloads\/Reports\/NFLIS-Drug-AR2018.pdf."},{"key":"ref_60","unstructured":"NFLIS (2021, February 24). Drug 2019 Annual Report, Available online: https:\/\/www.nflis.deadiversion.usdoj.gov\/DesktopModules\/ReportDownloads\/Reports\/NFLIS-Drug-AR2019.pdf."},{"key":"ref_61","unstructured":"DEA (2021, February 24). Emerging Threat Report: Annual 2018, Available online: https:\/\/cesar.umd.edu\/sites\/cesar.umd.edu\/files\/pubs\/DEA-Emerging-Threat-Report-2018-Annual.pdf."},{"key":"ref_62","unstructured":"DEA (2021, February 23). Emerging Threat Report: Annual 2019, Available online: https:\/\/cesar.umd.edu\/sites\/cesar.umd.edu\/files\/pubs\/DEA-Emerging-Threat-Report-2019-Annual.pdf."},{"key":"ref_63","unstructured":"UNODC (2020, September 18). World Drug Report 2019\u2014Booklet 5: Cannabis and Hallucinogens. Available online: https:\/\/wdr.unodc.org\/wdr2019\/prelaunch\/WDR19_Booklet_5_CANNABIS_HALLUCINOGENS.pdf."},{"key":"ref_64","unstructured":"EMCDDA (2021, March 03). Euroean Drug Report 2020: Trends and Developments. Available online: https:\/\/www.emcdda.europa.eu\/system\/files\/publications\/13236\/TDAT20001ENN_web.pdf."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"700","DOI":"10.3389\/fpsyt.2020.00700","article-title":"New Trends of Substance Abuse During COVID-19 Pandemic: An International Perspective","volume":"11","author":"Zaami","year":"2020","journal-title":"Front. Psychiatry"},{"key":"ref_66","first-page":"116","article-title":"Letter Increasing diversion of prescribed benzodiazepines and Z-drugs to new psychoactive substances","volume":"172","author":"Graziano","year":"2021","journal-title":"Clin. Ter."},{"key":"ref_67","doi-asserted-by":"crossref","unstructured":"Brunetti, P., Pirani, F., Carlier, J., Giorgetti, R., Busard\u00f2, F.P., and Lo Faro, A.F. (2020). A 2017\u20132019 Update on Acute Intoxications and Fatalities from Illicit Fentanyl and Analogs. J. Anal. Toxicol., bkaa115.","DOI":"10.1093\/jat\/bkaa115"},{"key":"ref_68","unstructured":"EMCDDA (2021, February 26). Trendspotter Briefing: Impact of COVID-19 on Patterns of Drug Use and Drug-Related Harms in Europe. Available online: https:\/\/www.emcdda.europa.eu\/system\/files\/publications\/13130\/EMCDDA-Trendspotter-Covid-19-Wave-2_1.pdf."},{"key":"ref_69","unstructured":"CFSRE (2021, January 21). NPS Benzodiazepines in the United States\u2014Trend Report: Q2. Available online: https:\/\/www.npsdiscovery.org\/wp-content\/uploads\/2020\/07\/2020-Q2_NPS-Benzodiazepines_Trend-Report_rev.pdf."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1186\/s13011-020-00260-y","article-title":"Benzodiazepines in the oral fluid of Spanish drivers","volume":"15","year":"2020","journal-title":"Subst. Abus. Treat. Prev. Policy"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1093\/jat\/bkaa050","article-title":"Driving Impairment Cases Involving Etizolam and Flubromazolam","volume":"45","author":"Rohrig","year":"2021","journal-title":"J. Anal. Toxicol."},{"key":"ref_72","unstructured":"UNODC (2021, March 25). Current NPS Threats Volume III. Available online: https:\/\/www.unodc.org\/documents\/scientific\/Current_NPS_Threats_Vol.3.pdf."},{"key":"ref_73","unstructured":"UNODC (2021, April 25). Early Warning Advisory: List of Announcements. Available online: https:\/\/www.unodc.org\/LSS\/Announcement?type=NPS."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1080\/15563650.2018.1506130","article-title":"Occurrence and time course of NPS benzodiazepines in Sweden\u2013results from intoxication cases in the STRIDA project","volume":"57","author":"Beck","year":"2019","journal-title":"Clin. Toxicol."},{"key":"ref_75","doi-asserted-by":"crossref","unstructured":"Nowak, K., Szpot, P., and Zawadzki, M. (2021). Fatal intoxication with U-47700 in combination with other NPS (N-ethylhexedrone, adinazolam, 4-CIC, 4-CMC) confirmed by identification and quantification in autopsy specimens and evidences. Forensic Toxicol.","DOI":"10.1007\/s11419-020-00568-1"},{"key":"ref_76","first-page":"1037","article-title":"Co-occurring Addiction of Synthetic Benzodiazepine Clonazolam and Propylhexedrine presenting as Acute Brief Psychosis","volume":"5","author":"Ghazi","year":"2017","journal-title":"J. Addict. Med. Ther."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1080\/24734306.2019.1661568","article-title":"Clonazolam: A novel liquid benzodiazepine","volume":"3","author":"Murphy","year":"2019","journal-title":"Toxicol. Commun."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1111\/1556-4029.13903","article-title":"Near-fatal Intoxication with the \u201cNew\u201d Synthetic Opioid U-47700: The First Reported Case in the Czech Republic","volume":"64","author":"Horsley","year":"2019","journal-title":"J. Forensic Sci."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1093\/jat\/bky092","article-title":"A liquid-chromatography high-resolution mass spectrometry method for non-FDA approved benzodiazepines","volume":"43","author":"Yun","year":"2019","journal-title":"J. Anal. Toxicol."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"110237","DOI":"10.1016\/j.forsciint.2020.110237","article-title":"Clonazolam a new designer benzodiazepine intoxication confirmed by blood concentration","volume":"310","year":"2020","journal-title":"Forensic Sci. Int."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"979","DOI":"10.1007\/s00414-017-1541-6","article-title":"Characterization and identification of eight designer benzodiazepine metabolites by incubation with human liver microsomes and analysis by a triple quadrupole mass spectrometer","volume":"131","author":"Chaslot","year":"2017","journal-title":"Int. J. Legal Med."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1097\/FTD.0000000000000557","article-title":"Documentation of a little-studied designer benzodiazepine after a controlled single administration: II. Concentration profile of deschloroetizolam in Saliva","volume":"40","author":"Ameline","year":"2018","journal-title":"Ther. Drug Monit."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1111\/1556-4029.13355","article-title":"A Case of Nonfatal Intoxication Associated with the Recreational use of Diphenidine","volume":"62","author":"Gerace","year":"2017","journal-title":"J. Forensic Sci."},{"key":"ref_84","first-page":"122","article-title":"Overdose from designer benzodiazepine Diclazepam","volume":"113","author":"Runnstrom","year":"2020","journal-title":"QJM"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.forsciint.2016.09.006","article-title":"Blood concentrations of new designer benzodiazepines in forensic cases","volume":"268","author":"Tuv","year":"2016","journal-title":"Forensic Sci. Int."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"905","DOI":"10.1093\/jat\/bkaa043","article-title":"Blood concentrations of designer benzodiazepines: Relation to impairment and findings in forensic cases","volume":"44","author":"Heide","year":"2020","journal-title":"J. Anal. Toxicol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1093\/jat\/bky039","article-title":"A Case Study Involving U-47700, Diclazepam and Flubromazepam\u2014Application of Retrospective Analysis of HRMS Data","volume":"42","author":"Partridge","year":"2018","journal-title":"J. Anal. Toxicol."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.annemergmed.2014.12.019","article-title":"Overdose of etizolam: The abuse and rise of a benzodiazepine analog","volume":"65","author":"Sadler","year":"2015","journal-title":"Ann. Emerg. Med."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1016\/j.jpeds.2020.12.075","article-title":"\u201cPressed\u201d Etizolam","volume":"232","author":"Love","year":"2021","journal-title":"J. Pediatr."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"655","DOI":"10.4103\/0253-7613.144943","article-title":"A case of etizolam dependence","volume":"46","author":"Gupta","year":"2014","journal-title":"Indian J. Pharmacol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1016\/j.ajp.2018.07.019","article-title":"Etizolam withdrawal catatonia: The first case report","volume":"37","author":"Banerjee","year":"2018","journal-title":"Asian J. Psychiatr."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.forsciint.2008.08.012","article-title":"Case report: Etizolam and its major metabolites in two unnatural death cases","volume":"182","author":"Nakamae","year":"2008","journal-title":"Forensic Sci. Int."},{"key":"ref_93","first-page":"38","article-title":"An autopsy case of multiple psychotropic drug poisoning","volume":"56","author":"Tanaka","year":"2011","journal-title":"Soud. Lek."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.forsciint.2016.02.017","article-title":"A fatal intoxication related to MDPV and pentedrone combined with antipsychotic and antidepressant substances in Cyprus","volume":"265","author":"Liveri","year":"2016","journal-title":"Forensic Sci. Int."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1177\/0025802420973814","article-title":"Femoral blood concentrations of the designer benzodiazepine etizolam in post-mortem cases","volume":"61","author":"Hikin","year":"2021","journal-title":"Med. Sci. Law"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1727","DOI":"10.1007\/s00414-020-02352-7","article-title":"The adulterated XANAX pill: A fatal intoxication with etizolam and caffeine","volume":"134","author":"Kolbe","year":"2020","journal-title":"Int. J. Legal Med."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Gevorkyan, J., Kinyua, J., Pearring, S., and Rodda, L.N. (2020). A Case Series of Etizolam in Opioid Related Deaths. J. Anal. Toxicol., bkaa146.","DOI":"10.1093\/jat\/bkaa146"},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"e20192953","DOI":"10.1542\/peds.2019-2953","article-title":"Flualprazolam: Report of an outbreak of a new psychoactive substance in adolescents","volume":"146","author":"Blumenberg","year":"2020","journal-title":"Pediatrics"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1093\/jat\/bkaa019","article-title":"Toxicokinetics and analytical toxicology of flualprazolam: Metabolic fate, isozyme mapping, human plasma concentration and main urinary excretion products","volume":"44","author":"Wagmann","year":"2020","journal-title":"J. Anal. Toxicol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"664","DOI":"10.1111\/1556-4029.14623","article-title":"Brorphine-Investigation and quantitation of a new potent synthetic opioid in forensic toxicology casework using liquid chromatography-mass spectrometry","volume":"66","author":"Krotulski","year":"2021","journal-title":"J. Forensic Sci."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1093\/jat\/bkaa070","article-title":"Flualprazolam Blood Concentrations in 197 Forensic Investigation Cases","volume":"45","author":"Papsun","year":"2021","journal-title":"J. Anal. Toxicol."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"110101","DOI":"10.1016\/j.forsciint.2019.110101","article-title":"Femoral blood concentrations of flualprazolam in 33 postmortem cases","volume":"307","author":"Kriikku","year":"2020","journal-title":"Forensic Sci. Int."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1093\/jat\/bkaa098","article-title":"Quantification of Flualprazolam in Blood by LC-MS-MS: A Case Series of Nine Deaths","volume":"45","author":"Rice","year":"2021","journal-title":"J. Anal. Toxicol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1080\/15563650.2017.1286016","article-title":"Analytically diagnosed intoxication by 2-methoxphenidine and flubromazepam mimicking an ischemic cerebral disease","volume":"55","author":"Valli","year":"2017","journal-title":"Clin. Toxicol."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1002\/dta.2391","article-title":"Mixed intoxication by the synthetic opioid U-47700 and the benzodiazepine flubromazepam with lethal outcome: Pharmacokinetic data","volume":"10","author":"Koch","year":"2018","journal-title":"Drug Test. Anal."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"66","DOI":"10.3109\/15563650.2015.1112907","article-title":"Flubromazolam\u2014A new life-threatening designer benzodiazepine","volume":"54","author":"Sommerfeld","year":"2016","journal-title":"Clin. Toxicol."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1093\/jat\/bkx060","article-title":"Multiple drug-toxicity involving novel psychoactive substances, 3-Fluorophenmetrazine and U-47700","volume":"41","author":"Ellefsen","year":"2017","journal-title":"J. Anal. Toxicol."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1177\/0025802420950273","article-title":"Flubromazolam: Detection in five post-mortem cases","volume":"60","author":"Abdul","year":"2020","journal-title":"Med. Sci. Law"},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1002\/dta.2203","article-title":"Flubromazolam\u2014Basic pharmacokinetic evaluation of a highly potent designer benzodiazepine","volume":"10","author":"Huppertz","year":"2018","journal-title":"Drug Test. Anal."},{"key":"ref_110","first-page":"516","article-title":"Missbruk av fenazepam\u2014Ny f\u00e4reteelse i Sverige. Bensodiazepinderivat fr\u00e5n Ryssland gav sv\u00e5r intoxikation","volume":"106","author":"Mrozkowska","year":"2009","journal-title":"Lakartidningen"},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1007\/s00228-012-1361-z","article-title":"First reported case in the UK of acute prolonged neuropsychiatric toxicity associated with analytically confirmed recreational use of phenazepam","volume":"69","author":"Dargan","year":"2013","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1080\/15563650.2016.1240806","article-title":"Synthetic agents off the darknet: A case of U-47700 and phenazepam abuse","volume":"55","author":"Vo","year":"2017","journal-title":"Clin. Toxicol."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.forsciint.2012.02.006","article-title":"Phenazepam abuse in Finland: Findings from apprehended drivers, post-mortem cases and police confiscations","volume":"220","author":"Kriikku","year":"2012","journal-title":"Forensic Sci. Int."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1093\/jat\/bks080","article-title":"Phenazepam and its effects on driving","volume":"37","author":"Stephenson","year":"2013","journal-title":"J. Anal. Toxicol."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"605","DOI":"10.1093\/jat\/bkt075","article-title":"Detection of phenazepam in impaired driving","volume":"37","author":"Kerrigan","year":"2013","journal-title":"J. Anal. Toxicol."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1093\/jat\/34.8.527","article-title":"Fatality involving the ingestion of phenazepam and poppy seed tea","volume":"34","author":"Bailey","year":"2010","journal-title":"J. Anal. Toxicol."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1002\/hup.2222","article-title":"Phenazepam abuse in the UK: An emerging problem causing serious adverse health problems, including death","volume":"27","author":"Corkery","year":"2012","journal-title":"Hum. Psychopharmacol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"926","DOI":"10.1002\/dta.1790","article-title":"Analysis of phenazepam and 3-hydroxyphenazepam in post-mortem fluids and tissues","volume":"7","author":"Crichton","year":"2015","journal-title":"Drug Test. Anal."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/j.forsciint.2015.07.033","article-title":"Phenazepam: A review of medico-legal deaths in South Scotland between 2010 and 2014","volume":"254","author":"Shearer","year":"2015","journal-title":"Forensic Sci. Int."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"109959","DOI":"10.1016\/j.forsciint.2019.109959","article-title":"Organ distribution of diclazepam, pyrazolam and 3-fluorophenmetrazine","volume":"303","author":"Lehmann","year":"2019","journal-title":"Forensic Sci. Int."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1177\/0091270004269105","article-title":"Kinetics and dynamics of intravenous adinazolam, N-desmethyl adinazolam, and alprazolam in healthy volunteers","volume":"45","author":"Venkatakrishnan","year":"2005","journal-title":"J. Clin. Pharmacol."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.bpa.2018.06.007","article-title":"New benzodiazepines for sedation","volume":"32","author":"Cornett","year":"2018","journal-title":"Best Pract. Res. Clin. Anaesthesiol."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/0165-1781(88)90012-1","article-title":"Comparison of adinazolam, amitriptyline, and placebo in the treatment of melancholic depression","volume":"23","author":"Hicks","year":"1988","journal-title":"Psychiatry Res."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1023\/A:1015975214070","article-title":"Multiple-dose pharmacokinetics and pharmacodynamics of adinazolam in elderly subjects","volume":"6","author":"Fleishaker","year":"1989","journal-title":"Pharm. Res."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1007\/BF00634449","article-title":"Adinazolam pharmacokinetics and behavioral effects following administration of 20-60 mg oral doses of its mesylate salt in healthy volunteers","volume":"99","author":"Fleishaker","year":"1989","journal-title":"Psychopharmacology"},{"key":"ref_126","unstructured":"EMCDDA (2021, June 10). New benzodiazepines in Europe\u2014A review. Available online: https:\/\/www.emcdda.europa.eu\/system\/files\/publications\/13759\/TD0221596ENN_002.pdf."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.1002\/jms.3840","article-title":"Characterization and in vitro phase I microsomal metabolism of designer benzodiazepines\u2014An update comprising adinazolam, cloniprazepam, fonazepam, 3-hydroxyphenazepam, metizolam and nitrazolam","volume":"51","author":"Moosmann","year":"2016","journal-title":"J. Mass Spectrom."},{"key":"ref_128","unstructured":"CFSRE (2021, March 20). Adinazolam Monograph. Available online: https:\/\/www.npsdiscovery.org\/wp-content\/uploads\/2020\/08\/Adinazolam_081120_CFSRE-Toxicology_Report.pdf."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/jat\/bkaa169","article-title":"Clarification of the Correct Nomenclature of the Amino Metabolite of Clonazolam: 8-Aminoclonazolam","volume":"45","author":"Maskell","year":"2021","journal-title":"J. Anal. Toxicol."},{"key":"ref_130","first-page":"365","article-title":"Exposure to 5f-P22, 5 IAI and diclazepam: A case report","volume":"52","author":"Grossenbacher","year":"2014","journal-title":"Clin. Toxicol."},{"key":"ref_131","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1111\/dar.13052","article-title":"Etizolam: A rapid review on pharmacology, non-medical use and harms","volume":"39","author":"Nielsen","year":"2020","journal-title":"Drug Alcohol Rev."},{"key":"ref_132","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1016\/j.forsciint.2019.05.018","article-title":"Is etizolam a safe medication? Effects on psychomotor perfomance at therapeutic dosages of a newly abused psychoactive substance","volume":"301","author":"Montanari","year":"2019","journal-title":"Forensic Sci. Int."},{"key":"ref_133","unstructured":"EMCDDA (2021, February 14). Europol 2011 Annual Report on the Implementation of Council Decision 2005\/387\/JHA. Available online: https:\/\/www.emcdda.europa.eu\/system\/files\/publications\/689\/EMCDDA-Europol_Annual_Report_2011_2012_final_335568.pdf."},{"key":"ref_134","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1002\/dta.1981","article-title":"Detection of phenazepam in illicitly manufactured Erimin 5 tablets","volume":"9","author":"Lim","year":"2017","journal-title":"Drug Test. Anal."},{"key":"ref_135","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1002\/dta.349","article-title":"Phenazepam and cannabinomimetics sold as herbal highs in New Zealand","volume":"4","author":"Couch","year":"2012","journal-title":"Drug Test. Anal."},{"key":"ref_136","unstructured":"EMCDDA (2021, April 04). Europol 2012 Annual Report on the Implementation of Council Decision 2005\/387\/JHA. Available online: https:\/\/www.emcdda.europa.eu\/system\/files\/publications\/734\/EMCDDA-Europol_2012_Annual_Report_final_439477.pdf."},{"key":"ref_137","unstructured":"EMCDDA (2021, April 04). New Psychoactive Substances: Global Markets, Glocal Threats and the COVID-19 Pandemic\u2014An Update from the EU Early Warning System. Available online: https:\/\/www.emcdda.europa.eu\/system\/files\/publications\/13464\/20205648_TD0320796ENN_PDF_rev.pdf."},{"key":"ref_138","unstructured":"EMCDDA (2021, April 04). European Drug Report 2016: Trends and Developments. Available online: https:\/\/www.emcdda.europa.eu\/system\/files\/publications\/2637\/TDAT16001ENN.pdf."},{"key":"ref_139","unstructured":"EMCDDA (2021, April 04). European Drug Report 2019: Trends and Developments. Available online: https:\/\/www.emcdda.europa.eu\/system\/files\/publications\/11364\/20191724_TDAT19001ENN_PDF.pdf."},{"key":"ref_140","unstructured":"EMCDDA (2021, April 04). European Drug Report 2018: Trends and Developments. Available online: http:\/\/www.emcdda.europa.eu\/publications\/edr\/trends-developments\/2018."},{"key":"ref_141","unstructured":"(2021, May 03). National Records of Scotland. Drug-Related Deaths in Scotland Rose in 2019, Available online: https:\/\/www.nrscotland.gov.uk\/files\/\/statistics\/drug-related-deaths\/2019\/drug-related-deaths-19-pub.pdf."},{"key":"ref_142","unstructured":"NFLIS (2021, April 04). Drug Snapshot (December 2020), Available online: https:\/\/www.nflis.deadiversion.usdoj.gov\/DesktopModules\/ReportDownloads\/Reports\/NFLIS_Snapshot_122020.pdf."},{"key":"ref_143","unstructured":"CFSRE (2021, April 04). NPS Benzodiazepines in the United States\u2014Trend Report: Q1 2021. Available online: https:\/\/www.npsdiscovery.org\/wp-content\/uploads\/2021\/04\/2021-Q1_NPS-Benzodiazepines_Trend-Report.pdf."},{"key":"ref_144","unstructured":"Direction De Sant\u00e9 Publique De La Mont\u00e9r\u00e9gie (2021, April 25). Agr\u00e9gat De Surdoses Li\u00e9es \u00c0 La Consommation De Contrefa\u00e7ons D \u2018 Alprazolam (Xanax) Dans Un Milieu Scolaire. Available online: http:\/\/extranet.santemonteregie.qc.ca\/userfiles\/file\/sante-publique\/maladies-infectieuses\/Appel-vigilance-Surdose-contexte-scolaire.pdf."},{"key":"ref_145","unstructured":"EMCDDA (2021, April 25). EU Drug Markets Report 2019. Available online: https:\/\/www.emcdda.europa.eu\/system\/files\/publications\/12078\/20192630_TD0319332ENN_PDF.pdf."},{"key":"ref_146","unstructured":"UNODC (2021, April 25). Global SMART Programme. Synthetic Drugs in East and South-East Asia 2019: Trends and Patterns of Amphetamine-type Stimulants and New Psychoactive Substances., Available online: https:\/\/www.unodc.org\/documents\/southeastasiaandpacific\/Publications\/2019\/2019_The_Challenge_of_Synthetic_Drugs_in_East_and_SEA.pdf."},{"key":"ref_147","unstructured":"UNODC (2021, April 25). Darknet Cybercrime Threats to Southeast Asia. Available online: https:\/\/www.unodc.org\/documents\/southeastasiaandpacific\/\/Publications\/2021\/Darknet_Cybercrime_Threats_to_Southeast_Asia_report.pdf."},{"key":"ref_148","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1007\/s13181-018-0659-3","article-title":"Assessment of the Availability, Cost, and Motivations for Use over Time of the New Psychoactive Substances\u2014Benzodiazepines Diclazepam, Flubromazepam, and Pyrazolam\u2014In the UK","volume":"14","author":"Abouchedid","year":"2018","journal-title":"J. Med. Toxicol."},{"key":"ref_149","unstructured":"EMCDDA (2021, April 25). European Drug Report 2014: Trends and Developments. Available online: https:\/\/www.emcdda.europa.eu\/publications\/edr\/trends-developments\/2014_en."},{"key":"ref_150","unstructured":"UNODC (2021, April 25). Global SMART Update Volume 25. Regional Diversity and the Impact of Scheduling on NPS Trends. Available online: https:\/\/www.unodc.org\/documents\/scientific\/Global_SMART_Update_2021-Vol.25-Eng-Final.pdf."},{"key":"ref_151","unstructured":"ACMD (2021, April 25). Novel Benzodiazepines: A Review of the Evidence of Use and Harms of Novel Benzodiazepines, Available online: https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/881969\/ACMD_report_-_a_review_of_the_evidence_of_use_and_harms_of_novel_benzodiazepines.pdf."},{"key":"ref_152","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1177\/1455072517706304","article-title":"The slippery slope of flubromazolam: Experiences of a novel psychoactive benzodiazepine as discussed on a Swedish online forum","volume":"34","author":"Andersson","year":"2017","journal-title":"NAD Nord. Stud. Alcohol Drugs"},{"key":"ref_153","doi-asserted-by":"crossref","first-page":"e58","DOI":"10.1093\/jat\/bky012","article-title":"Characterization of flunitrazolam, a new designer benzodiazepine, in oral fluid after a controlled single administration","volume":"42","author":"Ameline","year":"2018","journal-title":"J. Anal. Toxicol."},{"key":"ref_154","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1080\/15563650.2018.1510502","article-title":"Designer benzodiazepines: A report of exposures recorded in the National Poison Data System, 2014\u20132017","volume":"57","author":"Carpenter","year":"2019","journal-title":"Clin. Toxicol."},{"key":"ref_155","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1093\/jat\/bks008","article-title":"Reactivity of commercial benzodiazepine immunoassays to phenazepam","volume":"36","author":"Kyle","year":"2012","journal-title":"J. Anal. Toxicol."},{"key":"ref_156","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1002\/dta.2561","article-title":"Characterization and in vitro phase I microsomal metabolism of designer benzodiazepines: An update comprising flunitrazolam, norflurazepam, and 4\u2032-chlorodiazepam (Ro5\u20134864)","volume":"11","author":"Moosmann","year":"2019","journal-title":"Drug Test. Anal."},{"key":"ref_157","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1007\/164_2018_154","article-title":"Designer benzodiazepines: Another class of new psychoactive substances","volume":"252","author":"Moosmann","year":"2018","journal-title":"Handb. Exp. Pharmacol."},{"key":"ref_158","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/j.drugpo.2014.10.010","article-title":"Mortality related to novel psychoactive substances in Scotland, 2012: An exploratory study","volume":"26","author":"McAuley","year":"2015","journal-title":"Int. J. Drug Policy"},{"key":"ref_159","doi-asserted-by":"crossref","first-page":"242","DOI":"10.1093\/jat\/bku025","article-title":"Applying quantitative structure-activity relationship (QSAR) methodology for modeling postmortem redistribution of benzodiazepines and tricyclic antidepressants","volume":"38","author":"Giaginis","year":"2014","journal-title":"J. Anal. Toxicol."}],"container-title":["Pharmaceuticals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8247\/14\/6\/560\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:13:27Z","timestamp":1760163207000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8247\/14\/6\/560"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,11]]},"references-count":159,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2021,6]]}},"alternative-id":["ph14060560"],"URL":"https:\/\/doi.org\/10.3390\/ph14060560","relation":{},"ISSN":["1424-8247"],"issn-type":[{"value":"1424-8247","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,11]]}}}