Bromazolam Prevalence Surging Across the United States Driven In Part by Increasing Detections Alongside Fentanyl

Bromazolam first emerged in the recreational drug supply in 2016 (Europe) and 2019 (United States). Bromazolam was first synthesized during medicinal drug development in the 1970s but never approved for therapeutic use in the United States. Bromazolam is the brominated counterpart to the chlorinated drug alprazolam. Bromazolam has been linked to adverse events resulting in hospitalization and death. Bromazolam is commonly reported in combination with other drugs, including the opioid fentanyl. To date, bromazolam has been identified in more than 250 toxicology cases submitted to NMS Labs, including both antemortem and postmortem investigations. Bromazolam has been identified in more than 190 toxicology samples tested at the Center for Forensic Science Research and Education (CFSRE), displaying an increase in positivity from 1% in Q1 2021 to 13% in Q2 2022. More significantly, co-detections with fentanyl have increased in recent months to more than 75% for bromazolam positive samples. Bromazolam has also been confirmed in counterfeit benzodiazepine preparations at the CFSRE.
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