Designer Benzodiazepines: a New Challenge
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Flualprazolam Sample Type: Biological Fluid
Flualprazolam Sample Type: Biological Fluid Latest Revision: June 25, 2019 Date of Report: June 25, 2019 1. GENERAL INFORMATION IUPAC Name: 8-chloro-6-(2-fluorophenyl)-1-methyl-4H-[1,2,4]triazolo[4,3- a][1,4]benzodiazepine InChI String: InChI=1S/C17H12ClFN4/c1-10-21-22-16-9-20-17(12-4-2-3-5- 14(12)19)13-8-11(18)6-7-15(13)23(10)16/h2-8H,9H2,1H3 CFR: Not Scheduled (06/2019) CAS# 28910-91-0 Synonyms: 2’-Fluoro Alprazolam, ortho-Fluoro Alprazolam Source: NMS Labs – Toxicology Department 2. CHEMICAL DATA Chemical Molecular Molecular Exact Mass Analyte Formula Weight Ion (M) [M+H]+ Flualprazolam C17H12ClFN4 326.75 326 327.0807 Important Note: All identifications were made based on evaluation of analytical data (LC-QTOF) in comparison to analysis of acquired reference material. Report Prepared By: Alex J. Krotulski, MSFS, and Barry K. Logan, PhD, F-ABFT 3. SAMPLE HISTORY Flualprazolam has been identified in three cases since March 2018. The geographical and demographic breakdown is below: Geographical Location: Pennsylvania (n=2), Indiana (n=1) Biological Sample: Blood (n=3) Date of First: Collection: March 8, 2018 Receipt: March 10, 2018 Date of Most Recent: Collection: June 3, 2019 Receipt: June 7, 2019 Additional NPS: Etizolam (n=2), Clonazolam (n=1), Flubromazolam (n=1) 4. BRIEF DESCRIPTION Flualprazolam is classified as a novel benzodiazepine, although its synthesis and activity have been previously described in the literature.1 Benzodiazepines are central nervous system depressants. Novel benzodiazepines, often pirated from early drug discovery or pharmaceutical studies, have appeared on novel and illicit drug markets in recent years. -
NMS Labs Demo Report
NMS Labs CONFIDENTIAL 200 Welsh Road, Horsham, PA 19044-2208 Phone: (215) 657-4900 Fax: (215) 657-2972 e-mail: [email protected] Robert A. Middleberg, PhD, F-ABFT, DABCC-TC, Laboratory Director Demo Report Patient Name 0570B-POS Report Issued 06/19/2017 08:16 Patient ID 0570B-POS Last Report Issued 04/10/2017 13:19 Chain 17000768 Age Not Given DOB Not Given 88888 Gender Not Given Clinical Example Report Attn: IT Department Workorder 17000768 200 Welsh Road Horsham, PA 19044-2208 Received 04/10/2017 12:42 Sample ID 17000768-001 Collect Dt/Tm Not Given Matrix Blood Source Not Given Patient Name 0570B-POS Patient ID 0570B-POS Container Type Clear vial Approx Vol/Weight Not Given Receipt Notes None Entered Reporting Analysis and Comments Result Units Limit Notes 0570B Designer Benzodiazepines, Blood (Forensic) Analysis by High Performance Liquid Chromatography/Tandem Mass Spectrometry (LC-MS/MS) Bromazepam 50 ng/mL 5.0 Bromazepam is a benzodiazepine drug that is used as a novel psychoactive substance. It is reported to have CNS depressant properties and shares anticonvulsant, muscle relaxant, hypnotic, anxiolytic and sedative effects with other benzodiazepines. It is not approved for use in the United States, but is available in some other countries. Average peak plasma concentrations following a single 3 mg, 6 mg and 12 mg dose were reported to be 10 ng/mL at 8 hours, 83 ng/mL at 2 hours and 130 ng/mL at 1-4 hours after dosing, respectively. Chronic oral administration of 9 mg daily resulted in an steady-state plasma concentrations of 81-150 ng/mL (Average = 120 ng/mL). -
A Review of the Evidence of Use and Harms of Novel Benzodiazepines
ACMD Advisory Council on the Misuse of Drugs Novel Benzodiazepines A review of the evidence of use and harms of Novel Benzodiazepines April 2020 1 Contents 1. Introduction ................................................................................................................................. 4 2. Legal control of benzodiazepines .......................................................................................... 4 3. Benzodiazepine chemistry and pharmacology .................................................................. 6 4. Benzodiazepine misuse............................................................................................................ 7 Benzodiazepine use with opioids ................................................................................................... 9 Social harms of benzodiazepine use .......................................................................................... 10 Suicide ............................................................................................................................................. 11 5. Prevalence and harm summaries of Novel Benzodiazepines ...................................... 11 1. Flualprazolam ......................................................................................................................... 11 2. Norfludiazepam ....................................................................................................................... 13 3. Flunitrazolam .......................................................................................................................... -
Toxicology Drug Testing Panels
RTXMSJ06008UAH Toxicology Drug Testing Panels Document Number: RTXMSJ06008UAH Revision Number: 1.73 Document Type: Attachment Effective Date: 5/3/2021 3:08:59 PM Location: AHS Laboratory Services\Document Administration\Toxicology and Trace Elements\17. Drug Testing LCMSMS\1. Drug Testing LCMSMS Job Aids RTXMSJ06008UAH Toxicology Drug Testing Panels Urine Opioid Dependency Panel 1 (UODP) CUT-OFF DRUG CLASS COMMON TRADE NAMES INTERPRETIVE CONCENTRATION2 ANALYTE DETECTED (STREET NAME) NOTES (NG/ML) Amphetamines Adderall, Dexedrine, Vyvanse, A prescription drug; also a metabolite of Amphetamine 250 Lisdexamfetamine methamphetamine (Speed, Bennies, Crystal Meth, Metabolite of Selegiline; Metabolized to Methamphetamine 250 Uppers) amphetamine Metabolite of Methylenedioxyamphetamine (MDA) 250 methylenedioxymethamphetamine Methylenedioxymethamphetamine (Ecstasy, MDMA) Metabolized to methylenedioxyamphetamine 250 Page 1 of 15 RTXMSJ06008UAH Toxicology Drug Testing Panels Rev: 1.73 CUT-OFF DRUG CLASS COMMON TRADE NAMES INTERPRETIVE CONCENTRATION2 ANALYTE DETECTED (STREET NAME) NOTES (NG/ML) Benzodiazepines Flubromazepam prescription not available in Flubromazepam 50 Canada 7-Aminoclonazepam Metabolite of clonazepam (Rivotril) 50 7-Aminonitrazepam Metabolite of nitrazepam (Mogadon) 50 Alphahydroxyalprazolam Metabolite of alprazolam (Xanax) 50 Alphahydroxytriazolam Metabolite of triazolam (Halcion) 50 Bromazepam Lectopam 50 Clobazam Frisium Metabolized to norclobazam 50 o Norclobazam Metabolite of clobazam 50 Metabolite of chlordiazepoxide -
Test Update Immediate Action Notification
Effective Date: Monday, March 15, 2021 Test Updates Immediate Action Modified Update: Acodes CPT changes For the acodes 52500B, 52500SP, 52500U, 54458B and 54458U, the new CPT code is 80354, 80364 In our continuing effort to provide you with the highest quality toxicology laboratory services available, we have compiled important changes regarding a number of tests we perform. Listed below are the types of changes that may be included in this notification, effective Monday, March 15, 2021 Test Changes - Tests that have had changes to the method/ CPT code, units of measurement, scope of analysis, reference comments, or specimen requirements. Discontinued Tests - Tests being discontinued with alternate testing suggestions. Please use this information to update your computer systems/records. These changes are important to ensure standardization of our mutual laboratory databases. If you have any questions about the information contained in this notification, please call our Client Support Department at (866) 522-2206. Thank you for your continued support of NMS Labs and your assistance in implementing these changes. The CPT Codes provided in this document are based on AMA guidelines and are for informational purposes only. NMS Labs does not assume responsibility for billing errors due to reliance on the CPT Codes listed in this document. NMS Labs 200 Welsh Rd. Horsham, PA 19044-2208 [email protected] Page 1 of 40 Effective Date: Monday, March 15, 2021 Test Updates Test Test Name Test Method / Specimen Stability Scope Units Reference Discontinue -
MISSISSIPPI LEGISLATURE REGULAR SESSION 2020 By
MISSISSIPPI LEGISLATURE REGULAR SESSION 2020 By: Senator(s) Jordan, Jackson (11th) To: Drug Policy; Judiciary, Division A SENATE BILL NO. 2694 1 AN ACT TO AMEND SECTION 41-29-113, MISSISSIPPI CODE OF 1972, 2 TO ADD FLUALPRAZOLAM, FLUBROMAZEPAM, FLUBROMAZOLAM AND CLONAZOLAM 3 TO SCHEDULE I BECAUSE THESE DRUGS HAVE NO LEGITIMATE MEDICAL USE 4 AND HAVE HIGH POTENCY WITH GREAT POTENTIAL TO CAUSE HARM; TO AMEND 5 SECTION 41-29-115, MISSISSIPPI CODE OF 1972, TO REVISE SCHEDULE II 6 TO CLARIFY THE CHEMICAL NAME OF THIAFENTANIL; TO AMEND SECTION 7 41-29-119, MISSISSIPPI CODE OF 1972, TO ADD TO SCHEDULE IV THE 8 DRUGS BREXANOLONE (ZULRESSO) AND SOLRIAMFETOL (SUNOSI) BECAUSE 9 THESE DRUGS RECENTLY HAVE BEEN APPROVED FOR MEDICAL USE BY THE 10 FEDERAL DRUG ADMINISTRATION; AND FOR RELATED PURPOSES. 11 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI: 12 SECTION 1. Section 41-29-113, Mississippi Code of 1972, is 13 amended as follows: 14 41-29-113. 15 SCHEDULE I 16 (a) Schedule I consists of the drugs and other substances, 17 by whatever official name, common or usual name, chemical name, or 18 brand name designated, that is listed in this section. 19 (b) Opiates. Unless specifically excepted or unless listed 20 in another schedule, any of the following opiates, including their 21 isomers, esters, ethers, salts and salts of isomers, esters and S. B. No. 2694 *SS08/R210* ~ OFFICIAL ~ G1/2 20/SS08/R210 PAGE 1 (csq\tb) 22 ethers, whenever the existence of these isomers, esters, ethers 23 and salts is possible within the specific chemical designation: -
Forensic Toxicology Scope of Testing and Detection Limits
J. RYAN MCMAHON II County Executive INDU GUPTA, MD, MPH MEDICAL EXAMINER’S OFFICE Commissioner of Health FORENSIC TOXICOLOGY LABORATORY CAROLYN H. REVERCOMB, MD, DABP ONONDAGA COUNTY HEALTH DEPARTMENT Chief Medical Examiner KRISTIE BARBA, MS, D-ABFT-FT CENTER FOR FORENSIC SCIENCES Toxicologist Forensic Toxicology Scope of Testing and Detection Limits Table of Contents QUALITATIVE ANALYSES.........................................................................................................2 Volatile Screen by GC/FID .............................................................................................................2 Carbon Monoxide by Microdiffusion..............................................................................................2 Carbon Monoxide by CO-Oximeter ................................................................................................2 Ethylene Glycol by GC/MS.............................................................................................................2 ELISA Buprenorphine by IA for Blood/Urine ................................................................................2 ELISA by IA for Blood ...................................................................................................................3 ELISA by IA for Urine....................................................................................................................4 Gamma Hydroxybutyrate (GHB) by GC/MS..................................................................................5 Gabapentin, -
RPCC Pharmacy Forum: December 2016
December 2016 RPCC Pharmacy Forum Issue 19 Flubromazolam - Deadly Designer Benzodiazepine Brent Durrett, Pharm. D. Candidate, 2017 Special Interest Articles: Flubromazolam is a triazole analog of as binding to the benzodiazepine receptor flubromazepam and is a very high affinity, site on the gamma amino butyric acid in-vitro benzodiazepine related (GABA)-A receptor. By binding to the • Flubromazolam compound. It contains a fluorine, a GABA-A receptor, the benzodiazepine is bromine, and a methylated triazole able to change the shape of the receptor’s • PPIs and Dementia substituent on its core benzodiazepine chloride channel. This change causes the structure. Flubromazolam is a novel cell to hyperpolarize and causes the • Ultra-Long Acting Pill designer drug that is a synthetic version inhibitory effect, which decreases the of the benzodiazepine class. Many excitability of the brain’s neurons. designer drugs are former research drugs or drugs that were previously approved in The most common effect seen when other countries. Flubromazolam is a taking flubromazolam is heavy sedation. former research drug that did not make it Flubromazolam is a strong hypnotic with to clinical trials. It is still being sold as a moderate anxiolytic and amnesic effects. research chemical but has found its way Did you know? According to Erowid Experience Vaults, into the recreational drug marketplace. several drug users report that Twenty-five years flubromazolam would knock them out for Designer drugs are often many times most of the day, even on some of the ago, Eli Lilly’s Prozac stronger than the original substance due lowest doses of 0.25mg. This is due to the (fluoxetine) became to its creation for abuse. -
Advisory Council on the Misuse of Drugs
ACMD Advisory Council on the Misuse of Drugs Chair: Professor Les Iversen NPS Committee Secretary: Linsey Urquhart 1st Floor (NE), Peel Building 2 Marsham Street London SW1P 4DF Tel: 020 7035 1121 [email protected] Sarah Newton MP Minister for Vulnerability, Safeguarding and Countering Extremism Home Office 2 Marsham Street London SW1P 4DF 2 December 2016 Dear Minister, I am writing to recommend that you lay a temporary class drug order (TCDO) pursuant to section 2A of the Misuse of Drugs Act 1971 (MDA) for the following substances: • U-47,700 • Etizolam and other designer benzodiazepines. Please find enclosed two reports containing the Advisory Council on the Misuse of Drugs’ (ACMD) consideration of the evidence of harms on these substances. U-47,700 U-47,700 is a synthetic opioid, originally developed as a research chemical but with no legitimate use. Reportedly 7.5 times more potent than morphine it is a structural analogue of AH-7921. AH-7921 was controlled as a Class A drug in January 2015 following ACMD advice, particularly regarding its high addiction potential. The ACMD is concerned that abuse of U-47,700 has the potential for severe harms, particularly following reports from the USA of more than 80 deaths attributed to this substance and that the patterns of abuse are mirroring those of heroin. The US Drug Enforcement Administration has consequently subjected U-47,700 to temporary emergency scheduling under the Controlled Substances Act. Designer Benzodiazepines Benzodiazepines such as diazepam and chlordiazepoxide have had medical applications for more than 50 years, particularly as sedatives. -
List of Benzodiazepines - Wikipedia, the Free Encyclopedia
List of benzodiazepines - Wikipedia, the free encyclopedia Log in / create account Article Talk Read Edit Our updated Terms of Use will become effective on May 25, 2012. Find out more. List of benzodiazepines From Wikipedia, the free encyclopedia Main page The below tables contain a list of benzodiazepines that Benzodiazepines Contents are commonly prescribed, with their basic pharmacological Featured content characteristics such as half-life and equivalent doses to other Current events benzodiazepines also listed, along with their trade names and Random article primary uses. The elimination half-life is how long it takes for Donate to Wikipedia half of the drug to be eliminated by the body. "Time to peak" Interaction refers to when maximum levels of the drug in the blood occur Help after a given dose. Benzodiazepines generally share the About Wikipedia same pharmacological properties, such as anxiolytic, Community portal sedative, hypnotic, skeletal muscle relaxant, amnesic and Recent changes anticonvulsant (hypertension in combination with other anti The core structure of benzodiazepines. Contact Wikipedia hypertension medications). Variation in potency of certain "R" labels denote common locations of effects may exist among individual benzodiazepines. Some side chains, which give different Toolbox benzodiazepines produce active metabolites. Active benzodiazepines their unique properties. Print/export metabolites are produced when a person's body metabolizes Benzodiazepine the drug into compounds that share a similar pharmacological -
Controlled Substances List (Adopted by Alabama State Board of Health on January 20, 2021, Effective January 20, 2021)
1 Controlled Substances List (Adopted by Alabama State Board of Health on January 20, 2021, effective January 20, 2021) Schedule I (a) Schedule I shall consist of the drugs and other substances, by whatever official name, common or usual name, or brand name designated, listed in this section. Each drug or substance has been assigned the DEA Controlled Substances Code Number set forth opposite it. (b) Opiates. Unless specifically excepted or unless listed in another schedule, any of the following opiates, including their isomers, esters, ethers, salts, and salts of isomers, esters and ethers, whenever the existence of such isomers, esters, ethers and salts is possible within the specific chemical designation (for purposes of 3-methylthiofentanyl only, the term isomer includes the optical and geometric isomers): (1) Acetyl-alpha-methylfentanyl (N-[1-[1-methyl-2-phenethyl]-4-piperidinyl]- N-phenylacetamide -------------------------------------------------------------------- 9815 (Federal Control Nov. 29, 1985; State Dec. 29, 1985) (2) Acetylmethadol ------------------------------------------------------------------------- 9601 (3) AH-7921 (3,4-dichloro-N-[(1-dimethylamino)cyclohexylmethyl] benzamide -------------------------------------------------------------------------------- 9551 Federal Control May 16, 2016; State June 15, 2016 (4) Allylprodine ----------------------------------------------------------------------------- 9602 (5) Alphacetylmethadol --------------------------------------------------------------------- 9603 (6) Alphameprodine -
FLUBROMAZOLAM (Street Name: Liquid Xanax)
Drug Enforcement Administration Diversion Control Division Drug & Chemical Evaluation Section FLUBROMAZOLAM (Street Name: Liquid Xanax) August 2019 DEA/DC/DO/DOE Introduction (0.5 mg/day) of flubromazolam, sedative-hypnotic effects as Flubromazolam is a triazole analogue of the designer well as muscle relaxant effects occurred 90 minutes following benzodiazepine, flubromazepam. As a class of drugs, drug intake. Drowsiness occurred approximately three hours benzodiazepines produce central nervous system (CNS) post-drug ingestion, and lasted for five hours. Intoxication due depression and are commonly used to treat, panic disorders, to flubromazolam is characterized by excessive drowsiness, anxiety and insomnia. The United States Food and Drug partial amnesia and inability to follow or participate in Administration has not approved Flubromazolam for conversation. Peak serum concentration of flubromazolam is therapeutic use. reached approximately 5 hours (7.4 ng/mL) after administration with a second peak occurring after 8 hours (8.6 ng/mL), making Licit Uses it a long-acting benzodiazepine. In a single-dose Flubromazolam does not currently have an accepted pharmacokinetic study in humans, 30 hours following medical use in the United States. flubromazolam ingestion, a re-emergence of sedative effects was observed. Chemistry Flubromazolam (8-bromo-6-(2-fluorophenyl)-1-methyl- User Population 4H-benzo[f][1,2,4]triazolo[4,3-a][1,4]diazepine) is a triazole Flubromazolam is used as a recreational substance in the United States. It is abused by a broad range of groups analogue of the benzodiazepine flubromazepam. including youths, young adults, and older adults. Flubromazolam is composed of a benzene ring fused to a seven-membered 1,4-diazepine ring that is also fused to a 1,2,4 Illicit Distribution triazole ring.