目标:布罗马佐仑,一个新的设计师苯二氮卓(NBD),表现出强效的镇静剂,催眠和抗焦虑作用,引起人们对其滥用和致命后果的可能性的担忧,特别是当与阿片类药物如芬太尼联合使用时。尽管全球记录的死亡人数有限,它的使用构成了重大威胁,报告不足和缺乏常规测试加剧了这种情况。这项研究分析了美国一个主要城市在4年内与NBD相关的死亡。
方法:分析旧金山涉及NBD的意外过量死亡,CA,美国从2020年到2023年,利用包括全面法医毒理学在内的医学法律死亡调查进行,病理学和人口统计信息。旧金山对所有非自然和突然的意外死亡进行彻底调查,包括对其管辖下的死者进行常规酒精和药物测试,包括etizolam,氟哌唑仑,氟溴唑兰和溴唑兰分析。
结果:与溴唑兰相关的死亡突然激增,2023年有44人死亡记录,相比之下,与其他NBD相关的死亡人数相对较少。布罗马佐兰的死亡经常涉及与阿片类药物的共同摄入,主要是芬太尼,和兴奋剂,如甲基苯丙胺和可卡因。人口统计特征表明男性占主导地位,很大一部分缺乏固定地址。在研究期间,血液中溴唑仑的浓度增加,建议提高社区的可用性和/或纯度。
结论:在2023年,旧金山与溴唑兰相关的死亡人数激增,CA,美国,与前几年与其他NBD相关的相对稳定的死亡人数形成对比。调查结果强调了加强死亡调查的紧迫性,测试和报告,以促进有针对性的减少伤害的策略,为有风险的人溴唑兰相关的发病率和死亡率。
OBJECTIVE: Bromazolam, a novel designer benzodiazepine (NBD), exhibits potent sedative, hypnotic and anxiolytic effects, raising concerns regarding its potential for misuse and fatal outcomes, particularly when combined with opioids such as fentanyl. Despite limited documented fatalities globally, its use poses a significant threat, exacerbated by under-reporting and a lack of routine testing. This study analysed NBD-related deaths in a major US city over a 4-year period.
METHODS: Analysis of accidental overdose deaths involving NBDs in San Francisco, CA, USA from 2020 to 2023, was performed utilizing medico-legal death investigations including comprehensive forensic toxicology, pathology and demographic information. San Francisco conducts thorough investigations into all non-natural and sudden unexpected deaths, including routine alcohol and drug testing of decedents under its jurisdiction, including etizolam, flualprazolam, flubromazolam and bromazolam analysis.
RESULTS: There was a sudden surge in bromazolam-related deaths, with 44 fatalities documented in 2023, contrasting with relatively fewer deaths related to other NBDs. Bromazolam fatalities frequently involved co-ingestion with opioids, primarily fentanyl, and stimulants such as methamphetamine and cocaine. Demographic characteristics indicated a predominance of males, with a significant proportion lacking fixed addresses. Blood concentrations of bromazolam increased during the study period, suggesting heightened availability and/or purity in the community.
CONCLUSIONS: There was a surge in bromazolam-related deaths during 2023 in San Francisco, CA, USA, contrasting with relatively stable numbers of deaths associated with other NBDs over the preceding years. The findings underscore the urgency for enhanced death investigation, testing and reporting to facilitate targeted harm reduction strategies for individuals at risk of bromazolam-related morbidity and mortality.