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Alprazolam-related deaths in Scotland, 2004–2020

John Martin Corkery Orcid Logo, Amira Guirguis Orcid Logo, Stefania Chiappini Orcid Logo, Giovanni Martinotti Orcid Logo, Fabrizio Schifano

Journal of Psychopharmacology, Volume: 36, Issue: 9, Pages: 1020 - 1035

Swansea University Author: Amira Guirguis Orcid Logo

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Abstract

Background:The benzodiazepine drug alprazolam, a fast-acting tranquiliser, cannot be prescribed on the National Health Service in the United Kingdom. Illicit alprazolam supply and consumption have increased. Concern about increasing numbers of alprazolam-related fatalities started circulating in 201...

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Published in: Journal of Psychopharmacology
ISSN: 0269-8811 1461-7285
Published: SAGE Publications 2022
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa59998
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Abstract: Background:The benzodiazepine drug alprazolam, a fast-acting tranquiliser, cannot be prescribed on the National Health Service in the United Kingdom. Illicit alprazolam supply and consumption have increased. Concern about increasing numbers of alprazolam-related fatalities started circulating in 2018. However, statistics on this issue are very limited. This study examined patterns in such mortality in Scotland.Methods:Statistics on deaths where alprazolam was mentioned in the ‘cause of death’ were obtained from official mortality registers. Anonymised Scottish case-level data were obtained. Data were examined in respect of the characteristics of decedents and deaths using descriptive statistics.Results:Scotland registered 370 deaths in 2004–2020; 366 of these occurred in 2015–2020: most involved males (77.1%); mean age 39.0 (SD 12.6) years. The principal underlying cause of death was accidental poisoning: opiates/opioids (77.9%); sedatives/hypnotics (15.0%). Two deaths involved alprazolam alone. Main drug groups implicated: opiates/opioids (94.8%), ‘other benzodiazepines’ (67.2%), gabapentinoids (42.9%), stimulants (30.1%), antidepressants (15.0%). Two-thirds (64.2%) involved combinations of central nervous system (CNS) depressants.Discussion:Alprazolam-related deaths are likely due to an increasing illicit supply. The fall in deaths in 2019–2020 is partially due to increased use of designer benzodiazepines. Treatment for alprazolam dependence is growing. Clinicians need to be aware of continuing recreational alprazolam use. When such consumption occurs with CNS depressants, overdose and death risks increase.Conclusions:More awareness of alprazolam contributing to deaths, especially in conjunction with other CNS depressants, is needed by consumers and clinicians. Improved monitoring of illicit supplies could identify emerging issues of medicines’ abuse.
Keywords: Alprazolam, Xanax, Scotland, United Kingdom, deaths, fatalities, mortality
College: Faculty of Medicine, Health and Life Sciences
Funders: The author(s) received no financial support for the research, authorship, and/or publication of this article.
Issue: 9
Start Page: 1020
End Page: 1035