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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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DOI (Published version): 10.1177/02698811221104065

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
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URI: https://cronfa.swan.ac.uk/Record/cronfa59998
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This study examined patterns in such mortality in Scotland.Methods:Statistics on deaths where alprazolam was mentioned in the &#x2018;cause of death&#x2019; 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&#x2013;2020; 366 of these occurred in 2015&#x2013;2020: most involved males (77.1%); mean age 39.0 (SD 12.6)&#x2009;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%), &#x2018;other benzodiazepines&#x2019; (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&#x2013;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. 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spelling 2022-10-18T14:46:52.0454463 v2 59998 2022-05-11 Alprazolam-related deaths in Scotland, 2004–2020 b49270b9a0d580cf4f31f9a1b6c93f87 0000-0001-8255-0660 Amira Guirguis Amira Guirguis true false 2022-05-11 PHAR 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. Journal Article Journal of Psychopharmacology 36 9 1020 1035 SAGE Publications 0269-8811 1461-7285 Alprazolam, Xanax, Scotland, United Kingdom, deaths, fatalities, mortality 1 9 2022 2022-09-01 10.1177/02698811221104065 COLLEGE NANME Pharmacy COLLEGE CODE PHAR Swansea University Not Required The author(s) received no financial support for the research, authorship, and/or publication of this article. 2022-10-18T14:46:52.0454463 2022-05-11T09:55:45.9652164 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine John Martin Corkery 0000-0002-3849-817x 1 Amira Guirguis 0000-0001-8255-0660 2 Stefania Chiappini 0000-0002-6810-1540 3 Giovanni Martinotti 0000-0002-7292-2341 4 Fabrizio Schifano 5 59998__25489__e83297a1efdb4c54bdb1a54676fcd51c.pdf 59998_VoR.pdf 2022-10-18T14:44:59.1744974 Output 442158 application/pdf Version of Record true © The Author(s) 2022. This article is distributed under the terms of the Creative Commons Attribution 4.0 License true eng https://creativecommons.org/licenses/by/4.0/
title Alprazolam-related deaths in Scotland, 2004–2020
spellingShingle Alprazolam-related deaths in Scotland, 2004–2020
Amira Guirguis
title_short Alprazolam-related deaths in Scotland, 2004–2020
title_full Alprazolam-related deaths in Scotland, 2004–2020
title_fullStr Alprazolam-related deaths in Scotland, 2004–2020
title_full_unstemmed Alprazolam-related deaths in Scotland, 2004–2020
title_sort Alprazolam-related deaths in Scotland, 2004–2020
author_id_str_mv b49270b9a0d580cf4f31f9a1b6c93f87
author_id_fullname_str_mv b49270b9a0d580cf4f31f9a1b6c93f87_***_Amira Guirguis
author Amira Guirguis
author2 John Martin Corkery
Amira Guirguis
Stefania Chiappini
Giovanni Martinotti
Fabrizio Schifano
format Journal article
container_title Journal of Psychopharmacology
container_volume 36
container_issue 9
container_start_page 1020
publishDate 2022
institution Swansea University
issn 0269-8811
1461-7285
doi_str_mv 10.1177/02698811221104065
publisher SAGE Publications
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
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description 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.
published_date 2022-09-01T04:17:44Z
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score 10.950514

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