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Benzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniques

Anthony Mullin Orcid Logo, Mark Scott, Giorgia Vaccaro, Giuseppe Floresta Orcid Logo, Davide Arillotta Orcid Logo, Valeria Catalani Orcid Logo, John M. Corkery Orcid Logo, Jacqueline L. Stair Orcid Logo, Fabrizio Schifano Orcid Logo, Amira Guirguis Orcid Logo

Pharmacy, Volume: 12, Issue: 1, Start page: 13

Swansea University Author: Amira Guirguis Orcid Logo

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DOI (Published version): 10.3390/pharmacy12010013

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first_pagesettingsOrder Article ReprintsOpen AccessArticleBenzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniquesby Anthony Mullin 1ORCID,Mark Scott 1,Giorgia Vaccaro 1,Giuseppe Floresta 1,2ORC...

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Published in: Pharmacy
ISSN: 2226-4787
Published: MDPI AG 2024
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fullrecord <?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>65563</id><entry>2024-02-02</entry><title>Benzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniques</title><swanseaauthors><author><sid>b49270b9a0d580cf4f31f9a1b6c93f87</sid><ORCID>0000-0001-8255-0660</ORCID><firstname>Amira</firstname><surname>Guirguis</surname><name>Amira Guirguis</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2024-02-02</date><deptcode>PHAR</deptcode><abstract>first_pagesettingsOrder Article ReprintsOpen AccessArticleBenzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniquesby Anthony Mullin 1ORCID,Mark Scott 1,Giorgia Vaccaro 1,Giuseppe Floresta 1,2ORCID,Davide Arillotta 3ORCID,Valeria Catalani 1ORCID,John M. Corkery 1ORCID,Jacqueline L. Stair 1ORCID,Fabrizio Schifano 1ORCID andAmira Guirguis 4,*ORCID1Psychopharmacology, Drug Misuse &amp; Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield AL10 9AB, UK2Department of Drug and Health Sciences, University of Catania, 95131 Catania, Italy3School of Clinical Pharmacology and Toxicology, University of Florence, 50121 Florence, Italy4Pharmacy, Medical School, The Grove Extension, Swansea University, Swansea SA2 8PP, UK*Author to whom correspondence should be addressed.Pharmacy 2024, 12(1), 13; https://doi.org/10.3390/pharmacy12010013Submission received: 27 October 2023 / Revised: 1 January 2024 / Accepted: 4 January 2024 / Published: 12 January 2024Downloadkeyboard_arrow_down Browse Figures Review Reports Versions NotesAbstractIntroduction: The designer benzodiazepine (DBZD) market continues to expand whilst evading regulatory controls. The widespread adoption of social media by pro-drug use communities encourages positive discussions around DBZD use/misuse, driving demand. This research addresses the evolution of three popular DBZDs, etizolam (E), flubromazepam (F), and pyrazolam (P), available on the drug market for over a decade, comparing the quantitative chemical analyses of tablet samples, purchased from the internet prior to the implementation of the Psychoactive Substances Act UK 2016, with the thematic netnographic analyses of social media content. Method: Drug samples were purchased from the internet in early 2016. The characterisation of all drug batches were performed using UHPLC-MS and supported with 1H NMR. In addition, netnographic studies across the platforms X (formerly Twitter) and Reddit, between 2016–2023, were conducted. The latter was supported by both manual and artificial intelligence (AI)-driven thematic analyses, using numerous.ai and ChatGPT, of social media threads and discussions. Results: UHPLC-MS confirmed the expected drug in every sample, showing remarkable inter/intra batch variability across all batches (E = 13.8 ± 0.6 to 24.7 ± 0.9 mg; F = 4.0 ± 0.2 to 23.5 ± 0.8 mg; P = 5.2 ± 0.2 to 11.5 ± 0.4 mg). 1H NMR could not confirm etizolam as a lone compound in any etizolam batch. Thematic analyses showed etizolam dominated social media discussions (59% of all posts), with 24.2% of posts involving sale/purchase and 17.8% detailing new administration trends/poly-drug use scenarios. Artificial intelligence confirmed three of the top five trends identified manually. Conclusions: Purity variability identified across all tested samples emphasises the increased potential health risks associated with DBZD consumption. We propose the global DBZD market is exacerbated by surface web social media discussions, recorded across X and Reddit. Despite the appearance of newer analogues, these three DBZDs remain prevalent and popularised. Reporting themes on harm/effects and new developments in poly-drug use trends, demand for DBZDs continues to grow, despite their potent nature and potential risk to life. It is proposed that greater controls and constant live monitoring of social media user content is warranted to drive active regulation strategies and targeted, effective, harm reduction strategies.</abstract><type>Journal Article</type><journal>Pharmacy</journal><volume>12</volume><journalNumber>1</journalNumber><paginationStart>13</paginationStart><paginationEnd/><publisher>MDPI AG</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint/><issnElectronic>2226-4787</issnElectronic><keywords>designer benzodiazepines; social media; poly-drug use; analytical characterisation</keywords><publishedDay>12</publishedDay><publishedMonth>1</publishedMonth><publishedYear>2024</publishedYear><publishedDate>2024-01-12</publishedDate><doi>10.3390/pharmacy12010013</doi><url/><notes/><college>COLLEGE NANME</college><department>Pharmacy</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>PHAR</DepartmentCode><institution>Swansea University</institution><apcterm>Other</apcterm><funders>This research was supported in part by grants of the European Commission-targeted call on cross-border law enforcement cooperation in the field of drug trafficking—DG Justice/DG Migrations and Home Affairs (JUST/2013/ISEC/DRUGS/AG/6429) Project EPS/NPS (Enhancing Police Skills concerning novel psychoactive substances, NPS). This research was also funded by the University of Hertfordshire, grant number 11.101336.3367.</funders><projectreference/><lastEdited>2024-04-07T13:10:22.0774654</lastEdited><Created>2024-02-02T14:34:09.7540648</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Pharmacy</level></path><authors><author><firstname>Anthony</firstname><surname>Mullin</surname><orcid>0000-0001-6854-6171</orcid><order>1</order></author><author><firstname>Mark</firstname><surname>Scott</surname><order>2</order></author><author><firstname>Giorgia</firstname><surname>Vaccaro</surname><order>3</order></author><author><firstname>Giuseppe</firstname><surname>Floresta</surname><orcid>0000-0002-0668-1260</orcid><order>4</order></author><author><firstname>Davide</firstname><surname>Arillotta</surname><orcid>0000-0002-8843-0595</orcid><order>5</order></author><author><firstname>Valeria</firstname><surname>Catalani</surname><orcid>0000-0001-6338-8653</orcid><order>6</order></author><author><firstname>John M.</firstname><surname>Corkery</surname><orcid>0000-0002-3849-817x</orcid><order>7</order></author><author><firstname>Jacqueline L.</firstname><surname>Stair</surname><orcid>0000-0001-8365-5894</orcid><order>8</order></author><author><firstname>Fabrizio</firstname><surname>Schifano</surname><orcid>0000-0002-4178-5401</orcid><order>9</order></author><author><firstname>Amira</firstname><surname>Guirguis</surname><orcid>0000-0001-8255-0660</orcid><order>10</order></author></authors><documents><document><filename>65563__29636__89b1737c747b476a8db62a322404e0db.pdf</filename><originalFilename>65563VoR.pdf</originalFilename><uploaded>2024-03-05T10:58:59.7566226</uploaded><type>Output</type><contentLength>3666932</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>This article is distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language><licence>http://creativecommons.org/licenses/by/4.0/</licence></document></documents><OutputDurs/></rfc1807>
spelling v2 65563 2024-02-02 Benzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniques b49270b9a0d580cf4f31f9a1b6c93f87 0000-0001-8255-0660 Amira Guirguis Amira Guirguis true false 2024-02-02 PHAR first_pagesettingsOrder Article ReprintsOpen AccessArticleBenzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniquesby Anthony Mullin 1ORCID,Mark Scott 1,Giorgia Vaccaro 1,Giuseppe Floresta 1,2ORCID,Davide Arillotta 3ORCID,Valeria Catalani 1ORCID,John M. Corkery 1ORCID,Jacqueline L. Stair 1ORCID,Fabrizio Schifano 1ORCID andAmira Guirguis 4,*ORCID1Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield AL10 9AB, UK2Department of Drug and Health Sciences, University of Catania, 95131 Catania, Italy3School of Clinical Pharmacology and Toxicology, University of Florence, 50121 Florence, Italy4Pharmacy, Medical School, The Grove Extension, Swansea University, Swansea SA2 8PP, UK*Author to whom correspondence should be addressed.Pharmacy 2024, 12(1), 13; https://doi.org/10.3390/pharmacy12010013Submission received: 27 October 2023 / Revised: 1 January 2024 / Accepted: 4 January 2024 / Published: 12 January 2024Downloadkeyboard_arrow_down Browse Figures Review Reports Versions NotesAbstractIntroduction: The designer benzodiazepine (DBZD) market continues to expand whilst evading regulatory controls. The widespread adoption of social media by pro-drug use communities encourages positive discussions around DBZD use/misuse, driving demand. This research addresses the evolution of three popular DBZDs, etizolam (E), flubromazepam (F), and pyrazolam (P), available on the drug market for over a decade, comparing the quantitative chemical analyses of tablet samples, purchased from the internet prior to the implementation of the Psychoactive Substances Act UK 2016, with the thematic netnographic analyses of social media content. Method: Drug samples were purchased from the internet in early 2016. The characterisation of all drug batches were performed using UHPLC-MS and supported with 1H NMR. In addition, netnographic studies across the platforms X (formerly Twitter) and Reddit, between 2016–2023, were conducted. The latter was supported by both manual and artificial intelligence (AI)-driven thematic analyses, using numerous.ai and ChatGPT, of social media threads and discussions. Results: UHPLC-MS confirmed the expected drug in every sample, showing remarkable inter/intra batch variability across all batches (E = 13.8 ± 0.6 to 24.7 ± 0.9 mg; F = 4.0 ± 0.2 to 23.5 ± 0.8 mg; P = 5.2 ± 0.2 to 11.5 ± 0.4 mg). 1H NMR could not confirm etizolam as a lone compound in any etizolam batch. Thematic analyses showed etizolam dominated social media discussions (59% of all posts), with 24.2% of posts involving sale/purchase and 17.8% detailing new administration trends/poly-drug use scenarios. Artificial intelligence confirmed three of the top five trends identified manually. Conclusions: Purity variability identified across all tested samples emphasises the increased potential health risks associated with DBZD consumption. We propose the global DBZD market is exacerbated by surface web social media discussions, recorded across X and Reddit. Despite the appearance of newer analogues, these three DBZDs remain prevalent and popularised. Reporting themes on harm/effects and new developments in poly-drug use trends, demand for DBZDs continues to grow, despite their potent nature and potential risk to life. It is proposed that greater controls and constant live monitoring of social media user content is warranted to drive active regulation strategies and targeted, effective, harm reduction strategies. Journal Article Pharmacy 12 1 13 MDPI AG 2226-4787 designer benzodiazepines; social media; poly-drug use; analytical characterisation 12 1 2024 2024-01-12 10.3390/pharmacy12010013 COLLEGE NANME Pharmacy COLLEGE CODE PHAR Swansea University Other This research was supported in part by grants of the European Commission-targeted call on cross-border law enforcement cooperation in the field of drug trafficking—DG Justice/DG Migrations and Home Affairs (JUST/2013/ISEC/DRUGS/AG/6429) Project EPS/NPS (Enhancing Police Skills concerning novel psychoactive substances, NPS). This research was also funded by the University of Hertfordshire, grant number 11.101336.3367. 2024-04-07T13:10:22.0774654 2024-02-02T14:34:09.7540648 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Pharmacy Anthony Mullin 0000-0001-6854-6171 1 Mark Scott 2 Giorgia Vaccaro 3 Giuseppe Floresta 0000-0002-0668-1260 4 Davide Arillotta 0000-0002-8843-0595 5 Valeria Catalani 0000-0001-6338-8653 6 John M. Corkery 0000-0002-3849-817x 7 Jacqueline L. Stair 0000-0001-8365-5894 8 Fabrizio Schifano 0000-0002-4178-5401 9 Amira Guirguis 0000-0001-8255-0660 10 65563__29636__89b1737c747b476a8db62a322404e0db.pdf 65563VoR.pdf 2024-03-05T10:58:59.7566226 Output 3666932 application/pdf Version of Record true This article is distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. true eng http://creativecommons.org/licenses/by/4.0/
title Benzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniques
spellingShingle Benzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniques
Amira Guirguis
title_short Benzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniques
title_full Benzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniques
title_fullStr Benzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniques
title_full_unstemmed Benzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniques
title_sort Benzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniques
author_id_str_mv b49270b9a0d580cf4f31f9a1b6c93f87
author_id_fullname_str_mv b49270b9a0d580cf4f31f9a1b6c93f87_***_Amira Guirguis
author Amira Guirguis
author2 Anthony Mullin
Mark Scott
Giorgia Vaccaro
Giuseppe Floresta
Davide Arillotta
Valeria Catalani
John M. Corkery
Jacqueline L. Stair
Fabrizio Schifano
Amira Guirguis
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container_title Pharmacy
container_volume 12
container_issue 1
container_start_page 13
publishDate 2024
institution Swansea University
issn 2226-4787
doi_str_mv 10.3390/pharmacy12010013
publisher MDPI AG
college_str Faculty of Medicine, Health and Life Sciences
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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 - Pharmacy{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Pharmacy
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description first_pagesettingsOrder Article ReprintsOpen AccessArticleBenzodiazepine Boom: Tracking Etizolam, Pyrazolam, and Flubromazepam from Pre-UK Psychoactive Act 2016 to Present Using Analytical and Social Listening Techniquesby Anthony Mullin 1ORCID,Mark Scott 1,Giorgia Vaccaro 1,Giuseppe Floresta 1,2ORCID,Davide Arillotta 3ORCID,Valeria Catalani 1ORCID,John M. Corkery 1ORCID,Jacqueline L. Stair 1ORCID,Fabrizio Schifano 1ORCID andAmira Guirguis 4,*ORCID1Psychopharmacology, Drug Misuse & Novel Psychoactive Substances Research Unit, University of Hertfordshire, Hatfield AL10 9AB, UK2Department of Drug and Health Sciences, University of Catania, 95131 Catania, Italy3School of Clinical Pharmacology and Toxicology, University of Florence, 50121 Florence, Italy4Pharmacy, Medical School, The Grove Extension, Swansea University, Swansea SA2 8PP, UK*Author to whom correspondence should be addressed.Pharmacy 2024, 12(1), 13; https://doi.org/10.3390/pharmacy12010013Submission received: 27 October 2023 / Revised: 1 January 2024 / Accepted: 4 January 2024 / Published: 12 January 2024Downloadkeyboard_arrow_down Browse Figures Review Reports Versions NotesAbstractIntroduction: The designer benzodiazepine (DBZD) market continues to expand whilst evading regulatory controls. The widespread adoption of social media by pro-drug use communities encourages positive discussions around DBZD use/misuse, driving demand. This research addresses the evolution of three popular DBZDs, etizolam (E), flubromazepam (F), and pyrazolam (P), available on the drug market for over a decade, comparing the quantitative chemical analyses of tablet samples, purchased from the internet prior to the implementation of the Psychoactive Substances Act UK 2016, with the thematic netnographic analyses of social media content. Method: Drug samples were purchased from the internet in early 2016. The characterisation of all drug batches were performed using UHPLC-MS and supported with 1H NMR. In addition, netnographic studies across the platforms X (formerly Twitter) and Reddit, between 2016–2023, were conducted. The latter was supported by both manual and artificial intelligence (AI)-driven thematic analyses, using numerous.ai and ChatGPT, of social media threads and discussions. Results: UHPLC-MS confirmed the expected drug in every sample, showing remarkable inter/intra batch variability across all batches (E = 13.8 ± 0.6 to 24.7 ± 0.9 mg; F = 4.0 ± 0.2 to 23.5 ± 0.8 mg; P = 5.2 ± 0.2 to 11.5 ± 0.4 mg). 1H NMR could not confirm etizolam as a lone compound in any etizolam batch. Thematic analyses showed etizolam dominated social media discussions (59% of all posts), with 24.2% of posts involving sale/purchase and 17.8% detailing new administration trends/poly-drug use scenarios. Artificial intelligence confirmed three of the top five trends identified manually. Conclusions: Purity variability identified across all tested samples emphasises the increased potential health risks associated with DBZD consumption. We propose the global DBZD market is exacerbated by surface web social media discussions, recorded across X and Reddit. Despite the appearance of newer analogues, these three DBZDs remain prevalent and popularised. Reporting themes on harm/effects and new developments in poly-drug use trends, demand for DBZDs continues to grow, despite their potent nature and potential risk to life. It is proposed that greater controls and constant live monitoring of social media user content is warranted to drive active regulation strategies and targeted, effective, harm reduction strategies.
published_date 2024-01-12T13:10:18Z
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