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

Abstract

Introduction: The designer benzodiazepine (DBZD) market continues to expand driven by pro-drug use communities on social media, increasing demand. This research addresses the evolution of three popularised DBZDs, etizolam(E), flubromazepam(F) and pyrazolam(P), available on the drug market for over a decade. Methods: Quantitative analysis of multiple drug batches, purchased in bulk in 2016 from 15 open web vendors, under a Home Office licence, was performed by UHPLC-MS(MS) and qualitatively supported by 1H NMR. Underpinned by a systematic literature review and netnographic analyses, both manual and artificial intelligence (AI)-driven thematic analyses of social media content on X and Reddit were performed between 2016-2023, using numerous.ai and ChatGBT. Results: UHPLC-MS(MS) confirmed the presence of expected drugs in every sample, showing significant inter/intra batch variability (E = 13.8 ± 0.6 to 24.7 ± 0.9mg; F = 4.0 ± 0.2 to 23.5 ± 0.8mg; P = 5.2 ± 0.2 to 11.5 ± 0.4mg). 1H NMR could not confirm etizolam as a lone compound in any etizolam batch. Etizolam dominated social media discussions (59% of posts); with 24.2% involving sale/purchase and 17.8% discussing new administration trends/poly-drug use. AI confirmed three of the top five trends identified manually. Conclusions: The findings emphasise a broad-spectrum in purity variability among samples, highlighting potential health risks associated with DBZDs. The study suggests that social media discussions on platforms like X and Reddit exacerbate the global DBZD market. Despite newer analogues emerging, these three drugs remain popular. The increasing demand, despite their potency and potential life risks, calls for greater control and real-time monitoring of social media content to implement effective harm reduction strategies and regulations.