真假难辨？在澳大利亚定期使用非法药物的两个样本人群中，非处方苯二氮䓬类药物的来源和销售情况。
Real or fake? Sourcing and marketing of non-prescribed benzodiazepines amongst two samples of people who regularly use illicit drugs in Australia.
机构信息
National Drug Research Institute and enAble Institute, Curtin University, Perth, Australia.
National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia.
出版信息
Drug Alcohol Rev. 2023 Sep;42(6):1559-1565. doi: 10.1111/dar.13722. Epub 2023 Jul 25.
INTRODUCTION
There is concern around non-prescribed benzodiazepine use, particularly with increasing detections of counterfeit products containing high-risk novel compounds. The aims of this study were to investigate how and which non-prescribed benzodiazepines are being sourced; forms, appearance and packaging; and awareness of risks associated with non-prescribed benzodiazepines.
METHODS
Data were collected from a sample of Australians who inject drugs or use ecstasy and/or other illicit stimulants on a monthly or more frequent basis, and who reported past 6-month use of non-prescribed benzodiazepines (n = 235 and n = 250, respectively). Data were collected on source, diversion from a known/trusted prescription, product name and aesthetic characteristics for the last non-prescribed benzodiazepine obtained.
RESULTS
Amongst participants who injected drugs, 71% reported that their last non-prescribed benzodiazepines were diverted from a known/trusted prescription, compared to 59% of participants who used ecstasy/other stimulants. Sourcing via cryptomarkets was rare. Across both samples, the majority reported last obtaining substances sold/marketed as diazepam or alprazolam. Participants sourcing via non-diverted means were twice as likely to obtain alprazolam. Known sourcing of novel compounds was rare. Amongst participants who used ecstasy/other stimulants, 36% reported confidence in the content/dose of non-prescribed benzodiazepines even when the source is unknown.
DISCUSSION AND CONCLUSIONS
Most participants obtained substances sold as classic/registered benzodiazepines, mostly via diverted prescriptions, with a substantial minority potentially unaware of counterfeits circulating. While diverted use undeniably presents risks, tightening of prescriptions in Australia could inadvertently lead to greater supply of novel benzodiazepines as seen internationally, reinforcing prioritisation of demand and harm reduction strategies.
简介
非处方苯二氮䓬类药物的使用引起了关注，尤其是越来越多的检测发现含有高风险新型化合物的假冒产品。本研究的目的是调查非处方苯二氮䓬类药物的来源途径、来源类型、外观和包装，以及人们对非处方苯二氮䓬类药物相关风险的认识。
方法
从每月或更频繁地注射毒品或使用摇头丸和/或其他非法兴奋剂的澳大利亚人中收集数据，这些人报告过去 6 个月内使用过非处方苯二氮䓬类药物（分别为 235 人和 250 人）。数据收集的内容包括最后一次非处方苯二氮䓬类药物的来源、从已知/可信处方中转移的情况、产品名称和外观特征。
结果
在注射毒品的参与者中，71%的人报告说，他们最后一次非处方苯二氮䓬类药物是从已知/可信处方中转移过来的，而使用摇头丸/其他兴奋剂的参与者中这一比例为 59%。通过加密市场获取的情况很少见。在两个样本中，大多数人报告最后获得的是被销售/标记为地西泮或阿普唑仑的药物。通过非转移途径获得药物的参与者获得阿普唑仑的可能性是其两倍。很少有参与者报告知道新型化合物的来源。在使用摇头丸/其他兴奋剂的参与者中，36%的人即使不知道来源，也对非处方苯二氮䓬类药物的含量/剂量有信心。
讨论和结论
大多数参与者获得的是被销售为经典/注册苯二氮䓬类药物的物质，主要通过转移处方获得，少数人可能不知道正在流通的假冒药物。虽然转移使用不可避免地存在风险，但澳大利亚收紧处方可能会无意中导致新型苯二氮䓬类药物的供应增加，这在国际上已经得到证实，这进一步强调了需求和减少伤害策略的优先地位。
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