Rock Kirsten L, Frinculescu Anca, Shine Trevor, Kalk Nicola J, Copeland Caroline S
Institute of Pharmaceutical Science, King's College London, London, UK.
TICTAC Communications Limited, London, UK.
Drug Alcohol Rev. 2025 Jan;44(1):355-365. doi: 10.1111/dar.13979. Epub 2024 Nov 28.
'Street' benzodiazepines (BZD) are structurally and pharmacologically related to BZDs licensed for human use. In this study we investigated how street BZDs contribute to overall BZD use and death prevalences in England, Wales and Northern Ireland.
Data were analysed from deaths reported to the National Programme on Substance Use Mortality with post-mortem BZD detections (1999-2021), BZDs seized from music festivals (2017-2021) and drug samples with BZD detections submitted to Welsh Emerging Drugs and Identification of Novel Substances (WEDINOS) (2017-2021).
About 14,837 deaths with BZD detections were identified, with polydrug use evident in 99.3% of cases (n = 14,733/14,837). Deaths following BZD use increased by over 200% from 2010 (n = 556) to 2020 (n = 1245). Most BZD detections were of those available via NHS prescription (96.2%), although in most cases (61.9%) the BZD-majority diazepam (77.3% of detections)-had been illicitly sourced. While street BZD deaths represented only 8.5% of overall BZD deaths, street BZD deaths increased by over 1200% between 2015 (n = 26) and 2020 (n = 326). There were increasing proportions of street BZD deaths in each geographical region but was more marked in Northern Ireland. The proportion of individual BZDs seized at music festivals and submitted to WEDINOS largely reflected that of individual BZDs detected in deaths.
While deaths following street BZD use are increasing, most BZDs detected in deaths were prescribable BZDs that were often illicitly sourced. The types of BZD detected in post-mortem samples, festival seizures and WEDINOS submissions has evolved over time to reflect changes in BZD prevalence on the illicit drug market.
“街头”苯二氮䓬类药物（BZD）在结构和药理上与已获许可供人类使用的苯二氮䓬类药物相关。在本研究中，我们调查了街头苯二氮䓬类药物对英格兰、威尔士和北爱尔兰苯二氮䓬类药物总体使用情况和死亡流行率的影响。
对向国家药物使用死亡率计划报告的死亡数据进行分析，这些死亡案例经尸检检测出苯二氮䓬类药物（1999 - 2021年），分析了从音乐节查获的苯二氮䓬类药物（2017 - 2021年）以及提交给威尔士新兴药物与新型物质鉴定机构（WEDINOS）的检测出苯二氮䓬类药物的毒品样本（2017 - 2021年）。
共识别出约14837例检测出苯二氮䓬类药物的死亡案例，99.3%的案例（n = 14733/14837）存在多药使用情况。苯二氮䓬类药物使用后的死亡人数从2010年的556例（n = 556）增加到2020年的1245例，增长超过200%。大多数检测出的苯二氮䓬类药物是可通过英国国家医疗服务体系（NHS）处方获得的（96.2%），尽管在大多数情况下（61.9%），以苯二氮䓬类药物为主的地西泮（占检测案例的77.3%）是非法获取的。虽然街头苯二氮䓬类药物导致的死亡仅占苯二氮䓬类药物总体死亡人数的8.5%，但2015年（n = 26）至2020年（n = 326）期间，街头苯二氮䓬类药物导致的死亡人数增加了超过1200%。每个地理区域街头苯二氮䓬类药物导致的死亡比例都在上升，但在北爱尔兰更为明显。在音乐节查获并提交给WEDINOS的各类苯二氮䓬类药物比例在很大程度上反映了在死亡案例中检测出的各类苯二氮䓬类药物比例。
虽然街头苯二氮䓬类药物使用导致的死亡人数在增加，但在死亡案例中检测出的大多数苯二氮䓬类药物是可开具处方的苯二氮䓬类药物，且通常是非法获取的。随着时间的推移，尸检样本、音乐节查获物和提交给WEDINOS的样本中检测出的苯二氮䓬类药物类型发生了变化，以反映非法药物市场上苯二氮䓬类药物流行情况的变化。
