Flualprazolam has been confirmed in at least 44 biological specimens associated with postmortem (PM) death investigations and driving under the influence of drugs (DUID) investigations in the United States since June 2019. The objective of this public announcement is to notify public health and public safety officials, law enforcement, clinicians, medical examiners and coroners, laboratory personnel, and all other related communities about information surrounding the emergent benzodiazepine flualprazolam — a novel psychoactive substance (NPS). NPS benzodiazepines, sometimes referred to as designer benzodiazepines, are synthetically manufactured drugs, often associated with unknown biological effects and health risks, a dangerous combination for any recreational drug user. NPS benzodiazepines resemble traditional benzodiazepines, such as diazepam and alprazolam, but differ with the addition of new elements or functional groups. NPS benzodiazepines are often prepared in powder or tablet form and can be mixed with street level drugs, including traditional benzodiazepines and opioids. NPS benzodiazepines are of public health and safety concern due to high potency at low doses producing strong sedation and amnesia. Additional adverse effects include loss of coordination, drowsiness, dizziness, blurred vision, slurred speech, and, in some cases, death.
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