Samuel Tobias1, Aaron M Shapiro2, Cameron J Grant1, Priya Patel1, Mark Lysyshyn3, Lianping Ti4. 1. British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, British Columbia, V6Z 2A9, Canada. 2. Provincial Toxicology Centre, 655 West 12th Ave., Vancouver, British Columbia, V5Z 4R4, Canada; Department of Pathology and Laboratory Medicine, University of British Columbia, 2211 Wesbrook Mall, Vancouver, British Columbia, V6T 2B5, Canada. 3. School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, British Columbia, V6T 1Z3, Canada; Vancouver Coastal Health Authority, 801-601 West Broadway, Vancouver, British Columbia, V5Z 4C2, Canada. 4. British Columbia Centre on Substance Use, 400-1045 Howe Street, Vancouver, British Columbia, V6Z 2A9, Canada; Department of Medicine, University of British Columbia, 10th Floor-2775 Laurel Street, Vancouver, British Columbia, V5Z 1M9, Canada. Electronic address: bccsu-lt@bccsu.ubc.ca.
Abstract
BACKGROUND: Non-prescribed benzodiazepine use is increasing in North America, especially among youth. Owing to increasing demand, counterfeit benzodiazepine tablets are mass-produced in clandestine, unregulated environments and sold as legitimate pharmaceuticals. This study aimed to examine the contents of counterfeit alprazolam tablets available in the unregulated drug market in British Columbia, Canada. METHODS: Data were collected from an ongoing evaluation of a community drug checking service in British Columbia between October 2017 and March 2020. The service operates point-of-care in harm reduction sites using Fourier-transform infrared (FTIR) spectrometers coupled with fentanyl and benzodiazepine immunoassay strips. A subset of samples were sent for confirmatory analysis at partner laboratories and underwent one or more of gas chromatography/mass spectrometry, liquid chromatography/mass spectrometry, and quantitative nuclear magnetic resonance analysis. RESULTS: During the study period, 10,814 total samples were submitted for drug checking, 139 of which were expected to be Xanax (alprazolam) or generic tablets and met the criteria for inclusion. Using FTIR analysis, 33 (23.7 %) samples were identified to contain alprazolam. Only 122 samples were checked using benzodiazepine immunoassay strips and 88 (72.1 %) tested positive. Qualitative results from the 20 samples submitted for confirmatory analysis included various new psychoactive substances and only 2 contained only alprazolam. CONCLUSIONS: Our findings provide evidence that Xanax tablets obtained from the unregulated drug market are likely to be counterfeit and may not contain alprazolam. Drug checking offers people who use drugs a valuable means to determine the contents of their substances; however, limitations of point-of-care technologies must be considered.
BACKGROUND: Non-prescribed benzodiazepine use is increasing in North America, especially among youth. Owing to increasing demand, counterfeit benzodiazepine tablets are mass-produced in clandestine, unregulated environments and sold as legitimate pharmaceuticals. This study aimed to examine the contents of counterfeit alprazolam tablets available in the unregulated drug market in British Columbia, Canada. METHODS: Data were collected from an ongoing evaluation of a community drug checking service in British Columbia between October 2017 and March 2020. The service operates point-of-care in harm reduction sites using Fourier-transform infrared (FTIR) spectrometers coupled with fentanyl and benzodiazepine immunoassay strips. A subset of samples were sent for confirmatory analysis at partner laboratories and underwent one or more of gas chromatography/mass spectrometry, liquid chromatography/mass spectrometry, and quantitative nuclear magnetic resonance analysis. RESULTS: During the study period, 10,814 total samples were submitted for drug checking, 139 of which were expected to be Xanax (alprazolam) or generic tablets and met the criteria for inclusion. Using FTIR analysis, 33 (23.7 %) samples were identified to contain alprazolam. Only 122 samples were checked using benzodiazepine immunoassay strips and 88 (72.1 %) tested positive. Qualitative results from the 20 samples submitted for confirmatory analysis included various new psychoactive substances and only 2 contained only alprazolam. CONCLUSIONS: Our findings provide evidence that Xanax tablets obtained from the unregulated drug market are likely to be counterfeit and may not contain alprazolam. Drug checking offers people who use drugs a valuable means to determine the contents of their substances; however, limitations of point-of-care technologies must be considered.
Authors: Wendy Masterton; Danilo Falzon; Gillian Burton; Hannah Carver; Bruce Wallace; Elizabeth V Aston; Harry Sumnall; Fiona Measham; Rosalind Gittins; Vicki Craik; Joe Schofield; Simon Little; Tessa Parkes Journal: Int J Environ Res Public Health Date: 2022-09-22 Impact factor: 4.614