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Concentrations of alprazolam in blood from impaired drivers and forensic autopsies were not much different but showed a high prevalence of co-ingested illicit drugs.

Abstract

Alprazolam is a benzodiazepine anxiolytic widely prescribed for treatment of panic-disorder and social phobias, although this medication is also subject to abuse. In this paper, the concentrations of alprazolam in venous blood samples from impaired drivers were compared with femoral blood samples from forensic autopsies classified as intoxication or other causes of death (e.g. natural, trauma). After liquid-liquid extraction (n-butyl acetate) alprazolam was determined in blood by capillary gas chromatography with a nitrogen-phosphorous detector. The mean (median) and range of alprazolam concentrations in blood from impaired drivers (n = 773) were 0.08 mg/L (0.05 mg/L) and 0.02-3.9 mg/L, respectively. Many traffic offenders had co-ingested ethanol (13%), amphetamine (46%), cannabis (32%), or heroin (14%), as well as other drugs. In deaths attributed to drug intoxication, the mean (median) and range of alprazolam concentrations in blood (n = 438) were 0.10 mg/L (0.06 mg/L) and 0.02-1.6 mg/L, respectively, which were not much different from other causes of death (n = 278); 0.08 mg/L (0.05 mg/L) and 0.02-0.9 mg/L. Median concentrations of alprazolam in blood from living and deceased persons did not seem to depend on the number of co-ingested substances. The result of this pharmacoepidemiological study suggests that alprazolam is a fairly innocent drug when used as monotherapy, but toxicity problems arise when co-ingested with illicit drugs and/or psychoactive medication.

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  • Authors+Show Affiliations

    ,

    Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden. wayne.jones@rmv.se

    Source

    MeSH

    Age Factors
    Alcoholism
    Alprazolam
    Amphetamine
    Anti-Anxiety Agents
    Automobile Driving
    Crime
    Databases, Factual
    Female
    Forensic Toxicology
    Heroin
    Humans
    Male
    Marijuana Abuse
    Psychotropic Drugs
    Street Drugs
    Substance Abuse Detection
    Substance-Related Disorders
    Sweden
    Wounds and Injuries

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    23257168

    Citation

    Jones, Alan Wayne, and Anita Holmgren. "Concentrations of Alprazolam in Blood From Impaired Drivers and Forensic Autopsies Were Not Much Different but Showed a High Prevalence of Co-ingested Illicit Drugs." Journal of Psychopharmacology (Oxford, England), vol. 27, no. 3, 2013, pp. 276-81.
    Jones AW, Holmgren A. Concentrations of alprazolam in blood from impaired drivers and forensic autopsies were not much different but showed a high prevalence of co-ingested illicit drugs. J Psychopharmacol (Oxford). 2013;27(3):276-81.
    Jones, A. W., & Holmgren, A. (2013). Concentrations of alprazolam in blood from impaired drivers and forensic autopsies were not much different but showed a high prevalence of co-ingested illicit drugs. Journal of Psychopharmacology (Oxford, England), 27(3), pp. 276-81. doi:10.1177/0269881112471155.
    Jones AW, Holmgren A. Concentrations of Alprazolam in Blood From Impaired Drivers and Forensic Autopsies Were Not Much Different but Showed a High Prevalence of Co-ingested Illicit Drugs. J Psychopharmacol (Oxford). 2013;27(3):276-81. PubMed PMID: 23257168.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Concentrations of alprazolam in blood from impaired drivers and forensic autopsies were not much different but showed a high prevalence of co-ingested illicit drugs. AU - Jones,Alan Wayne, AU - Holmgren,Anita, Y1 - 2012/12/20/ PY - 2012/12/22/entrez PY - 2012/12/22/pubmed PY - 2013/8/21/medline SP - 276 EP - 81 JF - Journal of psychopharmacology (Oxford, England) JO - J. Psychopharmacol. (Oxford) VL - 27 IS - 3 N2 - Alprazolam is a benzodiazepine anxiolytic widely prescribed for treatment of panic-disorder and social phobias, although this medication is also subject to abuse. In this paper, the concentrations of alprazolam in venous blood samples from impaired drivers were compared with femoral blood samples from forensic autopsies classified as intoxication or other causes of death (e.g. natural, trauma). After liquid-liquid extraction (n-butyl acetate) alprazolam was determined in blood by capillary gas chromatography with a nitrogen-phosphorous detector. The mean (median) and range of alprazolam concentrations in blood from impaired drivers (n = 773) were 0.08 mg/L (0.05 mg/L) and 0.02-3.9 mg/L, respectively. Many traffic offenders had co-ingested ethanol (13%), amphetamine (46%), cannabis (32%), or heroin (14%), as well as other drugs. In deaths attributed to drug intoxication, the mean (median) and range of alprazolam concentrations in blood (n = 438) were 0.10 mg/L (0.06 mg/L) and 0.02-1.6 mg/L, respectively, which were not much different from other causes of death (n = 278); 0.08 mg/L (0.05 mg/L) and 0.02-0.9 mg/L. Median concentrations of alprazolam in blood from living and deceased persons did not seem to depend on the number of co-ingested substances. The result of this pharmacoepidemiological study suggests that alprazolam is a fairly innocent drug when used as monotherapy, but toxicity problems arise when co-ingested with illicit drugs and/or psychoactive medication. SN - 1461-7285 UR - https://www.unboundmedicine.com/medline/citation/23257168/Concentrations_of_alprazolam_in_blood_from_impaired_drivers_and_forensic_autopsies_were_not_much_different_but_showed_a_high_prevalence_of_co_ingested_illicit_drugs_ L2 - http://journals.sagepub.com/doi/full/10.1177/0269881112471155?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -