Etizolam Category: Depressants

Image Source: Drug Watch and Scottish Drug Forum Information Sheet: Etizolm

Etizolam is a benzodiazepine analogue. Benzodiazepines (benzos) are a large group of prescription drugs used to treat anxiety and insomnia. They can also be used to treat alcohol withdrawals, muscle spasms and seizures.

There are many different types of benzodiazepines that can be either short, medium or long-acting depending on the compound.
Etizolam was patented in the 1970s and has been marketed since the early 1980s. It is sold commercially as a medicine in a limited number of countries (Japan, Italy and India).

It has emerged on the New Psychoactive Substance Market and in counterfeit benzodiazepine tablets in Ireland, as a single ingredient in tablets but also mixed with other substances.

The emergence of Etizolam in products without a person knowing is a concern as it is more potent in low doses. It is also appearing in mixtures/combinations of substances pressed into one tablet which increases the risk of overdose. A 1mg Etizolam tablet is equivalent to 10mg Diazepam (Valium) tablet.

Etizolam was first notified to the European Early warning system in 2011 and has been associated with an increasing number of deaths, particularly in Scotland where it has had a prominent role in drug-related deaths since 2014. In Ireland, it was first documented by Forensic Science Ireland in their 2016 Annual Report. Etizolam was implicated in 18 deaths in Ireland from 2015-2017.

Learn more about new benzodiazepines and the current market here

Appearance

Often people consume etizolam in a counterfeit tablet without knowing. It is impossible to know what the tablets you buy without a prescription contain.
Etizolam has been identified in a range of tablets sold as benzodiazepines such as in Xanax sticks, ‘Nike’ counterfeit tablets and plain white tablets. You can never be fully sure of the contents of tablets sourced without a prescription.

Etizolam products are known to be blue or pink circular pills marked ‘EZ’. They can come in branded boxes containing blister packets or as single pills. Some may be called ‘pellets’. It is less often found as powders. There are a number of brand name products internationally.

How it’s used

Tablets are mostly consumed orally. Some people may inject benzodiazepine tablets but this is less common.

Effects

Drugs can effect each person differently. The effects will depend on personal factors such as your physical and mental health as well as the dose and potency of a substance.

The effects will also be influenced by the product you receive and if etizolam is mixed with other substances.

Below are common effects associated with Etizolam products:

It is readily absorbed after oral ingestion and it has a shorter half-life than many benzodiazepines meaning it leaves your system quicker
Sleepiness/groggy, sedative effects and impaired coordination
Confusion or memory loss
Respiratory depression
Relaxation, reduced anxiety or mood elevation
Nausea

Other risks

Etizolam use may be more risky for people with liver function issues as it is entirely metabolised by the liver.
Using with other substances such as alcohol or opioids increases the risk of overdose.
Etizolam pressed in pills that contain other substances increase the risk of overdose without the person knowing.
Some people report experiencing a ‘come down’ after using etizolam. This can mean feeling very tired, low or depressed for a number of days after using.

Dependence

There is some evidence to suggest that etizolam is less likely to induce tolerance and dependence compared with classical benzodiazepines due to the short acting effect of the substance. However, as with all benzodiazepines, dependence may develop after regular use. Abrupt cessation after a period of regular use may cause withdrawal symptoms to appear.

What are the European trends?

We learn about drug trends from our EU counterparts who provide drug monitoring and drug checking services. From this we know that Etizolam has been appearing in tablets sold as well known benzodiazepines such as Diazepam.

Image source: WEIDNOS (Welsh Emerging Drugs & Identification of Novel Substanaces Project)

'Street benzodiazepine' deaths have been rapidly increasing in Scotland.Etizolam is the ‘street’ benzodiazepine that is most often implicated in drug- related deaths

Image source: Crew 2000 Trends Report 2019- 2020

Etizolam in Ireland

Etizolam has been found on it's own as well as mixed with other substances in tables/sticks/bars. See below examples where it has been identified.

Further information

Drug Watch Factsheet: Etizolam
Information about new benzodiazepines for the general public
HSE update for professionals
Welsh Emerging Drugs & Identification of Novel Substanaces Project

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