This report provides a technical review of the current body of knowledge regarding new benzodiazepines that are monitored by the EU Early Warning System. The aims of this report are to strengthen situational awareness of new benzodiazepines in Europe, and to help stakeholders prepare for and respond to public health and social threats caused by such substances. 

Often marketed as ‘designer benzodiazepines’, these substances are sold as ‘legal’ replacements for controlled benzodiazepines and are becoming increasingly available in Europe. They are monitored by the agency as new psychoactive substances (NPS) through the EU Early Warning System (EWS). The EMCDDA currently monitors 30 new benzodiazepines, over 80% of which were detected for the first time between 2014 and 2020. Despite this relatively large number, the new benzodiazepine market in Europe is currently dominated by etizolam and flualprazolam — although this may change, as both substances were placed under international control in November 2020. In 2019, 1 240 seizures of new benzodiazepines were reported by the EU Member States (around 5% of NPS seizures).

Initially, the substances were sold as ‘legal highs’ or ‘research chemicals’ under their own names (e.g. phenazepam, pyrazolam). While this continues to be the case, increasingly, they are also used by criminal groups to manufacture fake versions of commonly prescribed benzodiazepine medicines (e.g. Valium®, Xanax®), which are then sold on the illicit market. Users may be unaware of the substances or doses they are taking, increasing the risk of severe poisoning, particularly if consumed with alcohol or other sedatives. As some new benzodiazepines (e.g. flualprazolam and etizolam) are placed under control, there is a risk that other substances will take their place. One possibility is the re-emergence of flubromazolam and deschloroetizolam, which were first notified in Europe in 2014.

Table of contents

• Methods and information sources
• Executive summary
• Background
• New benzodiazepines in Europe
• Pshysical, chemical and pharmalogical properties 
• Health and social risks
• Extent and patterns of use, availability and potential for diffusion
• Conclusion
• References
• Annex - Profiles pf selected new benzodiazepines