A systematic review published in *PLOS ONE* on October 2024, provides alarming insights into the escalating drug-related death crisis in Scotland. Conducted by researchers from the University of the West of Scotland, the review highlights the concerning role of gabapentinoids and etizolam in contributing to the country's surging drug-related fatalities.
Scotland has been grappling with a disproportionately high rate of drug-related deaths (DRDs) compared to the rest of Europe, and this review sheds light on two substances increasingly found in toxicology reports: gabapentinoids, commonly prescribed for pain and anxiety, and etizolam, a designer benzodiazepine.
The study, led by Beata Ciesluk, Dr. Greig Inglis, Adrian Parke, and Dr. Lucy J. Troup, analyzed 18 peer-reviewed studies published between 2013 and 2023. It reveals that since 2015, deaths related to both gabapentinoids and etizolam have shown a marked increase, particularly among older women and within the Scottish prison system.
The report notes a growing trend of polydrug use—where gabapentinoids and etizolam are combined with other substances like opioids, amplifying the risk of fatal overdoses. In fact, polydrug use was identified as the most significant factor contributing to adverse outcomes and fatalities involving these substances.
The review identifies gabapentinoids—prescribed for neuropathic pain and anxiety—as increasingly implicated in drug-related deaths in Scotland. Prescriptions for gabapentinoids have surged, despite concerns about their misuse and abuse potential. The report indicates that these drugs, while not typically lethal on their own, become dangerous when combined with opioids and other depressants, often leading to respiratory depression and fatal outcomes.
Etizolam, a designer benzodiazepine originally developed as an anxiolytic, has also seen a sharp rise in misuse. Although marketed as less lethal than traditional benzodiazepines, its widespread availability and frequent use in conjunction with other drugs have made it a significant contributor to Scotland’s DRD crisis. The illicit market for etizolam has expanded rapidly, with counterfeit pills circulating widely. These often contain unpredictable dosages, exacerbating the risk of overdose.
The report calls for urgent action to address these troubling trends. It suggests that Scotland’s initiatives to restrict opioid and benzodiazepine prescriptions may have unintentionally driven individuals towards gabapentinoids and designer benzodiazepines like etizolam. As the crisis worsens, the need for targeted education, harm reduction strategies, and more stringent regulations becomes increasingly clear.
The full article can be accessed at this link (clearnet).
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