Increasing prevalence of designer benzodiazepines in impaired driving: A 5-year analysis from 2017 to 2021.

This article focuses on the increasing detection and impact of designer benzodiazepines (DBZDs)—a subclass of novel psychoactive substances (NPS) with central nervous system depressant effects—in driving under the influence of drugs (DUID) cases between 2017 and 2021. Analysis of 805 blood samples revealed 11 different DBZDs, with etizolam and flualprazolam being the most frequently detected, often alongside other substances such as opioids and cannabis. Drug recognition expert evaluations of cases where DBZDs were the sole or primary intoxicant showed impairment consistent with CNS depressants, including slurred speech, poor coordination, and lethargy. The study highlights challenges in toxicological detection due to evolving DBZD compounds and metabolites, underreporting from variable testing protocols, and the public safety risks posed by DBZDs found in counterfeit pharmaceuticals and illicit drug mixtures.