Newly emerging synthetic cannabinoids and novel modes of use of benzodiazepines in prisons: An update from the Scottish Prisons Non-Judicial Seizures Drug Monitoring Project

In July 2021, the Chinese government implemented analogue controls for synthetic cannabinoid receptor agonists (SCRAs) covering the most popular compounds on the market at the time. International legislation is one of the main driving forces of market change and prisons can act as an early warning system for the emergence of new psychoactive substances (NPS) and novel modes of use. This study reports the latest synthetic cannabinoid receptor agonists (SCRAs) and benzodiazepines to emerge in the Scottish prisons following the international controls and the new modes of use of benzodiazepines that have emerged. Since the start of the Scottish Prisons Non-Judicial Seizures Drug Monitoring Project in September 2018, over 1600 individual samples from over 1200 unattributable suspected drug seizures have been tested. Samples included infused paper and card, tablets, powders, infused clothing, and blotters. Qualitative screening of seized samples suspected to contain controlled substances was carried out using gas chromatography-mass spectrometry (GC-MS) with verification by comparison to reference standards and/or orthogonal analysis by ultra-performance liquid chromatography with quadrupole time of flight mass spectrometry (UPLC-QToF-MS) if reference standards were not available. Following the enactment of the Chinese analogue controls for SCRAs in July 2021, seven new (or re-emerged) compounds have been detected in the Scottish prisons that circumvent this legislation, including 5F-3,5-AB-PFUPPYCA and 5,3-ADB-4en-PFUPPYCA in Q3 2021; BZO-HEXOXIZID (MDA-19), MDMB-5Br-INACA, ADB-5Br-INACA, and ADB-FUBIATA in Q4 2021; and CH-PIATA in Q1 2022. However, despite being controlled by this Chinese legislation, ADB-BUTINACA has remained the most common SCRA detected within the Scottish Prisons, appearing in over 66% of all SCRA samples since its first detection in Q1 2021. This could be due to a supply stockpile; production in other countries, such as India; or a new “self-assembly” product where people buy a pre-synthesis product, such as ADB-5Br-INACA, in a set with additional chemicals and instructions to complete the synthesis themselves. Etizolam was the most commonly detected benzodiazepine, appearing in over 81% of all benzodiazepine samples since Q1 2021, despite its international control in March 2020. Once again, this could be due to a supply stockpile or production in other countries without an etizolam control, such as India. Although there may be other routes of supply for etizolam, other benzodiazepines have emerged that are not internationally controlled, including flubromazepam and bromazolam. Flubromazepam emerged in Q3 2021 and since then has been detected in over 35% of benzodiazepine samples. In Q4 2020, benzodiazepines began to be detected in infused card and paper, a method previously almost exclusively used with SCRAs. By Q3 2021, card and paper became the most common matrix for benzodiazepines in the Scottish prisons. Benzodiazepine-infused cards and papers are often boiled in kettles and the liquid ingested; however, they are also vaped. There is little, if any, published information to date regarding the effects or harms of smoking or vaping benzodiazepines. Near-real time analysis of seized samples is vital for the rapid detection of new NPS compounds emerging in prisons and the general population in response to changes in international legislation. Compounds may have different potency and/or effects depending on the mode of use, so it is important for intelligence around modes of use to be gathered and investigated.