Phenazepam is currently being misused in the UK

Phenazepam is a benzodiazepine not currently controlled in the United Kingdom, mainland Europe, or the United States. Developed in the 1970s for the treatment of epilepsy, alcohol withdrawal syndrome, insomnia, and anxiety,1 2 it is currently prescribed only in the former Soviet Bloc.

However, recent reports from Sweden, Finland, and the US describe its illicit use.3 In the UK concern over the safety of phenazepam was raised in 2010, when three people in the East Midlands and six people in Scotland were admitted to hospital after phenazepam overdoses.4 5 These cases and increased seizures of the drug by police led the Scottish Government to issue warnings about phenazepam. Having been alerted about its presence, we began screening necropsy blood samples for phenazepam in our forensic toxicology laboratory in Dundee from the end of January 2011.

To date, we have identified nine cases in which postmortem blood samples contained phenazepam. There was a history of drug misuse in all cases, and they occurred in men and women aged 31 to 45. Death was from the adverse effects of opiates in seven cases and from non-drug related causes in two.

This many cases suggests that the use of phenazepam by drug misusers in the UK is on the rise. Phenazepam can be obtained legally on the internet so it could become more widely used as substitute for controlled benzodiazepines or designer drugs such as mephedrone. Doctors should be aware of both the availability and illicit use of phenazepam in the UK.