• Christena Watts and Teri L Martin.
• Toxicology Section, Centre of Forensic Sciences, 25 Morton Shulman Ave, Toronto ON M3M 0B1, Canada.
• J Anal Toxicol. 2021 Sep 28.

AbstractAlthough not used clinically in North America, etizolam has been identified in forensic samples as an illicit, "designer" benzodiazepine. Having central nervous system (CNS) depressant effects, analysis for etizolam has probative value in both death investigations and in forensic cases where incapacitation or human psychomotor performance are relevant. This report examines toxicological findings and demographic data in a series of authentic forensic cases analyzed between November 2019 and December 2020 in which etizolam was quantified by LC-MS/MS analysis. Blood concentrations were determined in 191 individuals aged 1 to 75 years. In living individuals (i.e., impaired driving, sexual assaults), etizolam concentrations ranged from < 5 ng/mL to 767 ng/mL which overlapped with the range of < 5 ng/mL to 260 ng/mL reported in death investigations. In all but one case, other drugs were detected in combination with etizolam. Fentanyl was the most common co-occurring drug and was present in 164 cases (86%). Additional case details are provided for cases of forensic interest: two deaths involving children under three years of age, two deaths involving body-packing, and an individual arrested for drug-impaired driving with, to our knowledge, the highest reported etizolam concentration to date.© The Author(s) 2021. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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