Although etizolam is related to benzodiazepine drugs such as Xanax, Klonopin, and Valium, it is technically in a different drug class called thienodiazepines. Etizolam is much more potent than any of its benzodiazepine relatives—usually around 10 times more potent than diazepam or Valium—but produces many of the same effects.
Three countries—Italy, India, and Japan—have etizolam available as a prescription sedative, but most other countries have not passed legislation on the drug yet. That said, etizolam is considered a drug of abuse in the United States, but it is not technically illegal because it is not scheduled under the Controlled Substances Act (CSA).
When etizolam is prescribed in the countries that have made it legal, it is prescribed for some of the same conditions that benzodiazepines are prescribed for, like anxiety disorders, panic attacks, and insomnia. Etizolam was initially introduced in Japan in 1983 as a treatment for these neurological conditions, and it is usually prescribed in 0.25 mg, 0.5 mg, or 1 mg tablets.
When etizolam is found outside these countries, it is a drug of abuse, and it is most often found in the pure powdered form. This form of the drug is sold over the internet and sometimes in local convenience stores or “head shops” where it is labeled a research chemical. Unlike other new psychoactive substances (NPS), etizolam has been used in other countries in medical settings, and it is related to common drugs, so its side effects are better understood and predicted than many other NPS.
Long-term harm can be caused by consistent, high-dose benzodiazepine abuse, which means that abusing etizolam likely also leads to serious physical and mental harm.
Someone who has taken a lot of benzodiazepines or a larger dose of etizolam may appear drunk without consuming alcohol. Benzodiazepines, etizolam, and alcohol all work on the same area of the brain, so the effects across these three types of drugs will be very similar.
Some reports suggest there are few, if any, comedown effects from taking etizolam. However, like benzodiazepines, as the drug wears off, you are likely to experience depression, rebound anxiety, rebound insomnia, and trouble staying awake from fatigue. You also may feel sick or have trouble falling asleep. Feeling bad after abusing a drug that makes you feel good puts you at risk of returning immediately to that drug and taking more of it to feel normal.
Tolerance to benzodiazepines can develop quickly with regular consumption. Doctors are likely to prescribe a benzodiazepine in the smallest possible dose for as-needed use or regular use for two weeks or less. This is because the body rapidly develops a tolerance to these drugs, so you will feel like you need more of them to feel the original effects. This increases the risk that you could develop a dependence on them, meaning you may crave more to feel normal, not just high.
To understand how truly dangerous etizolam is, comparing the drug to Xanax, another widely prescribed and abused benzodiazepine, may be helpful.
Benzodiazepines are known to be an addiction risk in the U.S. Etizolam has been shown in studies involving monkeys to have reinforcing effects, meaning it is associated with drug addiction. In the countries that made it legal, it has been associated with some reports of addictive behaviors, dependence, and overdose.
Etizolam is only now making its way to the United States and the United Kingdom as a drug of abuse. According to law enforcement in the U.S., the number of reports of etizolam being seized in the country rose from just three in 2012 to 92 reports in 2013. Then, in just the first six months of 2014, there were 45 reports. Before 2012, law enforcement had no reports of etizolam anywhere in the U.S. However, the use of the drug is spreading across the country, worrying officials everywhere.
In fact, in February 2018, the Ohio State Board of Pharmacy voted to classify etizolam as a Schedule I substance. While it is not scheduled at the federal level, any reports of the drug in Ohio will be considered a serious drug crime since there is no recognized medical use for the substance in the U.S., and it is only available as a substance of abuse.
Other states that have banned etizolam include Alabama, Arkansas, Florida, Louisiana, and Mississippi. Georgia and Texas have both made the drug Schedule IV so it can be tracked, and it has been nonspecifically scheduled in Arizona and Indiana.
Benzodiazepines have been used as a date rape drug—the most infamous of which is Rohypnol—in the U.S. Mixing any benzodiazepine with alcohol unbeknownst to the person drinking the beverage can lead to them passing out or blacking out, making them extremely vulnerable to crime. Although there are not yet specific reports of etizolam being abused in this way in the U.S., the potency of the substance and ease of finding it online may lead someone to abuse etizolam mixed with alcohol as a date rape drug.
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The World Health Organization (WHO) does not list any specific differences between the effectiveness of Xanax versus etizolam and considers etizolam to have a “low-to-moderate” addiction risk. At the same time, Xanax is one of the most abused drugs in the U.S., even among benzodiazepines. Some studies in the late 1980s found there was greater somatization among people who took etizolam compared to Xanax, but this was not considered to be significant.
Etizolam is largely dangerous in the U.S. because it is always an illicit drug here. It could be mixed with other substances such as the stimulant cocaine, opioid fentanyl, or other illicit benzodiazepines. There is no way to appropriately dose it because there is no medical supervision for the drug. It is more potent than several benzodiazepines, so taking too much will lead to an overdose. As a result, you are more likely to abuse the drug and become addicted to it.
There are no known treatments for etizolam addiction, but treatment programs specializing in benzodiazepine addiction can help. A medically supervised detox, followed by evidence-based behavioral therapy, creates the core foundation to overcome addiction to any drug, especially potent and illicit substances like etizolam.
(October 2014). Etizolam. Drug Enforcement Administration (DEA), Office of Diversion Control, Drug & Chemical Evaluation Section. Retrieved September 2018 from https://www.deadiversion.usdoj.gov/drug_chem_info/etizolam.pdf
(August 14, 2018). STREET VALIUM Etizolam is TEN TIMES more potent that Valium and Diazepam – what is the psychoactive drug used for, what are the side effects and is it legal? The Scottish Sun. Retrieved September 2018 from https://www.thescottishsun.co.uk/news/3045939/etizolam-valoum-diazepam-scotland-uk-drug-side-effects-legal/
(October 29, 2013). Benzodiazepines. Center for Substance Abuse Research (CESAR). Retrieved September 2018 from http://www.cesar.umd.edu/cesar/drugs/benzos.asp
(June 17, 2014). Information Sheet: Etizolam. Scottish Drugs Forum (SDF), DrugWatch. Retrieved September 2018 from http://www.policecare.scot.nhs.uk/wp-content/uploads/2016/05/Etizolam_Infosheet_SDF_DrugWatch1_01.pdf
(July 7, 2018). Etizolam vs. Xanax (Alprazolam): What’s The Difference? Mental Health Daily. Retrieved September 2018 from https://mentalhealthdaily.com/2018/07/17/etizolam-vs-xanax-alprazolam/
Benzodiazepine Abuse. WebMD. Retrieved September 2018 from https://www.webmd.com/mental-health/addiction/benzodiazepine-abuse#1
(February 19, 2018). State Board of Pharmacy Classifies Etizolam as a Schedule I Controlled Substance. State of Ohio Board of Pharmacy. Retrieved September 2018 from https://www.pharmacy.ohio.gov/Documents/LawsRules/RuleChanges/Year/2018/State%20Board%20of%20Pharmacy%20Classifies%20Etizolam%20as%20a%20Schedule%20I%20Controlled%20Substance.pdf
(September 4, 2018). Rohypnol. Drugs.com. Retrieved September 2018 from https://www.drugs.com/illicit/rohypnol.html