Postmortem distribution of zolpidem in aviation accident victims.

The purpose of the study was to confirm there is a consistent postmortem distribution of zolpidem in postmortem blood and body tissues, and/or fluids making it possible to estimate zolpidem blood concentrations from fluid and tissue concentrations. The samples for the study were zolpidem-positive fatalities located in the CAMI ToxFlo database at the FAA's Bioaeronautical Sciences Research Laboratory. A UPLC/MS method was developed and validated. The LDR, LOD, LOQ, accuracy, precision, and matrix effect were evaluated. The specimens were analyzed for the distribution of zolpidem. The results of this study confirmed there is a consistent postmortem distribution of zolpidem found in the spleen, kidney, and lung; making it possible to roughly estimate, zolpidem blood concentrations from these tissues

Novel Designer Benzodiazepines: Comprehensive Review of Evolving Clinical and Adverse Effects.

As tranquilizers, benzodiazepines have a wide range of clinical uses. Recently, there has been a significant rise in the number of novel psychoactive substances, including designer benzodiazepines. Flubromazolam(8-bromo-6-(2-fluorophenyl)-1-methyl-

Cognitive Abilities Related to Driving Performance in a Simulator and Crashing on the Road

The purpose of this study was to examine the relationships between performances on standardized neuropsychological measures of cognitive abilities, simulated driving performance, and state crash records in drivers with cognitive decline due to aging and dementia. Participants were 202 experienced older adult drivers ages 55 years and older: 70 had mild dementia due to probable early Alzheimer’s disease and 132 had no neurologic disease. All completed a battery of neuropsychological tests and drove contemporaneously on a high fidelity simulator. The participants’ State Department of Transportation driving records were monitored for up to two years after testing. The simulator composite score, reflecting overall driving ability, was significantly correlated with overall cognitive ability, as indexed by the neuropsychology composite score, as well as with individual cognitive tests of attention, memory, visuospatial and visuomotor abilities. Drivers who crashed during an intersection incursion scenario performed significantly worse on the composite measure of cognitive function than those who successfully steered around the incurring vehicle. Crashers had specific cognitive deficits on measures of visuomotor abilities and attention. Memory test performances for both verbal information and visual material were associated with subsequent on-road crashes. These findings provide support for the validity of driving simulation as a safe means of evaluating a range of driving responses that cannot be tested on the road, and suggest that relatively simple and inexpensive neuropsychological tests of specific cognitive abilities could be used to help evaluate older drivers’ risk of unsafe drivin

‘New/Designer Benzodiazepines’: an analysis of the literature and psychonauts’ trip reports

BACKGROUND:NPS belonging to the benzodiazepine (BZD) class, e.g., 'legal/designer BZDs'/'research chemicals', have recently emerged on the drug (mainly online/virtual) market.OBJECTIVE:Whilst certain NPS belonging to the BZD class possess pharmacological profiles similar to controlled pharmaceutical BZDs, clinical and pharmacological profiles of current emerging BZDs are still not well-described. Therefore, there is a need to increase clinicians'/public health knowledge/awareness, to incentive harm reduction strategies.METHOD:A comprehensive overview was carried out by using the EMCDDA/EDND database regularly monitored by our research team, by specifically looking at the 'new BZDs' so far notified. Furthermore, given the limitation of peer-reviewed data published so far, a nonparticipant multilingual qualitative netnographic study was conducted to obtain further clinical/pharmacological/toxicological data, including psychonauts' online trip reports.RESULTS:First designer BZDs appeared as NPS around 2007. So far, 29 designer BZDs have been notified to the EMCDDA, being some of them extremely powerful, also at lower dosages. They are sold as tablets/powder/pellets/capsules/blotters/liquids, at very affordable prices, and variably administered. Some are also sold on the illicit drugmarket as counterfeit forms of traditional BZDs or as either adulterants or diluents in heroin or other synthetic opioids/cannabinoids. Nowadays, there is no guarantee of the quality of designer BZDs composition/purification and, hence, most NPS consumers may be inadvertently exposed to unsafe and harmful compounds.CONCLUSIONS:Given the limited information on their pharmacology/toxicity, variations in dosage, onset of effects, combination of substances, potency, and general patient or individual variability, the concomitant use of these substances with other drugs entails several and unpredictable risks