Etizolam: Difference between revisions

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[[Subjective effects]] include [[anxiety suppression]], [[disinhibition]], [[muscle relaxation]], [[sedation]], and [[euphoria]]. Etizolam is commonly administered [[oral|orally]] and [[sublingual|sublingually]] due to the high bioavailability of these routes.  
[[Subjective effects]] include [[anxiety suppression]], [[disinhibition]], [[muscle relaxation]], [[sedation]], and [[euphoria]]. Etizolam is commonly administered [[oral|orally]] and [[sublingual|sublingually]] due to the high bioavailability of these routes.  


Users should note that that as with [[benzodiazepines]], [[Thienodiazepine#Discontinuation|the sudden discontinuation of thienodiazepines]] can be dangerous or even life-threatening for long-term or heavy users. As a result, individuals who are physically dependent on this substance are advised to [[taper]] their dose by gradually lowering the amount taken each day over a prolonged period of time instead of stopping use abruptly.<ref>{{cite journal | vauthors=((Kahan, M.)), ((Wilson, L.)), ((Mailis-Gagnon, A.)), ((Srivastava, A.)) | journal=Canadian Family Physician | title=Canadian guideline for safe and effective use of opioids for chronic noncancer pain. Appendix B-6: Benzodiazepine Tapering | volume=57 | issue=11 | pages=1269–1276 | date= November 2011 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215603/ | issn=0008-350X}}</ref>
As with [[benzodiazepines]], [[Thienodiazepine#Discontinuation|the sudden discontinuation of thienodiazepines]] can be dangerous or even life-threatening for long-term or heavy users. As a result, individuals who are physically dependent on this substance are advised to [[taper]] their dose by gradually lowering the amount taken each day over a prolonged period of time instead of stopping use abruptly.<ref>{{cite journal | vauthors=((Kahan, M.)), ((Wilson, L.)), ((Mailis-Gagnon, A.)), ((Srivastava, A.)) | journal=Canadian Family Physician | title=Canadian guideline for safe and effective use of opioids for chronic noncancer pain. Appendix B-6: Benzodiazepine Tapering | volume=57 | issue=11 | pages=1269–1276 | date= November 2011 | url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3215603/ | issn=0008-350X}}</ref>


Due to its high abuse and addiction potential, it is highly advised to use proper [[harm reduction practices]] if using this substance.{{citation needed|reason=Personal experience and anecdotal reports suggest the contrary. Are there any references on specifically etizolam causing strong addiction as benzodiazepines?|date=November 2020}}
Due to its high abuse and addiction potential, it is highly advised to use proper [[harm reduction practices]] if using this substance.{{citation needed|reason=Personal experience and anecdotal reports suggest the contrary. Are there any references on specifically etizolam causing strong addiction as benzodiazepines?|date=November 2020}}
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==Pharmacology==
==Pharmacology==
Thienodiazepines produce a variety of effects by binding to the benzodiazepine receptor site and magnifying the efficiency and effects of the neurotransmitter [[GABA|gamma aminobutyric acid (GABA)]] by acting on its [[receptor]]s.<ref>{{cite journal | vauthors=((Haefely, W.)) | journal=Neuroscience Letters | title=Benzodiazepine interactions with GABA receptors | volume=47 | issue=3 | pages=201–206 | date=29 June 1984 | issn=0304-3940 | doi=10.1016/0304-3940(84)90514-7}}</ref> As this site is the most prolific inhibitory receptor set within the brain, its modulation results in the [[sedating]] (or [[anxiety suppression|calming effects]]) of etizolam on the nervous system.
Thienodiazepines produce a variety of effects by binding to the benzodiazepine binding site (formerly referred to as the BZD receptor) at the GABA-A receptor complex, magnifying the efficicacy and effects of the neurotransmitter [[GABA|gamma aminobutyric acid (GABA)]] by increasing its ability to bind more readily to its own [[receptor]]s.<ref>{{cite journal | vauthors=((Haefely, W.)) | journal=Neuroscience Letters | title=Benzodiazepine interactions with GABA receptors | volume=47 | issue=3 | pages=201–206 | date=29 June 1984 | issn=0304-3940 | doi=10.1016/0304-3940(84)90514-7}}</ref> This is known as positive allosteric modulation.<ref>https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684331/#s2title</ref> As this site is the most prolific inhibitory receptor set within the brain, its modulation results in the [[sedating]] (or [[anxiety suppression|calming effects]]) of etizolam on the nervous system.


==Subjective effects==
==Subjective effects==
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Like most benzodiazepines, etizolam is considered to be [[Addiction potential::highly addictive with a high potential for abuse]].  
Like most benzodiazepines, etizolam is considered to be [[Addiction potential::highly addictive with a high potential for abuse]].  


In one study in which multiple doses of either etizolam or lorazepam were administered to rat neurons, tolerance to the anticonvulsant effects of lorazepam but not to etizolam was observed.<ref name="thirteen">{{cite journal | vauthors=((Sanna, E.)), ((Busonero, F.)), ((Talani, G.)), ((Mostallino, M. C.)), ((Mura, M. L.)), ((Pisu, M. G.)), ((Maciocco, E.)), ((Serra, M.)), ((Biggio, G.)) | journal=European Journal of Pharmacology | title=Low tolerance and dependence liabilities of etizolam: molecular, functional, and pharmacological correlates | volume=519 | issue=1–2 | pages=31–42 | date=5 September 2005 | issn=0014-2999 | doi=10.1016/j.ejphar.2005.06.047}}</ref> Etizolam therefore has a reduced liability to induce tolerance, and dependence when compared with classic benzodiazepines.<ref name="thirteen"/>
In one study in which multiple doses of either etizolam or lorazepam were administered to rat neurons, tolerance to the anticonvulsant effects of lorazepam but not to etizolam was observed.<ref name="thirteen">{{cite journal | vauthors=((Sanna, E.)), ((Busonero, F.)), ((Talani, G.)), ((Mostallino, M. C.)), ((Mura, M. L.)), ((Pisu, M. G.)), ((Maciocco, E.)), ((Serra, M.)), ((Biggio, G.)) | journal=European Journal of Pharmacology | title=Low tolerance and dependence liabilities of etizolam: molecular, functional, and pharmacological correlates | volume=519 | issue=1–2 | pages=31–42 | date=5 September 2005 | issn=0014-2999 | doi=10.1016/j.ejphar.2005.06.047}}</ref> Etizolam therefore has a reduced liability to induce tolerance, and dependence when compared with classic benzodiazepines.<ref name="thirteen" />


Tolerance will, however, develop to the sedative-hypnotic effects [[Time to full tolerance::within a couple of days of continuous use]]. After cessation, the tolerance returns to baseline in [[Time to zero tolerance::7 - 14 days]]. However, in certain cases this may take significantly longer in a manner which is proportional to the duration and intensity of one's long-term usage.
Tolerance will, however, develop to the sedative-hypnotic effects [[Time to full tolerance::within a couple of days of continuous use]]. After cessation, the tolerance returns to baseline in [[Time to zero tolerance::7 - 14 days]]. However, in certain cases this may take significantly longer in a manner which is proportional to the duration and intensity of one's long-term usage.
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*'''Switzerland''': Etizolam is a controlled substance specifically named under Verzeichnis B. Medicinal use is permitted.<ref>{{cite web|url=https://www.admin.ch/opc/de/classified-compilation/20101220/index.html|title=Verordnung des EDI über die Verzeichnisse der Betäubungsmittel, psychotropen Stoffe, Vorläuferstoffe und Hilfschemikalien|publisher=Bundeskanzlei [Federal Chancellery of Switzerland]|access-date=January 1, 2020|language=de}}</ref>
*'''Switzerland''': Etizolam is a controlled substance specifically named under Verzeichnis B. Medicinal use is permitted.<ref>{{cite web|url=https://www.admin.ch/opc/de/classified-compilation/20101220/index.html|title=Verordnung des EDI über die Verzeichnisse der Betäubungsmittel, psychotropen Stoffe, Vorläuferstoffe und Hilfschemikalien|publisher=Bundeskanzlei [Federal Chancellery of Switzerland]|access-date=January 1, 2020|language=de}}</ref>
*'''Turkey:''' Etizolam is a classed as drug and is illegal to possess, produce, supply, or import.<ref name="Bakanlar Kurulu Kararı - Karar Sayısı : 2013/5742">{{Citation | title=Başbakanlık Mevzuatı Geliştirme ve Yayın Genel Müdürlüğü | url=https://resmigazete.gov.tr/eskiler/2014/01/20140125-3.htm}}</ref> <ref name="List of illegal substances for law"> https://resmigazete.gov.tr/eskiler/2014/01/20140125-3-1.pdf</ref>
*'''Turkey:''' Etizolam is a classed as drug and is illegal to possess, produce, supply, or import.<ref name="Bakanlar Kurulu Kararı - Karar Sayısı : 2013/5742">{{Citation | title=Başbakanlık Mevzuatı Geliştirme ve Yayın Genel Müdürlüğü | url=https://resmigazete.gov.tr/eskiler/2014/01/20140125-3.htm}}</ref> <ref name="List of illegal substances for law"> https://resmigazete.gov.tr/eskiler/2014/01/20140125-3-1.pdf</ref>
*'''The Netherlands''': Etizolam is a List 2 substance of the Opium Law, making it illegal.<ref>{{Citation|title=Opiumwet, Lijst II (Dutch) | year=2023|url=https://wetten.overheid.nl/BWBR0001941/2023-09-12#BijlageII}}</ref>
*'''United Kingdom''': As of May 31st, 2017, etizolam is a Class C substance in the United Kingdom, making it illegal to possess, produce, or supply.<ref>The Misuse of Drugs (Amendment) (England, Wales and Scotland) Regulations 2017 | http://www.tihs.org.uk/timeline/resources/2017-631.pdf</ref>
*'''United Kingdom''': As of May 31st, 2017, etizolam is a Class C substance in the United Kingdom, making it illegal to possess, produce, or supply.<ref>The Misuse of Drugs (Amendment) (England, Wales and Scotland) Regulations 2017 | http://www.tihs.org.uk/timeline/resources/2017-631.pdf</ref>
*'''United States''': Etizolam is not federally prohibited in the United States. However, some state legislatures have passed laws prohibiting it in their jurisdictions. As of July 2019, etizolam is a controlled substance in the following states: Alabama<ref>{{Citation | title=Alabama Code Title 20. Food, Drugs, and Cosmetics § 20-2-23 | url=https://codes.findlaw.com/al/title-20-food-drugs-and-cosmetics/al-code-sect-20-2-23.html}}</ref>, Arkansas<ref>http://www.healthy.arkansas.gov/aboutadh/rulesregs/controlled_substances_list.pdf</ref>, Florida<ref>{{Citation | title=Statutes & Constitution :View Statutes : Online Sunshine | url=http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0800-0899/0893/Sections/0893.03.html}}</ref>, Georgia<ref>http://www.namsdl.org/library/946E60B2-ABB3-24A6-F087859B3EA48EC1/</ref>, Louisiana, Mississippi<ref>{{Citation | title=HB1231 (As Sent to Governor) - 2014 Regular Session | url=http://billstatus.ls.state.ms.us/documents/2014/html/HB/1200-1299/HB1231SG.htm}}</ref>, Texas,{{citation needed}} South Carolina<ref>{{Citation | title=Controlled Substance Schedule, SCDHEC | url=https://scdhec.gov/healthcare-quality/drug-control-register-verify/controlled-substance-schedule}}</ref> and Virginia<ref>{{Citation | title=18VAC110-20-322. Placement of chemicals in Schedule I. | url=https://law.lis.virginia.gov/admincode/title18/agency110/chapter20/section322/}}</ref>, Indiana<ref>{{Citation | title=Ellington’s bill banning two deadly drugs could soon be law, State of Indiana House of Representatives | url=https://www.indianahouserepublicans.com/news/press-releases/ellington-s-bill-banning-two-deadly-drugs-could-soon-be-law/}}</ref>, and Ohio{{citation needed}}.
*'''United States''': Etizolam was temporarily scheduled on January 23rd, 2023 by the DEA, making Etizolam a Schedule I controlled substance <ref>Schedules of Controlled Substances: Temporary Placement of Etizolam, Flualprazolam, Clonazolam, Flubromazolam, and Diclazepam in Schedule I | https://www.federalregister.gov/documents/2022/12/23/2022-27278/schedules-of-controlled-substances-temporary-placement-of-etizolam-flualprazolam-clonazolam</ref>. Prior to its temporary scheduling, some state legislatures have passed laws prohibiting it in their jurisdictions. As of July 2019, etizolam is a controlled substance in the following states: Alabama<ref>{{Citation | title=Alabama Code Title 20. Food, Drugs, and Cosmetics § 20-2-23 | url=https://codes.findlaw.com/al/title-20-food-drugs-and-cosmetics/al-code-sect-20-2-23.html}}</ref>, Arkansas<ref>http://www.healthy.arkansas.gov/aboutadh/rulesregs/controlled_substances_list.pdf</ref>, Florida<ref>{{Citation | title=Statutes & Constitution :View Statutes : Online Sunshine | url=http://www.leg.state.fl.us/Statutes/index.cfm?App_mode=Display_Statute&URL=0800-0899/0893/Sections/0893.03.html}}</ref>, Georgia<ref>http://www.namsdl.org/library/946E60B2-ABB3-24A6-F087859B3EA48EC1/</ref>, Louisiana, Mississippi<ref>{{Citation | title=HB1231 (As Sent to Governor) - 2014 Regular Session | url=http://billstatus.ls.state.ms.us/documents/2014/html/HB/1200-1299/HB1231SG.htm}}</ref>, Texas,{{citation needed}} South Carolina<ref>{{Citation | title=Controlled Substance Schedule, SCDHEC | url=https://scdhec.gov/healthcare-quality/drug-control-register-verify/controlled-substance-schedule}}</ref> and Virginia<ref>{{Citation | title=18VAC110-20-322. Placement of chemicals in Schedule I. | url=https://law.lis.virginia.gov/admincode/title18/agency110/chapter20/section322/}}</ref>, Indiana<ref>{{Citation | title=Ellington’s bill banning two deadly drugs could soon be law, State of Indiana House of Representatives | url=https://www.indianahouserepublicans.com/news/press-releases/ellington-s-bill-banning-two-deadly-drugs-could-soon-be-law/}}</ref>, and Ohio{{citation needed}}.


:*'''Arizona:''' In 2018, The State Of Arizona Legislature has listed Etizolam as a controlled substance under House Bill 2033<ref>{{Citation | title=HB2033 - 531R - H Ver | url=https://www.azleg.gov/legtext/53leg/1r/bills/hb2033h.htm}}</ref>
:*'''Arizona:''' In 2018, The State Of Arizona Legislature has listed Etizolam as a controlled substance under House Bill 2033<ref>{{Citation | title=HB2033 - 531R - H Ver | url=https://www.azleg.gov/legtext/53leg/1r/bills/hb2033h.htm}}</ref>
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*[http://www.erowid.org/pharms/etizolam Etizolam (Erowid Vault)]
*[http://www.erowid.org/pharms/etizolam Etizolam (Erowid Vault)]
*[https://isomerdesign.com/PiHKAL/explore.php?id=3039 Etizolam (Isomer Design)]
*[https://isomerdesign.com/PiHKAL/explore.php?id=3039 Etizolam (Isomer Design)]
*[https://drugs-forum.com/wiki/Etizolam Etizolam (Drugs-Forum)]


==Literature==
==Literature==