ABSTRACT
Introduction: Alprazolam is a high potency and short-acting anxiolytic benzodiazepine. Alprazolam was one of the most misused benzodiazepines during the first lockdown related to the Covid-19 pandemic [1]. Thus, an evaluation of the abuse of alprazolam was requested by the French Medicines Agency. Material and methods: Analysis of the epidemiological tools of the French Addictovigilance network (FAN) over the period 2011-2020: spontaneous notifications (NotS), supplemented by data collected in addictology care centers (OPPIDUM), false prescriptions (OSIAP), substance-related deaths (DRAMES), and chemical submission data. Results: During the study period, among the 675 NotS analysed, women were slightly in the majority (51.7%), and the median age of users was 39 years. The desired effects were the intensification of the therapeutic or recreational effects, a euphoric effect and the management of withdrawal from other substances (opioids, psychostimulants). Regarding tools, a male predominance (60-72%) was observed with an age of approximately 35-39 years. Alprazolam was the 3rd benzodiazepine listed in OPPIDUM after diazepam and oxazepam. Analysis of NotS and OPPIDUM showed a recent increase in the combination of alprazolam and opioids. In DRAMES, alprazolam was found in 10 deaths/11. Regarding CHEMICAL SUBMISSION, alprazolam was the 1st benzodiazepine reported in 2019. Finally, in the OSIAP survey, alprazolam was in 2020 the 5th drug cited and the first benzodiazepine ahead of bromazepam, diazepam and oxazepam (citation rate: 7.8%, slightly increasing since 2019). It should also be noted a rejuvenation of this population and an increase in the proportion of men during the study period. Discussion/Conclusion: Analysis of FAN data showed an increase in criteria for abuse: false prescriptions and users seen in drug addiction care centres. In addition, the increase of the alprazolam-opioid combination and the significant part of this association in deaths constitute a signal already observed in the international literature and to be investigated [2].