Bromazolam, often referred to as “designer Xanax,” has quickly become one of the most concerning new substances in the illicit drug supply. Unlike prescription benzodiazepines such as alprazolam (Xanax), bromazolam is not approved for medical use and is considered a novel psychoactive substance (NPS) [6][7]. Over the past few years, forensic labs and toxicology reports have identified a surge in bromazolam across the United States and Europe, particularly in counterfeit pills disguised as legitimate Xanax or other benzodiazepines [7][8][11].
What Is Bromazolam?
Bromazolam is a synthetic benzodiazepine first developed in the late 1970s but never approved for medical use. It shares pharmacological properties with other benzodiazepines, acting on the brain’s GABA-A receptors to produce sedative, hypnotic, and anxiolytic effects [6]. Its potency, however, is unpredictable, and because it is manufactured illicitly, doses vary widely—making overdose and fatal outcomes much more likely.
Health Risks and Overdose Dangers
Like other benzodiazepines, bromazolam can cause sedation, respiratory depression, memory impairment, and coma at high doses. However, its dangers are magnified when combined with opioids, particularly fentanyl, which is frequently found in counterfeit pills containing bromazolam [7][10].
The National Institute on Drug Abuse (NIDA) warns that combining benzodiazepines and opioids sharply increases the risk of fatal overdose because both depress breathing [9][10]. This has contributed to a rise in polysubstance overdoses where benzodiazepines are present alongside drugs like heroin.
Real-World Cases
- In Chicago, Illinois (February 2023), three young adults were hospitalized after unknowingly ingesting bromazolam disguised as Xanax. They suffered seizures, hyperthermia, and even myocardial injury [1].
- In San Francisco, bromazolam was linked to at least 44 overdose deaths in 2023, with toxicology reports showing its replacement of other designer benzodiazepines like flualprazolam [2].
- Alerts from Public Health Scotland’s RADAR program also emphasize bromazolam’s extreme sedative effects and its presence in counterfeit pills [12].
Legal and Policy Responses
Because bromazolam is not approved for any medical use, regulatory bodies are taking steps to control it.
- In August 2025, Kentucky issued an emergency ban on bromazolam after clusters of overdoses [3].
- The Virginia Attorney General’s Office announced that bromazolam was officially scheduled as a controlled substance in the state [4].
- Nationally, 21 attorneys general have petitioned the DEA to add bromazolam to the federal controlled substances list [4].
- The Legislative Analysis and Public Policy Association (LAPPA) confirms that multiple states, including Kentucky and
image from: https://www.dea.gov/onepill Virginia, have already scheduled it, with others considering similar actions [5].
Why It’s So Dangerous
The greatest risk with bromazolam is that users often do not know they are taking it. Counterfeit pills are pressed to look identical to real Xanax bars, but they may
contain wildly different, and often deadly, doses [11].
Because bromazolam is illicitly manufactured, there is no quality control, no dosing accuracy, and no medical oversight. People may ingest a dose far higher than their body can tolerate, especially if fentanyl or other opioids are present.
Table 1: Comparing Bromazolam to Other Benzodiazepines
| Substance | Approved Medical Use? | Potency Compared to Diazepam | Risk When Mixed with Opioids | Availability |
| Diazepam (Valium) | Yes | Baseline | High | Prescription only |
| Alprazolam (Xanax) | Yes | 10x stronger | High | Prescription only |
| Flualprazolam | No | 10–20x stronger | Very High | Illicit only |
| Bromazolam | No [6] | Similar to alprazolam | Extremely High [9][10] | Illicit only [7][11] |
Protecting Communities
At Brooks Healing Center, we recognize that the emergence of substances like bromazolam highlights the importance of comprehensive addiction treatment and harm reduction strategies. Our team is trained to address the unique challenges of polysubstance use, including the dangers of benzodiazepine and opioid combinations.
Through medical detox, residential treatment, and ongoing therapeutic care, we help individuals not only get off the drug safely but also rebuild their lives in long-term recovery. If you or someone you love may be struggling with counterfeit pill use, now is the time to seek help.
FAQ’s
Why isn’t bromazolam available in the USA?
Bromazolam was never approved by the FDA for medical use. It was originally synthesized in the 1970s but abandoned before clinical approval. Today, it is considered a novel psychoactive substance (NPS) and is only found in the illicit market [6][7].
What is bromazolam?
Bromazolam is a synthetic benzodiazepine, sometimes called “designer Xanax.” It produces sedative and anxiolytic effects by acting on GABA-A receptors in the brain, but it is far riskier than prescription benzodiazepines because it is made illicitly [6][11].
What is bromazolam used for?
There is no legitimate medical use for bromazolam. Its only “use” is recreational or misuse in counterfeit pills. Unlike approved benzodiazepines, bromazolam has no established therapeutic role [6][7].
Is bromazolam a controlled substance?
At the federal level, bromazolam is not yet scheduled, though multiple states (including Kentucky and Virginia) have already classified it as a controlled substance [3][4][5]. Many experts believe it is only a matter of time before it is federally scheduled.
How long does bromazolam last?
Like other benzodiazepines, bromazolam has a half-life estimated around 10–20 hours, meaning sedative effects can last well into the next day depending on the dose [6][12].
How long does bromazolam stay in your system?
Traces of bromazolam can remain detectable in urine for several days, and in chronic users, it may persist for more than a week. Exact times vary depending on metabolism, dosage, and frequency of use [6][12].
Sources
- Ehlers, P. F., Deitche, A., Wise, L. M., Patrick, S. L., Holloway-Beth, A., Ellison, R., Trecki, J., Gerona, R., & Wahl, M. S. (2024). Notes from the field: Seizures, hyperthermia, and myocardial injury in three young adults who consumed bromazolam disguised as alprazolam—Chicago, Illinois, February 2023. MMWR Morbidity and Mortality Weekly Report, 72(52–53), 1392–1393. https://www.cdc.gov/mmwr/volumes/72/wr/mm725253a5.htm
- Rodda, L. N., Pilgrim, J. L., Erickson, T. B., & Kiphuth, A. K. (2024). The surge of bromazolam-related fatalities replacing other novel designer benzodiazepines-related fatalities in San Francisco. Addiction. https://onlinelibrary.wiley.com/doi/10.1111/add.16520 PubMed summary: https://pubmed.ncbi.nlm.nih.gov/38679868/
- Associated Press. (2025, August 18). Beshear bans drug in Kentucky that’s being targeted by attorneys general across the nation. https://apnews.com/article/e8a49e9cca5de545968556b2eaf31023
- Office of the Attorney General, Commonwealth of Virginia. (2025, August 18). Attorney General Miyares joins 21-state coalition calling on DEA to ban “designer Xanax.” https://www.oag.state.va.us/media-center/news-releases/2898-august-18-2025-attorney-general-miyares-joins-21-state-coalition-calling-on-dea-to-ban-designer-xanax
Legislative Analysis and Public Policy Association (LAPPA). (2023, October). Bromazolam fact sheet. https://legislativeanalysis.org/wp-content/uploads/2023/10/Bromazolam-Fact-Sheet-FINAL-1.pdf - World Health Organization. (2023). Bromazolam: Critical review report (46th ECDD). https://cdn.who.int/media/docs/default-source/46th-ecdd/bromazolam_46th-ecdd-critical-review_public-version.pdf
- Center for Forensic Science Research & Education (CFSRE). (2022, June 15). Public alert: Bromazolam prevalence surging across the United States (driven in part by increasing detections alongside fentanyl). https://www.cfsre.org/images/content/reports/public_alerts/Public-Alert_Bromazolam_NPS-Discovery_061522.pdf
- EU Drugs Agency (EUDA/EMCDDA). (2024, June 27). EU drug markets: New psychoactive substances—Benzodiazepines. https://www.euda.europa.eu/publications/eu-drug-markets/new-psychoactive-substances/distribution-and-supply/benzodiazepines_en
- National Institute on Drug Abuse. (2022, November 7). Benzodiazepines and opioids. https://nida.nih.gov/research-topics/opioids/benzodiazepines-opioids
- Liu, S., O’Donnell, J., Gladden, M. R., McGlone, L., Chowdhury, F., Gonsalves, S., & Mattson, C. L. (2021). Trends in nonfatal and fatal overdoses involving benzodiazepines—38 states and the District of Columbia, 2019–2020. MMWR Morbidity and Mortality Weekly Report, 70(34), 1136–1141. https://www.cdc.gov/mmwr/volumes/70/wr/mm7034a2.htm
- U.S. Drug Enforcement Administration. (2024, November). Fake pills fact sheet (One Pill Can Kill). https://www.dea.gov/sites/default/files/2024-11/DEA-OPCK_FactSheet_November_2024.pdf
- Public Health Scotland. (2025, January 16; updated June 26, 2025). RADAR alert: Bromazolam.https://publichealthscotland.scot/publications/rapid-action-drug-alerts-and-response-radar-alert-bromazolam/rapid-action-drug-alerts-and-response-radar-alert-bromazolam-version-12/bromazolam/
