Pennsylvania's attorney general has joined a growing call for emergency action against bromazolam, a dangerous drug often dubbed "designer Xanax" that has killed hundreds -- including dozens in Allegheny and Westmoreland counties.
In a letter sent last week to the federal Drug Enforcement Administration, Attorney General Dave Sunday and others warned of the synthetic drug's potency and lack of predictability, especially when it is mixed with opioids.
Bromazolam also is resistant to Narcan, a widely distributed medicine that rapidly reverses opioid overdoses, officials said.
An estimated 6.1 million people ages 12 or older in the U.S. reported having an opioid use disorder in 2022, the most recent data available, according to the federal Centers for Disease Control and Prevention. That same year, federal programs distributed about 1.2 million doses of Narcan.
"It is a race to stay ahead of drug traffickers when dealing with synthetic drugs -- and lives depend on immediate action that will give law enforcement the tools to proactively target traffickers," Sunday said in a prepared statement.
"Designer" benzodiazepines, such as bromazolam, emerged in Pennsylvania around 2022, when coroners and medical examiners linked them to at least 59 overdose deaths statewide, officials said.
That figure nearly tripled a year later, according to the Pennsylvania Department of Health.
In Allegheny County, the number of deaths associated with bromazolam peaked in 2023, when 30 cases were found, the Allegheny County Medical Examiner's Office told TribLive. There were 18 cases in 2024 and two this year, to date.
Allegheny County reported 665 accidental overdose deaths in 2023, down from 689 in 2022, according to its annual reports.
The numbers are harder to parse in Westmoreland County. The coroner there reported 81 drug- and overdose-related deaths throughout the county last year, down from 95 in 2023 and 118 in 2022.
While 10 of last year's drug deaths in Westmoreland County were linked to benzodiazepines, the coroner does not break down what specific types of benzodiazepines are found in their examinations.
Doctors often prescribe benzodiazepines to treat anxiety, insomnia and seizures. But bromazolam has never been approved for a medical use.
Adolescents and young adults, the drug's most frequent users, ingest it orally or crush it up and snort it to get high, the DEA said. Opioid users often co-abuse bromazolam and drugs like it to enhance euphoria.
Abuse of the drug can cause extreme drowsiness, confusion, decreased reflexes and respiratory depression, drug officials said. It also can lead to comas and possible death.
Last week's letter to the DEA, signed by Kentucky Attorney General Russell Coleman, calls for federal officials to schedule and start regulating the drug.
"We live at a time when as little as one pill can kill -- and is killing -- our children," he wrote. "There is zero margin of error when it comes to illicit drugs and counterfeit pills. As parents and public officials, we must do everything possible to cut off the supply of these deadly substances."
The letter has been backed by attorneys general from 20 states, including Pennsylvania neighbors Ohio and West Virginia.