Each month the National Drug Treatment Monitoring System (NDTMS), facilitated by Release, collects anecdotal reports from drug users and workers around the country and combines this with data from drug-checking service WEDINOS to try to gain some insights into what is happening in the UK drugs market. The network’s findings consistently show that people who use benzodiazepines continue to face many risks from the illicit benzo supply.
For the period December 2024 to February 2025, roughly one third of all drugs sold as benzodiazepines were missold, either containing a different benzo, or a drug from an entirely different family altogether. February 2025 also saw the first reports of pills containing ethylbromazolam, a new benzodiazepine not previously detected in the UK market. ‘Research chemical’ benzos such as this are becoming increasingly common across Europe, as manufacturers try to evade existing legislation in countries which have not yet imposed blanket bans on psychoactive substances.
We are also continuing to see drugs sold as benzodiazepines that instead contain nitazenes, a category of synthetic opioid. Analysis of WEDINOS data by the Benzo Research Project found that of all the drug samples they received containing a nitazene in 2024, just over half were sold as benzos. These pills pose a particular risk, as many benzo users are opioid-naïve and so are at a much higher risk of overdose. What’s more, they may not be aware of how to respond to an opioid overdose, and are less likely to carry naloxone.
Given this context, it’s vital that our services are able to provide a safe supply of benzodiazepines for people who are dependent on these drugs. Maintaining a dependence without experiencing dangerous withdrawals, avoiding increased tolerance, or reducing at a safe and manageable rate become almost impossible if you can’t guarantee the pills you’ve bought contain the correct drug – let alone the correct dosage.
In spite of these dangers, we’re still finding that many drug services are unable or unwilling to prescribe benzodiazepines for dependent users. Recently we were in touch with Dan, a client who, after having been in treatment for some time, sought additional support for his use of illicit diazepam. Despite the dangers of benzo withdrawal, he was told by his prescriber that the service does not prescribe benzos under any circumstances.
Furthermore, this decision came not from the lead clinicians at the service, but from the local authority commissioner. This is contrary to chapter 4, section 10 of the UK guidelines on clinical management of drug misuse and dependence, which supports clinicians to prescribe substitution medication for the managed reduction of benzodiazepine dependent people.
The decision not to prescribe benzodiazepines to dependent users is putting lives at risk. We do not expect opiate users to manage their own dependencies without medical support, while dependent drinkers have access to a safe and regulated supply of alcohol and are closely observed and supported while they undergo medical detoxes. So why are we expecting benzo users to manage their own dependencies with an unregulated and unsafe drug supply?
It’s also important to examine the role of commissioners in decisions like this. Clinicians are understandably frustrated that the treatment options available to them are being limited. Yet it’s not clear which levers can be pulled to challenge these decisions, or to hold commissioners accountable.
Many of the risks associated with illicit benzodiazepine use are a direct result of prohibition. An unregulated market can push people towards poorly understood research chemicals that are less likely to see them criminalised. Manufacturers of illicit drugs are also more likely to produce stronger tablets at a higher price than lower-strength tablets that they’d have to sell more of.
For treatment services, however, there’s still much more that can be done to mitigate some of the risks. People who develop a dependence on benzos shouldn’t have to win the postcode lottery in order to access effective treatment, yet still the offers from our services vary wildly from town to town. Finally, we need to reintroduce mechanisms that can hold commissioners accountable when unpopular decisions are made. Without these positive changes, the lives of benzodiazepine dependent people will continue to be put at unnecessary risk.
Fraser Parry is drugs advocacy and support advisor at Release