Schedules of Controlled Substances: Temporary Placement of Etizolam, Flualprazolam, Clonazolam, Flubromazolam, and Diclazepam in Schedule I, 78887-78892 [2022-27278]
Download as PDF
Federal Register / Vol. 87, No. 246 / Friday, December 23, 2022 / Proposed Rules
Lists of Subjects in 14 CFR Part 71
Airspace, Incorporation by reference,
Navigation (air).
The Proposed Amendment
In consideration of the foregoing, the
Federal Aviation Administration
proposes to amend 14 CFR part 71 as
follows:
PART 71—DESIGNATION OF CLASS A,
B, C, D, AND E AIRSPACE AREAS; AIR
TRAFFIC SERVICE ROUTES; AND
REPORTING POINTS
1. The authority citation for part 71
continues to read as follows:
■
Authority: 49 U.S.C. 106(f), 106(g); 40103,
40113, 40120; E.O. 10854, 24 FR 9565, 3 CFR,
1959–1963 Comp., p. 389.
§ 71.1
[Amended]
2. The incorporation by reference in
14 CFR 71.1 of Federal Aviation
Administration Order JO 7400.11G,
Airspace Designations and Reporting
Points, dated August 19, 2022, and
effective September 15, 2022, is
amended as follows:
■
Paragraph 5000
Class D Airspace.
*
*
*
*
*
TKELLEY on DSK125TN23PROD with PROPOSALS
Class E Surface Airspace
*
*
*
*
*
ASO GA E2 Macon, GA [Amended]
Middle Georgia Regional Airport, Macon, GA
(Lat. 32°41′34″ N, long. 83°38′57″ W)
Robins AFB
(Lat. 32°38′25″ N, long. 83°35′31″ W)
That airspace extending upward from the
surface from the intersection of the Middle
VerDate Sep<11>2014
19:21 Dec 22, 2022
Jkt 259001
AGENCY:
providing this notice of intent to
publish a temporary order to schedule
five synthetic benzodiazepine
substances, as identified in this notice,
in schedule I of the Controlled
Substances Act. When it is issued, the
temporary scheduling order will impose
the regulatory controls and
administrative, civil, and criminal
sanctions applicable to schedule I
controlled substances on persons who
handle (manufacture, distribute, reverse
distribute, import, export, engage in
research, conduct instructional
activities or chemical analysis with, or
possess) or propose to handle these five
specified controlled substances.
DATES: This notice of intent is effective
December 23, 2022.
FOR FURTHER INFORMATION CONTACT: Dr.
Terrence L. Boos, Drug and Chemical
Evaluation Section, Diversion Control
Division, Drug Enforcement
Administration; Mailing Address: 8701
Morrissette Drive, Springfield, Virginia
22152; Telephone: (571) 362–3249.
SUPPLEMENTARY INFORMATION: The notice
of intent contained in this document is
issued pursuant to the temporary
scheduling provisions of 21 U.S.C.
811(h). The Drug Enforcement
Administration (DEA) intends to issue a
temporary scheduling order 1 (in the
form of a temporary amendment) to add
the following five substances, including
their salts, isomers, and salts of isomers,
whenever the existence of such salts,
isomers, and salts of isomers is possible,
to schedule I under the Controlled
Substances Act (CSA):
• 4-(2-chlorophenyl)-2-ethyl-9methyl-6H-thieno[3,2f][1,2,4]triazolo[4,3-a][1,4]diazepine
(commonly known as etizolam),
• 8-chloro-6-(2-fluorophenyl)-1methyl-4H-benzo[f][1,2,4]triazolo[4,3a][1,4]diazepine (commonly known as
flualprazolam),
• 6-(2-chlorophenyl)-1-methyl-8nitro-4H-benzo[f][1,2,4]triazolo[4,3a][1,4]diazepine (commonly known as
clonazolam),
• 8-bromo-6-(2-fluorophenyl)-1methyl-4H-benzo[f][1,2,4]triazolo[4,3a][1,4]diazepine (alternate chemical
name: 8-bromo-6-(2-fluorophenyl)-1methyl-4H-[1,2,4]triazolo[4,3a][1,4]benzodiazepine and commonly
known as, flubromazolam), and
• 7-chloro-5-(2-chlorophenyl)-1methyl-1,3-dihydro-2Hbenzo[e][1,4]diazepin-2-one (commonly
known as diclazepam).
The Administrator of the Drug
Enforcement Administration is
1 Though DEA has used the term ‘‘final order’’
with respect to temporary scheduling orders in the
past, this notice of intent adheres to the statutory
language of 21 U.S.C. 811(h), which refers to a
‘‘temporary scheduling order.’’ No substantive
change is intended.
Paragraph 6005 Class E Airspace Areas
Extending Upward From 700 Feet or More
Above the Surface of the Earth.
*
ASO GA D Macon, GA [Amended]
Middle Georgia Regional Airport, Macon, GA
(Lat. 32°41′34″ N, long. 83°38′57″ W)
Robins AFB
(Lat. 32°38′25″ N, long. 83°35′31″ W)
That airspace extending upward from the
surface to and including 2,900 feet MSL from
the intersection of the Middle Georgia
Regional Airport 210° bearing and the 5.5mile radius of the Robins AFB Airport,
clockwise along the 4.9-mile radius centered
on Middle Georgia Regional Airport to the
intersection of Middle Georgia Regional
Airport 065° bearing and Robins AFB Airport
5.5-mile radius, counter-clockwise along the
Robins AFB Airport 5.5-mile radius to the
intersection of the Middle Georgia Regional
Airport 055° bearing, directly across to the
Middle Georgia Regional Airport 219°
bearing and the intersection of the Robins
AFB Airport 5.5-mile radius, counterclockwise along the Robins AFB Airport 5.5mile radius to the point of beginning. This
Class D airspace area is effective during the
specific dates and times established in
advance by a Notice to Air Missions. The
effective date and time will thereafter be
continuously published in the Chart
Supplement.
Paragraph 6002
Georgia Regional Airport 210° bearing and
the 5.5-mile radius of the Robins AFB
Airport, clockwise along the 4.9-mile radius
centered on Middle Georgia Regional Airport
to the intersection of Middle Georgia
Regional Airport 065° bearing and Robins
AFB Airport 5.5-mile radius, counterclockwise along the Robins AFB Airport 5.5mile radius to the intersection of the Middle
Georgia Regional Airport 055° bearing,
directly across to the Middle Georgia
Regional Airport 219° bearing and the
intersection of the Robins AFB Airport 5.5mile radius, counter-clockwise along the
Robins AFB Airport 5.5-mile radius to the
point of beginning. This Class E airspace area
is effective during the specific dates and
times established in advance by a Notice to
Air Missions. The effective date and time
will thereafter be continuously published in
the Chart Supplement.
78887
*
*
*
*
ASO GA E5 Macon, GA [Amended]
Middle Georgia Regional Airport, GA
(Lat. 32°41′34″ N, long. 83°38′57″ W)
Macon Downtown Airport
(Lat. 32°49′18″ N, long. 83°33′43″ W)
Robins AFB
(Lat. 32°38′25″ N, long. 83°35′31″ W)
Perry-Houston County Airport
(Lat. 32°30′38″ N, long. 83°46′02″ W)
That airspace extending upward from 700
feet above the surface within a 7.4-mile
radius of Middle Georgia Regional Airport,
and within a 7.5-mile radius of Macon
Downtown Airport, a 7-mile radius of Robins
AFB, and a 9.8-mile radius of Perry-Houston
County Airport.
Issued in College Park, Georgia, on
December 15, 2022.
Andreese C. Davis,
Manager, Airspace & Procedures Team South,
Eastern Service Center, Air Traffic
Organization
[FR Doc. 2022–27931 Filed 12–22–22; 8:45 am]
BILLING CODE 4910–13–P
DEPARTMENT OF JUSTICE
Drug Enforcement Administration
21 CFR Part 1308
[Docket No. DEA–989]
Schedules of Controlled Substances:
Temporary Placement of Etizolam,
Flualprazolam, Clonazolam,
Flubromazolam, and Diclazepam in
Schedule I
Drug Enforcement
Administration, Department of Justice.
ACTION: Proposed amendment; notice of
intent.
SUMMARY:
PO 00000
Frm 00010
Fmt 4702
Sfmt 4702
E:\FR\FM\23DEP1.SGM
23DEP1
78888
Federal Register / Vol. 87, No. 246 / Friday, December 23, 2022 / Proposed Rules
The temporary scheduling order will
be published in the Federal Register on
or after January 23, 2023.
TKELLEY on DSK125TN23PROD with PROPOSALS
Legal Authority
The CSA provides the Attorney
General (as delegated to the
Administrator of DEA (Administrator)
pursuant to 28 CFR 0.100) with the
authority to temporarily place a
substance in schedule I of the CSA for
two years without regard to the
requirements of 21 U.S.C. 811(b), if the
Administrator finds that such action is
necessary to avoid an imminent hazard
to the public safety. 21 U.S.C. 811(h)(1).
In addition, if proceedings to control a
substance are initiated under 21 U.S.C.
811(a)(1) while the substance is
temporarily controlled under section
811(h), the Administrator may extend
the temporary scheduling for up to one
year. 21 U.S.C. 811(h)(2).
Where the necessary findings are
made, a substance may be temporarily
scheduled if it is not listed in any other
schedule under 21 U.S.C. 812, or if there
is no exemption or approval in effect for
the substance under section 505 of the
Federal Food, Drug, and Cosmetic Act,
21 U.S.C. 355. 21 U.S.C. 811(h)(1); 21
CFR part 1308.
Background
The CSA requires the Administrator
to notify the Secretary of the
Department of Health and Human
Services (HHS) of an intent to place a
substance in schedule I of the CSA
temporarily (i.e., to issue a temporary
scheduling order). 21 U.S.C. 811(h)(4).
The Administrator transmitted the
required notice to the Assistant
Secretary for Health of HHS (Assistant
Secretary),2 by letter dated October 25,
2021, regarding etizolam, flualprazolam,
clonazolam, flubromazolam, and
diclazepam. The Assistant Secretary
responded to this notice by a letter
dated January 3, 2022, and advised that
based on a review by the Food and Drug
Administration (FDA), there are
currently no investigational new drug
applications (INDs) or approved new
drug applications (NDAs) for etizolam,
flualprazolam, clonazolam,
flubromazolam, and diclazepam. The
Assistant Secretary also stated that HHS
had no objection to the temporary
placement of these substances in
schedule I. Etizolam, flualprazolam,
clonazolam, flubromazolam, and
diclazepam currently are not listed in
any schedule under the CSA, and no
exemptions or approvals under 21
2 The Secretary of HHS has delegated to the
Assistant Secretary for Health of HHS the authority
to make domestic drug scheduling
recommendations. 58 FR 35460, July 1, 1993.
VerDate Sep<11>2014
19:21 Dec 22, 2022
Jkt 259001
U.S.C. 355 are in effect for these five
benzodiazepine substances.
To find that temporarily placing a
substance in schedule I of the CSA is
necessary to avoid an imminent hazard
to the public safety, the Administrator
must consider three of the eight factors
set forth in 21 U.S.C. 811(c): The
substance’s history and current pattern
of abuse; the scope, duration and
significance of abuse; and what, if any,
risk there is to the public health. 21
U.S.C. 811(h)(3). This consideration
includes any information indicating
actual abuse, diversion from legitimate
channels, and clandestine importation,
manufacture, or distribution of these
substances.
Substances meeting the statutory
requirements for temporary scheduling
may only be placed in schedule I. 21
U.S.C. 811(h)(1). Substances in schedule
I have high potential for abuse, no
currently accepted medical use in
treatment in the United States, and no
accepted safety for use under medical
supervision. 21 U.S.C. 812(b)(1).
Five Benzodiazepine Substances:
Etizolam, Flualprazolam, Clonazolam,
Flubromazolam, and Diclazepam
The dramatic increase in trafficking
and abuse associated with novel
psychoactive substances (NPS) of the
benzodiazepine class in the United
States has become a national public
health concern in recent years. The
availability of NPS benzodiazepine
substances in the illicit drug market
continues to pose an imminent hazard
to the public safety. The Centers for
Disease Control and Prevention (CDC)
highlights this issue in their Morbidity
and Mortality Weekly Report (MMWR)
published on August 27, 2021.3 CDC
indicated that, from April 2019 to June
2020, prescription and illicit
benzodiazepine-involved overdose
deaths increased by 21.8% and 519.6%
respectively. Additionally,
benzodiazepines were involved in
nearly 7,000 overdose deaths in 23
states from January 2019 to June 2020,
accounting for 17% of all drug overdose
deaths. Adverse health effects
associated with the abuse of such
substances known collectively as the
‘‘designer benzodiazepines,’’ their
continued evolution, and increased
popularity of these substances have
been a serious concern in recent years.
The increase in the co-use of opioids
with the ‘‘designer benzodiazepines’’
3 Centers for Disease Control and Prevention
Morbidity and Mortality Weekly Report: Trends in
Nonfatal and Fatal Overdoses Involving
Benzodiazepines—38 States and the District of
Columbia, 2019–2020. Vol. 70, No. 34. August 27,
2021.
PO 00000
Frm 00011
Fmt 4702
Sfmt 4702
has become a particular concern as the
United States continues to experience
an unprecedented epidemic of opioid
misuse and abuse. CDC’s 2021 MMWR
further states that between January and
June 2020, 92.7% of benzodiazepineinvolved deaths also involved opioids
and 66.7% involved illicitly
manufactured fentanyl. It is well known
that the combination of benzodiazepines
with opioids substantially enhances the
potential for lethality. Etizolam,
flualprazolam, clonazolam,
flubromazolam, and diclazepam are
benzodiazepine substances recently
identified on the illicit drug market in
the United States.
The abuse of etizolam, flualprazolam,
clonazolam, flubromazolam, and
diclazepam has been associated with
numerous fatalities in recent years in
the United States. The positive
identification of these five substances in
post-mortem cases is a serious concern
to the public safety. Additionally, law
enforcement data indicate that the
substances at issue here have significant
presence in the United States illicit drug
market. In light of the law enforcement
encounters and fatalities associated with
the abuse of etizolam, flualprazolam,
clonazolam, flubromazolam, and
diclazepam these substances pose an
imminent hazard to public safety.
Available data and information for
etizolam, flualprazolam, clonazolam,
flubromazolam, and diclazepam,
summarized below, indicate that these
substances have high potential for
abuse, no currently accepted medical
use in treatment in the United States,
and lack of accepted safety for use
under medical supervision. DEA’s threefactor analysis is available in its entirety
under ‘‘Supporting and Related
Material’’ of the public docket for this
action at www.regulations.gov under
Docket Number DEA–989.
Factor 4. History and Current Pattern of
Abuse
The chemical synthesis of etizolam,
flualprazolam, clonazolam,
flubromazolam, and diclazepam were
previously reported in the scientific
literature; however, the research did not
lead to any medically approved
products in the United States. Since
2012, numerous synthetic drugs
belonging to the benzodiazepine class
have begun to emerge in the illicit drug
market as evidenced by the
identification of these drugs in forensic
drug exhibits from the National Forensic
Laboratory Information System
(NFLIS),4 and toxicology samples.
4 NFLIS represents an important resource in
monitoring illicit drug trafficking, including the
E:\FR\FM\23DEP1.SGM
23DEP1
Federal Register / Vol. 87, No. 246 / Friday, December 23, 2022 / Proposed Rules
TKELLEY on DSK125TN23PROD with PROPOSALS
Beginning in 2012, etizolam emerged on
the illicit synthetic drug market as
evidenced by its identification in drug
seizures in the United States. In recent
years, there has been a rise in the
recreational use of etizolam. As
evidenced by their identification in
NFLIS-Drug, diclazepam emerged in the
United States’ illicit drug market in
2014, flubromazolam and clonazolam in
2015, and flualprazolam in 2017. While
these substances are not approved for
medical use in the United States,
etizolam is approved for medical use in
Italy, India, and Japan.5 In a letter dated
January 3, 2022, the Assistant Secretary
informed DEA that there are no INDs or
FDA-approved NDAs for etizolam,
flualprazolam, clonazolam,
flubromazolam, and diclazepam in the
United States. Hence, there are no
legitimate channels for these substances
as marketed drug products in the United
States. These five benzodiazepine
substances are likely to be abused in the
same manner as other sedative
hypnotics. They have been identified in
tablet form, as white to beige powders,
or in liquid forms, typically of unknown
purity or concentration.
Based on data from NFLIS, law
enforcement often encountered
etizolam, flualprazolam, clonazolam,
flubromazolam, and diclazepam in
counterfeit pills, liquid, or powder.
Substances often found in combination
with some of these benzodiazepines
include substances of abuse such as
heroin (schedule I), fentanyl (schedule
II), other substances structurally related
to fentanyl (schedule I and other noncontrolled substances), other
benzodiazepines (both FDA-approved
schedule IV benzodiazepines and other
diversion of legally manufactured pharmaceuticals
into illegal markets. NFLIS is a comprehensive
information system that includes data from forensic
laboratories that handle more than 96% of an
estimated 1.0 million distinct annual state and local
drug analysis cases. NFLIS includes drug chemistry
results from completed analyses only. While NFLIS
data is not direct evidence of abuse, it can lead to
an inference that a drug has been diverted and
abused. See 76 FR 77330, 77332, Dec. 12, 2011.
5 Although there is no evidence suggesting that
etizolam, flualprazolam, clonazolam,
flubromazolam, or diclazepam has a currently
accepted medical use in treatment in the United
States, it bears noting that a drug cannot be found
to have such medical use unless DEA concludes
that it satisfies a five-part test. Specifically, with
respect to a drug that has not been approved by
FDA, to have a currently accepted medical use in
treatment in the United States, all of the following
must be demonstrated: i. The drug’s chemistry must
be known and reproducible; ii. there must be
adequate safety studies; iii. there must be adequate
and well-controlled studies proving efficacy; iv. the
drug must be accepted by qualified experts; and v.
the scientific evidence must be widely available. 57
FR 10499 (1992), pet. for rev. denied, Alliance for
Cannabis Therapeutics v. DEA, 15 F.3d 1131, 1135
(D.C. Cir. 1994).
VerDate Sep<11>2014
19:21 Dec 22, 2022
Jkt 259001
novel non-controlled benzodiazepines),
and tramadol (schedule IV). Evidence
suggests that individuals are using these
substances to obtain ‘‘legal highs’’ or to
self-medicate. Information gathered
from case histories and autopsy findings
shows that deaths involving etizolam,
flualprazolam, clonazolam,
flubromazolam, and diclazepam were
predominantly associated with polydrug use.
Factor 5. Scope, Duration, and
Significance of Abuse
Etizolam, flualprazolam, clonazolam,
flubromazolam, and diclazepam are
novel benzodiazepines, and evidence
suggests they are abused for their
sedative effects (see Factor 6). In death
investigations involving polysubstance
use, the co-appearance of
benzodiazepines and opioids in
toxicological analysis was common.
Between August 2019 and January 2020,
flualprazolam and etizolam were
identified in seven and six postmortem
blood specimens, respectively, out of 18
deaths associated with the abuse of
isotonitazene, a schedule I opioid that
was recently controlled. These cases
corresponded to four states—Illinois (9),
Indiana (7), Minnesota (1), and
Wisconsin (1). Most (n = 12) of the
decedents were male. The ages ranged
from 24 to 66 years old with an average
age of 41 years.6
In another recent publication, 20
forensic postmortem cases were
reviewed and analyzed for the presence
of metonitazine, NPS benzodiazepines,
and opioids. Results indicated that NPS
benzodiazepines were the most
commonly identified substances found
in combination with metonitazene.
Specifically, clonazolam was positively
identified in four cases, etizolam in two
cases, flualprazolam in two cases, and
pyrazolam in one case.7 Law
enforcement encounters of etizolam,
flualprazolam, clonazolam,
flubromazolam, and diclazepam as
reported to NFLIS (Federal, State and
local laboratories) include 34,781 drug
reports since 2014 (queried 01/13/2022).
NFLIS-Drug registered three encounters
of etizolam in 2012 (first year of
encounter) and 3,022 reports in 2021.
Flualprazolam was first encountered in
2017 when one report was identified in
6 Krotulski AJ, Papsun DM, Kacinko SL, and
Logan BK. Isotonitazene Quantitation and
Metabolite Discovery in Authentic Forensic
Casework. Journal of Analytical Toxicology, 2020,
44(6):521–530.
7 Krotulski AJ, Papsun DM, Walton SE, and Logan
BK. Metonitazene in the United States-Forensic
toxicology assessment of a potent new synthetic
opioid using liquid chromatography mass
spectrometry. Drug Testing Analysis, 2021,
13(10):1697–1711.
PO 00000
Frm 00012
Fmt 4702
Sfmt 4702
78889
NFLIS-Drug, and then in 2021, 1,305
encounters were reported. A similar
trend was seen with clonazolam. During
2015 (its first year of encounter), 57
cases were reported in NFLIS-Drug,
while 3,994 drug reports were identified
in 2021. NFLIS-Drug registered five
diclazepam encounters in 2014 (its first
year of encounter) and 54 encounters in
2021. Flubromazolam encounters
totaled 14 in 2015 (its first year of
encounter) and 414 in 2021.
The population likely to abuse
etizolam, flualprazolam, clonazolam,
flubromazolam, and diclazepam appears
to be the same as those abusing
prescription benzodiazepines,
barbiturates, and other sedative
hypnotic substances. This is evidenced
by drug user reports associated with
these substances. Because abusers of
etizolam, flualprazolam, clonazolam,
flubromazolam, and diclazepam are
likely to obtain these substances
through unregulated sources, the
identity, purity, and quantity of these
substances are uncertain and
inconsistent, thus posing significant
adverse health risks to the end user.
The misuse and abuse of
benzodiazepines have been
demonstrated and are wellcharacterized.8 According to the most
recent data from the National Survey on
Drug Use and Health (NSDUH),9 as of
2020, an estimated 4.8 million people
aged 12 years or older misused
prescription benzodiazepines in the past
year. This included 1.1 million young
adults aged 18 to 25, 3.5 million adults
aged 26 or older, and 157,000
adolescents aged 12 to 17. This
population abusing prescription
benzodiazepines is likely to be at risk of
abusing etizolam, flualprazolam,
clonazolam, flubromazolam, and
diclazepam. Individuals who initiate
8 Votaw VR, Geyer R, Rieselbach MM, and
McHugh RK. The epidemiology of benzodiazepine
misuse: A systematic review. Drug Alcohol
Dependence, 2019, 200:95–114.
9 The National Survey on Drug Use and Health
(NSDUH), formerly known as the National
Household Survey on Drug Abuse (NHSDA), is
conducted annually by the Department of Health
and Human Services Substance Abuse and Mental
Health Services Administration (SAMHSA). It is the
primary source of estimates of the prevalence and
incidence of nonmedical use of pharmaceutical
drugs, illicit drugs, alcohol, and tobacco use in the
United States. The survey is based on a nationally
representative sample of the civilian, noninstitutionalized population 12 years of age and
older. The survey excludes homeless people who
do not use shelters, active military personnel, and
residents of institutional group quarters such as
jails and hospitals. The NSDUH provides yearly
national and state level estimates of drug abuse, and
includes prevalence estimates by lifetime (i.e., ever
used), past year, and past month abuse or
dependence. The 2020 NSDUH annual report is
available at https://www.samhsa.gov/data/ (last
accessed February 8, 2022).
E:\FR\FM\23DEP1.SGM
23DEP1
78890
Federal Register / Vol. 87, No. 246 / Friday, December 23, 2022 / Proposed Rules
use of these five substances (i.e., use a
drug for the first time) are likely to be
at risk of developing substance use
disorder, overdose, and death at rates
similar to that of other sedative
hypnotics (e.g., alprazolam, clonazolam,
etc.). Law enforcement or toxicology
reports demonstrate that the five
substances at issue are being distributed
and abused.
TKELLEY on DSK125TN23PROD with PROPOSALS
Factor 6. What, if Any, Risk There Is to
the Public Health
The increase in benzodiazepinerelated overdose deaths in the United
States has been exacerbated recently by
the availability of NPS benzodiazepines
in the illicit drug market. Etizolam,
flualprazolam, clonazolam,
flubromazolam, and diclazepam have
been described as derivatives of other
known benzodiazepines, each
possessing various degrees of potency.
Evidence suggests these substances are
being abused for their sedative/hypnotic
effects (see DEA 3-Factor Analysis).
Public health risks associated with the
five substances at issue here relate to
their pharmacological similarities with
known benzodiazepines. Thus, risk to
the public health is associated with
adverse reactions in humans, which are
expected to include CNS depressant-like
effects, such as slurred speech, ataxia,
altered mental state, and respiratory
depression.
Etizolam, flualprazolam, clonazolam,
flubromazolam, and diclazepam have
been increasingly identified in
toxicology reports, death investigations,
and driving under the influence of drugs
(DUID) cases since their first appearance
in law enforcement seizures. According
to the Center for Forensic Science
Research and Education (CFSRE), a nonprofit organization in collaboration with
the Department of Justice and Centers
for Disease Control, between 2020 and
2021, etizolam was the most identified
NPS benzodiazepine accounting for 697
total toxicology cases in 2020, many of
which were co-identified with fentanyl.
In 2021, etizolam was identified in
1,012 toxicology cases, while
flualprazolam, clonazolam,
flubromazolam, and diclazepam were
associated with 432, 331, 170, and four
toxicology cases, respectively (CSFRE
Quarterly Trend Reports: NPS
Benzodiazepines in the United States).
Death investigations associated with
four of the five NPS benzodiazepines at
issue here have increased in recent
years. In a 2021 publication by the
Orange County Crime Lab in Santa Ana,
California, flualprazolam was identified
as serving a contributory role in the
death of 13 of 24 cases analyzed in the
VerDate Sep<11>2014
19:21 Dec 22, 2022
Jkt 259001
study.10 In another recently published
study, between August 2019 and
January 2020, flualprazolam and
etizolam were identified in seven and
six postmortem blood specimens
respectively, out of 18 deaths associated
with the abuse of isotonitazene, a
schedule I opioid.11 Then, a study
published in 2021 which compiled data
from 254 reports published between
2008 and 2021, identified: 33 deaths
associated with etizolam, 20
flualprazolam-related deaths, six
emergency department (ED) visits
associated with clonazolam, 14
flubromazolam-related ED visits, and
one death, 12 DUID cases, and four ED
visits associated with diclazepam.12
Additionally, in 2020, the European
Monitoring Centre for Drugs and Drug
Addiction reported 34 deaths associated
with diclazepam use, which were
determined through the analysis of
biological samples.13 Furthermore, the
National Poison Data System reported
that between January 2014 and
December 2017, clonazolam was the
second most common benzodiazepine
associated with poison control center
calls, accounting for 50 incidents.14
Impaired driving is another risk factor
associated with the use and abuse of
etizolam, flualprazolam, clonazolam,
flubromazolam, and diclazepam. In a
recent published report from the
Sedgwick County Regional Forensic
Science Center in Wichita, Kansas, 12
DUID case samples were analyzed.
Etizolam was positively identified in
three cases, while flubromazolam was
identified in nine of these cases.15 In a
2021 publication, similar involvement
of flubromazolam in drug-impaired
driving was reported in Canada where
flubromazolam was detected in 10
10 Ha HH and Mata DC. Flualprazolam
distribution in postmortem samples. Journal of
Forensic Sciences, 2022, 67(1): 297–308.
11 Krotulski AJ, Papsun DM, Kacinko SL, and
Logan BK. Isotonitazene Quantitation and
Metabolite Discovery in Authentic Forensic
Casework. Journal of Analytical Toxicology, 2020,
44(6): 521–530.
12 Brunetti P, Giorgetti R, Tagliabracci A, Huestis
MA, Busardo` FP. Designer Benzodiazepines: A
Review of Toxicology and Public Health Risks.
Pharmaceuticals (Basel). 2021 Jun 11;14(6):560.
13 EMCDDA (2020). EMCDDA response to WHO
request for information on the new psychoactive
substances, eutylone, a-PHiP, 4F-furanylfentanyl, 2methyl-AP-237, and, diclazepam.
14 Carpenter JE, Murray BP, Dunkley C, Kazzi ZN,
Gittinger MH. Designer benzodiazepines: a report of
exposures recorded in the National Poison Data
System, 2014–2017. Clin Toxicol (Phila). 2019
Apr;57(4):282–286.
15 Rohrig TP, Osawa KA, Baird TR, Youso KB.
Driving Impairment Cases Involving Etizolam and
Flubromazolam. J Anal Toxicol. 2021 Feb
6;45(1):93–98.
PO 00000
Frm 00013
Fmt 4702
Sfmt 4702
percent of 113 case samples.16
Diclazepam has also been implicated in
DUID cases domestically and
internationally. In a Norwegian study
conducted between July 2013 and May
2016, diclazepam was identified in 15 of
77 analyzed samples taken from
impaired drivers and individuals
involved in other criminal offenses.
Then, in 2019, a study of Norwegian
drivers was conducted using 575
samples taken predominantly from
intoxicated drivers and individuals who
committed other criminal offenses.17
Notably, 334 samples were found to
contain diclazepam. Additionally, in a
2021 publication, researchers identified
22 samples that tested positive for
flualprazolam in samples obtained from
DUID investigations between August
2018 and September 2020.18
Finding of Necessity of Schedule I
Placement To Avoid Imminent Hazard
to Public Safety
In accordance with 21 U.S.C.
811(h)(3), based on the available data
and information summarized above, the
uncontrolled manufacture, distribution,
reverse distribution, importation,
exportation, conduct of research and
chemical analysis, possession, and
abuse of etizolam, flualprazolam,
clonazolam, flubromazolam, and
diclazepam pose imminent hazards to
public safety. DEA is not aware of any
currently accepted medical uses for
these substances in the United States.
As required by 21 U.S.C. 811(h)(4), the
Administrator transmitted to the
Assistant Secretary for Health, via a
letter dated October 25, 2021, notice of
her intent to place etizolam,
flualprazolam, clonazolam,
flubromazolam, and diclazepam in
schedule I on a temporary basis. HHS
had no objection to the temporary
placement of these substances in
schedule I.
Conclusion
This notice of intent provides the 30day notice pursuant to 21 U.S.C.
811(h)(1) of DEA’s intent to issue a
temporary scheduling order. In
accordance with 21 U.S.C. 811(h)(1) and
(3), the Administrator considered
16 Vaillancourt L, Viel E, Dombrowski C,
Desharnais B, Mireault P. Drugs and driving prior
to cannabis legalization: A 5-year review from DECP
(DRE) cases in the province of Quebec, Canada.
Accid Anal Prev. 2021 Jan;149:105832.
17 Heide G, H2014
19:21 Dec 22, 2022
Jkt 259001
811(h)(1), the Administrator (as
delegated by the Attorney General) may,
by order, temporarily schedule
substances in schedule I. Such orders
may not be issued before the expiration
of 30 days from: (1) The publication of
a notice in the Federal Register of the
intent to issue such order and the
grounds upon which such order is to be
issued, and (2) the date that notice of
the proposed temporary scheduling
order is transmitted to the Assistant
Secretary for Health of HHS, as
delegated by the Secretary of HHS.
Inasmuch as this section directs that
temporary scheduling actions be issued
by order and sets forth the procedures
by which such orders are to be issued,
including the requirement to publish in
the Federal Register a notice of intent,
the notice-and-comment requirements
of section 553 of the Administrative
Procedure Act (APA), 5 U.S.C. 553, do
not apply to this notice of intent. The
APA expressly differentiates between
orders and rules, as it defines an
‘‘order’’ to mean a ‘‘final disposition,
whether affirmative, negative,
injunctive, or declaratory in form, of an
agency in a matter other than rule
making.’’ 5 U.S.C. 551(6) (emphasis
added). The specific language chosen by
Congress indicates its intent that DEA
issue orders instead of proceeding by
rulemaking when temporarily
scheduling substances. Given that
Congress specifically requires the
Administrator (as delegated by the
Attorney General) to follow rulemaking
procedures for other kinds of scheduling
actions, see 21 U.S.C. 811(a), it is
noteworthy that, in section 811(h),
Congress authorized the issuance of
temporary scheduling actions by order
rather than by rule.
Even assuming that this notice of
intent is subject to section 553 of the
APA, the Administrator finds that there
is good cause to forgo its notice-andcomment requirements, as any further
delays in the process for issuing
temporary scheduling orders would be
impracticable and contrary to the public
interest given the manifest urgency to
avoid an imminent hazard to the public
safety.
Although DEA believes this notice of
intent to issue a temporary scheduling
order is not subject to the notice-andcomment requirements of section 553 of
the APA, DEA notes that in accordance
with 21 U.S.C. 811(h)(4), the
Administrator took into consideration
comments submitted by the Assistant
Secretary in response to the notice that
DEA transmitted to the Assistant
Secretary pursuant to such subsection.
Further, DEA believes that this notice
of intent is not a ‘‘rule’’ as defined by
PO 00000
Frm 00014
Fmt 4702
Sfmt 4702
78891
5 U.S.C. 601(2), and, accordingly, is not
subject to the requirements of the
Regulatory Flexibility Act. The
requirements for the preparation of an
initial regulatory flexibility analysis in 5
U.S.C. 603(a) are not applicable where,
as here, DEA is not required by section
553 of the APA or any other law to
publish a general notice of proposed
rulemaking.
In accordance with the principles of
Executive Orders (E.O.) 12866 and
13563, this notice of intent is not a
significant regulatory action. E.O. 12866
directs agencies to assess all costs and
benefits of available regulatory
alternatives and, if regulation is
necessary, to select regulatory
approaches that maximize net benefits
(including potential economic,
environmental, public health, and safety
effects; distributive impacts; and
equity). E.O. 13563 is supplemental to
and reaffirms the principles, structures,
and definitions governing regulatory
review as established in E.O. 12866.
E.O. 12866 classifies a ‘‘significant
regulatory action,’’ requiring review by
the Office of Management and Budget,
as any regulatory action that is likely to
result in a rule that may: (1) have an
annual effect on the economy of $100
million or more or adversely affect in a
material way the economy; a sector of
the economy; productivity; competition;
jobs; the environment; public health or
safety; or State, local, or tribal
governments or communities; (2) create
a serious inconsistency or otherwise
interfere with an action taken or
planned by another agency; (3)
materially alter the budgetary impact of
entitlements, grants, user fees, or loan
programs, or the rights and obligations
of recipients thereof; or (4) raise novel
legal or policy issues arising out of legal
mandates, the President’s priorities, or
the principles set forth in the E.O.
Because this is not a rulemaking action,
this is not a significant regulatory action
as defined in Section 3(f) of E.O. 12866.
This action will not have substantial
direct effects on the States, on the
relationship between the national
government and the States, or on the
distribution of power and
responsibilities among the various
levels of government. Therefore, in
accordance with E.O. 13132, it is
determined that this action does not
have sufficient federalism implications
to warrant the preparation of a
federalism assessment.
List of Subjects in 21 CFR Part 1308
Administrative practice and
procedure, Drug traffic control,
Reporting and recordkeeping
requirements.
E:\FR\FM\23DEP1.SGM
23DEP1
78892
Federal Register / Vol. 87, No. 246 / Friday, December 23, 2022 / Proposed Rules
For the reasons set out above, DEA
proposes to amend 21 CFR part 1308 as
follows:
2. In § 1308.11, add paragraphs (h)(63)
through (67) to read as follows:
PART 1308—SCHEDULES OF
CONTROLLED SUBSTANCES
■
1. The authority citation for part 1308
continues to read as follows:
§ 1308.11
■
Authority: 21 U.S.C. 811, 812, 871(b),
956(b), unless otherwise noted.
*
Schedule I.
*
*
(h) * * *
*
*
(63) 4-(2-chlorophenyl)-2-ethyl-9-methyl-6H-thieno[3,2-f][1,2,4]triazolo[4,3-a][1,4]diazepine, its salts, isomers, and salts of isomers
(Other name: etizolam) ...................................................................................................................................................................................
(64) 8-chloro-6-(2-fluorophenyl)-1-methyl-4H-benzo[f][1,2,4]triazolo[4,3-a][1,4]diazepine, its salts, isomers, and salts of isomers
(Other name: flualprazolam) ..........................................................................................................................................................................
(65) 6-(2-chlorophenyl)-1-methyl-8-nitro-4H-benzo[f][1,2,4]triazolo[4,3-a][1,4]diazepine, its salts, isomers, and salts of isomers (Other
name: clonazolam) ..........................................................................................................................................................................................
(66) 8-bromo-6-(2-fluorophenyl)-1-methyl-4H-benzo[f][1,2,4]triazolo[4,3-a][1,4]diazepine, its salts, isomers, and salts of isomers
(Other name: flubromazolam) ........................................................................................................................................................................
(67) 7-chloro-5-(2-chlorophenyl)-1-methyl-1,3-dihydro-2H-benzo[e][1,4]diazepin-2-one, its salts, isomers, and salts of isomers (Other
name: diclazepam) ..........................................................................................................................................................................................
Signing Authority
This document of the Drug
Enforcement Administration was signed
on December 12, 2022, by Administrator
Anne Milgram. That document with the
original signature and date is
maintained by DEA. For administrative
purposes only, and in compliance with
requirements of the Office of the Federal
Register, the undersigned DEA Federal
Register Liaison Officer has been
authorized to sign and submit the
document in electronic format for
publication, as an official document of
DEA. This administrative process in no
way alters the legal effect of this
document upon publication in the
Federal Register.
Scott Brinks,
Federal Register Liaison Officer, Drug
Enforcement Administration.
[FR Doc. 2022–27278 Filed 12–22–22; 8:45 am]
BILLING CODE 4410–09–P
ENVIRONMENTAL PROTECTION
AGENCY
40 CFR Part 52
[EPA–R04–OAR–2022–0155; FRL–10503–
01–R4]
Air Plan Approval; Tennessee;
Packaging Corporation of America
Nitrogen Oxides SIP Call Alternative
Monitoring
Environmental Protection
Agency (EPA).
ACTION: Proposed rule.
TKELLEY on DSK125TN23PROD with PROPOSALS
AGENCY:
VerDate Sep<11>2014
19:21 Dec 22, 2022
Jkt 259001
Comments must be received on
or before January 23, 2023.
DATES:
Submit your comments,
identified by Docket ID No. EPA–R04–
OAR–2022–0155 at
www.regulations.gov. Follow the online
instructions for submitting comments.
Once submitted, comments cannot be
edited or removed from Regulations.gov.
EPA may publish any comment received
to its public docket. Do not submit
electronically any information you
consider to be Confidential Business
Information (CBI) or other information
whose disclosure is restricted by statute.
Multimedia submissions (audio, video,
etc.) must be accompanied by a written
comment. The written comment is
considered the official comment and
should include discussion of all points
you wish to make. EPA will generally
not consider comments or comment
contents located outside of the primary
submission (i.e., on the web, cloud, or
other file sharing system). For
additional submission methods, the full
EPA public comment policy,
information about CBI or multimedia
submissions, and general guidance on
making effective comments, please visit
www.epa.gov/dockets/commenting-epadockets.
ADDRESSES:
FOR FURTHER INFORMATION CONTACT:
The Environmental Protection
Agency (EPA) is proposing to
conditionally approve a source-specific
State Implementation Plan (SIP)
revision submitted by the State of
Tennessee, through the Tennessee
Department of Environment and
Conservation (TDEC), through a letter
SUMMARY:
dated June 29, 2021, which would
establish alternative monitoring,
recordkeeping, and reporting
requirements under the Nitrogen Oxides
(NOX) SIP Call.
Steven Scofield, Air Regulatory
Management Section, Air Planning and
Implementation Branch, Air and
Radiation Division, U.S. Environmental
Protection Agency, Region 4, 61 Forsyth
Street SW, Atlanta, Georgia 30303–8960.
The telephone number is (404) 562–
9034. Mr. Scofield can also be reached
via electronic mail at scofield.steve@
epa.gov.
PO 00000
Frm 00015
Fmt 4702
Sfmt 4702
2780
2785
2786
2788
2789
SUPPLEMENTARY INFORMATION:
I. Background
Under Clean Air Act (CAA or Act)
section 110(a)(2)(D)(i)(I), also called the
good neighbor provision, states are
required to address the interstate
transport of air pollution. Specifically,
the good neighbor provision requires
that each state’s implementation plan
contain adequate provisions to prohibit
air pollutant emissions from within the
state that will significantly contribute to
nonattainment of the national ambient
air quality standards (NAAQS), or that
will interfere with maintenance of the
NAAQS, in any other state.
On October 27, 1998 (63 FR 57356),
EPA finalized the ‘‘Finding of
Significant Contribution and
Rulemaking for Certain States in the
Ozone Transport Assessment Group
Region for Purposes of Reducing
Regional Transport of Ozone’’ (NOX SIP
Call). The NOX SIP Call required eastern
states, including Tennessee, to submit
SIPs limiting emissions of ozone season
NOX by implementing statewide
emissions budgets. The NOX SIP Call
addressed the good neighbor provision
for the 1979 ozone NAAQS and was
designed to mitigate the impact of
transported NOX emissions, one of the
precursors of ozone.1 EPA developed
the NOX Budget Trading Program, an
allowance trading program that states
could adopt to meet their obligations
under the NOX SIP Call. This trading
program allowed the following sources
to participate in a regional cap and trade
program: generally, electricity
generating units (EGUs) with capacity
greater than 25 megawatts (MW); and
large industrial non-EGUs, such as
1 As originally promulgated, the NO SIP Call
X
also addressed good neighbor obligations under the
1997 8-hour ozone NAAQS, but EPA subsequently
stayed and later rescinded the rule’s provisions
with respect to that standard. See 65 FR 56245
(September 18, 2000); 84 FR 8422 (March 8, 2019).
E:\FR\FM\23DEP1.SGM
23DEP1
Agencies
[Federal Register Volume 87, Number 246 (Friday, December 23, 2022)]
[Proposed Rules]
[Pages 78887-78892]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-27278]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF JUSTICE
Drug Enforcement Administration
21 CFR Part 1308
[Docket No. DEA-989]
Schedules of Controlled Substances: Temporary Placement of
Etizolam, Flualprazolam, Clonazolam, Flubromazolam, and Diclazepam in
Schedule I
AGENCY: Drug Enforcement Administration, Department of Justice.
ACTION: Proposed amendment; notice of intent.
-----------------------------------------------------------------------
SUMMARY: The Administrator of the Drug Enforcement Administration is
providing this notice of intent to publish a temporary order to
schedule five synthetic benzodiazepine substances, as identified in
this notice, in schedule I of the Controlled Substances Act. When it is
issued, the temporary scheduling order will impose the regulatory
controls and administrative, civil, and criminal sanctions applicable
to schedule I controlled substances on persons who handle (manufacture,
distribute, reverse distribute, import, export, engage in research,
conduct instructional activities or chemical analysis with, or possess)
or propose to handle these five specified controlled substances.
DATES: This notice of intent is effective December 23, 2022.
FOR FURTHER INFORMATION CONTACT: Dr. Terrence L. Boos, Drug and
Chemical Evaluation Section, Diversion Control Division, Drug
Enforcement Administration; Mailing Address: 8701 Morrissette Drive,
Springfield, Virginia 22152; Telephone: (571) 362-3249.
SUPPLEMENTARY INFORMATION: The notice of intent contained in this
document is issued pursuant to the temporary scheduling provisions of
21 U.S.C. 811(h). The Drug Enforcement Administration (DEA) intends to
issue a temporary scheduling order \1\ (in the form of a temporary
amendment) to add the following five substances, including their salts,
isomers, and salts of isomers, whenever the existence of such salts,
isomers, and salts of isomers is possible, to schedule I under the
Controlled Substances Act (CSA):
---------------------------------------------------------------------------
\1\ Though DEA has used the term ``final order'' with respect to
temporary scheduling orders in the past, this notice of intent
adheres to the statutory language of 21 U.S.C. 811(h), which refers
to a ``temporary scheduling order.'' No substantive change is
intended.
---------------------------------------------------------------------------
4-(2-chlorophenyl)-2-ethyl-9-methyl-6H-thieno[3,2-
f][1,2,4]triazolo[4,3-a][1,4]diazepine (commonly known as etizolam),
8-chloro-6-(2-fluorophenyl)-1-methyl-4H-
benzo[f][1,2,4]triazolo[4,3-a][1,4]diazepine (commonly known as
flualprazolam),
6-(2-chlorophenyl)-1-methyl-8-nitro-4H-
benzo[f][1,2,4]triazolo[4,3-a][1,4]diazepine (commonly known as
clonazolam),
8-bromo-6-(2-fluorophenyl)-1-methyl-4H-
benzo[f][1,2,4]triazolo[4,3-a][1,4]diazepine (alternate chemical name:
8-bromo-6-(2-fluorophenyl)-1-methyl-4H-[1,2,4]triazolo[4,3-
a][1,4]benzodiazepine and commonly known as, flubromazolam), and
7-chloro-5-(2-chlorophenyl)-1-methyl-1,3-dihydro-2H-
benzo[e][1,4]diazepin-2-one (commonly known as diclazepam).
[[Page 78888]]
The temporary scheduling order will be published in the Federal
Register on or after January 23, 2023.
Legal Authority
The CSA provides the Attorney General (as delegated to the
Administrator of DEA (Administrator) pursuant to 28 CFR 0.100) with the
authority to temporarily place a substance in schedule I of the CSA for
two years without regard to the requirements of 21 U.S.C. 811(b), if
the Administrator finds that such action is necessary to avoid an
imminent hazard to the public safety. 21 U.S.C. 811(h)(1). In addition,
if proceedings to control a substance are initiated under 21 U.S.C.
811(a)(1) while the substance is temporarily controlled under section
811(h), the Administrator may extend the temporary scheduling for up to
one year. 21 U.S.C. 811(h)(2).
Where the necessary findings are made, a substance may be
temporarily scheduled if it is not listed in any other schedule under
21 U.S.C. 812, or if there is no exemption or approval in effect for
the substance under section 505 of the Federal Food, Drug, and Cosmetic
Act, 21 U.S.C. 355. 21 U.S.C. 811(h)(1); 21 CFR part 1308.
Background
The CSA requires the Administrator to notify the Secretary of the
Department of Health and Human Services (HHS) of an intent to place a
substance in schedule I of the CSA temporarily (i.e., to issue a
temporary scheduling order). 21 U.S.C. 811(h)(4). The Administrator
transmitted the required notice to the Assistant Secretary for Health
of HHS (Assistant Secretary),\2\ by letter dated October 25, 2021,
regarding etizolam, flualprazolam, clonazolam, flubromazolam, and
diclazepam. The Assistant Secretary responded to this notice by a
letter dated January 3, 2022, and advised that based on a review by the
Food and Drug Administration (FDA), there are currently no
investigational new drug applications (INDs) or approved new drug
applications (NDAs) for etizolam, flualprazolam, clonazolam,
flubromazolam, and diclazepam. The Assistant Secretary also stated that
HHS had no objection to the temporary placement of these substances in
schedule I. Etizolam, flualprazolam, clonazolam, flubromazolam, and
diclazepam currently are not listed in any schedule under the CSA, and
no exemptions or approvals under 21 U.S.C. 355 are in effect for these
five benzodiazepine substances.
---------------------------------------------------------------------------
\2\ The Secretary of HHS has delegated to the Assistant
Secretary for Health of HHS the authority to make domestic drug
scheduling recommendations. 58 FR 35460, July 1, 1993.
---------------------------------------------------------------------------
To find that temporarily placing a substance in schedule I of the
CSA is necessary to avoid an imminent hazard to the public safety, the
Administrator must consider three of the eight factors set forth in 21
U.S.C. 811(c): The substance's history and current pattern of abuse;
the scope, duration and significance of abuse; and what, if any, risk
there is to the public health. 21 U.S.C. 811(h)(3). This consideration
includes any information indicating actual abuse, diversion from
legitimate channels, and clandestine importation, manufacture, or
distribution of these substances.
Substances meeting the statutory requirements for temporary
scheduling may only be placed in schedule I. 21 U.S.C. 811(h)(1).
Substances in schedule I have high potential for abuse, no currently
accepted medical use in treatment in the United States, and no accepted
safety for use under medical supervision. 21 U.S.C. 812(b)(1).
Five Benzodiazepine Substances: Etizolam, Flualprazolam, Clonazolam,
Flubromazolam, and Diclazepam
The dramatic increase in trafficking and abuse associated with
novel psychoactive substances (NPS) of the benzodiazepine class in the
United States has become a national public health concern in recent
years. The availability of NPS benzodiazepine substances in the illicit
drug market continues to pose an imminent hazard to the public safety.
The Centers for Disease Control and Prevention (CDC) highlights this
issue in their Morbidity and Mortality Weekly Report (MMWR) published
on August 27, 2021.\3\ CDC indicated that, from April 2019 to June
2020, prescription and illicit benzodiazepine-involved overdose deaths
increased by 21.8% and 519.6% respectively. Additionally,
benzodiazepines were involved in nearly 7,000 overdose deaths in 23
states from January 2019 to June 2020, accounting for 17% of all drug
overdose deaths. Adverse health effects associated with the abuse of
such substances known collectively as the ``designer benzodiazepines,''
their continued evolution, and increased popularity of these substances
have been a serious concern in recent years. The increase in the co-use
of opioids with the ``designer benzodiazepines'' has become a
particular concern as the United States continues to experience an
unprecedented epidemic of opioid misuse and abuse. CDC's 2021 MMWR
further states that between January and June 2020, 92.7% of
benzodiazepine-involved deaths also involved opioids and 66.7% involved
illicitly manufactured fentanyl. It is well known that the combination
of benzodiazepines with opioids substantially enhances the potential
for lethality. Etizolam, flualprazolam, clonazolam, flubromazolam, and
diclazepam are benzodiazepine substances recently identified on the
illicit drug market in the United States.
---------------------------------------------------------------------------
\3\ Centers for Disease Control and Prevention Morbidity and
Mortality Weekly Report: Trends in Nonfatal and Fatal Overdoses
Involving Benzodiazepines--38 States and the District of Columbia,
2019-2020. Vol. 70, No. 34. August 27, 2021.
---------------------------------------------------------------------------
The abuse of etizolam, flualprazolam, clonazolam, flubromazolam,
and diclazepam has been associated with numerous fatalities in recent
years in the United States. The positive identification of these five
substances in post-mortem cases is a serious concern to the public
safety. Additionally, law enforcement data indicate that the substances
at issue here have significant presence in the United States illicit
drug market. In light of the law enforcement encounters and fatalities
associated with the abuse of etizolam, flualprazolam, clonazolam,
flubromazolam, and diclazepam these substances pose an imminent hazard
to public safety.
Available data and information for etizolam, flualprazolam,
clonazolam, flubromazolam, and diclazepam, summarized below, indicate
that these substances have high potential for abuse, no currently
accepted medical use in treatment in the United States, and lack of
accepted safety for use under medical supervision. DEA's three-factor
analysis is available in its entirety under ``Supporting and Related
Material'' of the public docket for this action at www.regulations.gov
under Docket Number DEA-989.
Factor 4. History and Current Pattern of Abuse
The chemical synthesis of etizolam, flualprazolam, clonazolam,
flubromazolam, and diclazepam were previously reported in the
scientific literature; however, the research did not lead to any
medically approved products in the United States. Since 2012, numerous
synthetic drugs belonging to the benzodiazepine class have begun to
emerge in the illicit drug market as evidenced by the identification of
these drugs in forensic drug exhibits from the National Forensic
Laboratory Information System (NFLIS),\4\ and toxicology samples.
[[Page 78889]]
Beginning in 2012, etizolam emerged on the illicit synthetic drug
market as evidenced by its identification in drug seizures in the
United States. In recent years, there has been a rise in the
recreational use of etizolam. As evidenced by their identification in
NFLIS-Drug, diclazepam emerged in the United States' illicit drug
market in 2014, flubromazolam and clonazolam in 2015, and flualprazolam
in 2017. While these substances are not approved for medical use in the
United States, etizolam is approved for medical use in Italy, India,
and Japan.\5\ In a letter dated January 3, 2022, the Assistant
Secretary informed DEA that there are no INDs or FDA-approved NDAs for
etizolam, flualprazolam, clonazolam, flubromazolam, and diclazepam in
the United States. Hence, there are no legitimate channels for these
substances as marketed drug products in the United States. These five
benzodiazepine substances are likely to be abused in the same manner as
other sedative hypnotics. They have been identified in tablet form, as
white to beige powders, or in liquid forms, typically of unknown purity
or concentration.
---------------------------------------------------------------------------
\4\ NFLIS represents an important resource in monitoring illicit
drug trafficking, including the diversion of legally manufactured
pharmaceuticals into illegal markets. NFLIS is a comprehensive
information system that includes data from forensic laboratories
that handle more than 96% of an estimated 1.0 million distinct
annual state and local drug analysis cases. NFLIS includes drug
chemistry results from completed analyses only. While NFLIS data is
not direct evidence of abuse, it can lead to an inference that a
drug has been diverted and abused. See 76 FR 77330, 77332, Dec. 12,
2011.
\5\ Although there is no evidence suggesting that etizolam,
flualprazolam, clonazolam, flubromazolam, or diclazepam has a
currently accepted medical use in treatment in the United States, it
bears noting that a drug cannot be found to have such medical use
unless DEA concludes that it satisfies a five-part test.
Specifically, with respect to a drug that has not been approved by
FDA, to have a currently accepted medical use in treatment in the
United States, all of the following must be demonstrated: i. The
drug's chemistry must be known and reproducible; ii. there must be
adequate safety studies; iii. there must be adequate and well-
controlled studies proving efficacy; iv. the drug must be accepted
by qualified experts; and v. the scientific evidence must be widely
available. 57 FR 10499 (1992), pet. for rev. denied, Alliance for
Cannabis Therapeutics v. DEA, 15 F.3d 1131, 1135 (D.C. Cir. 1994).
---------------------------------------------------------------------------
Based on data from NFLIS, law enforcement often encountered
etizolam, flualprazolam, clonazolam, flubromazolam, and diclazepam in
counterfeit pills, liquid, or powder. Substances often found in
combination with some of these benzodiazepines include substances of
abuse such as heroin (schedule I), fentanyl (schedule II), other
substances structurally related to fentanyl (schedule I and other non-
controlled substances), other benzodiazepines (both FDA-approved
schedule IV benzodiazepines and other novel non-controlled
benzodiazepines), and tramadol (schedule IV). Evidence suggests that
individuals are using these substances to obtain ``legal highs'' or to
self-medicate. Information gathered from case histories and autopsy
findings shows that deaths involving etizolam, flualprazolam,
clonazolam, flubromazolam, and diclazepam were predominantly associated
with poly-drug use.
Factor 5. Scope, Duration, and Significance of Abuse
Etizolam, flualprazolam, clonazolam, flubromazolam, and diclazepam
are novel benzodiazepines, and evidence suggests they are abused for
their sedative effects (see Factor 6). In death investigations
involving polysubstance use, the co-appearance of benzodiazepines and
opioids in toxicological analysis was common. Between August 2019 and
January 2020, flualprazolam and etizolam were identified in seven and
six postmortem blood specimens, respectively, out of 18 deaths
associated with the abuse of isotonitazene, a schedule I opioid that
was recently controlled. These cases corresponded to four states--
Illinois (9), Indiana (7), Minnesota (1), and Wisconsin (1). Most (n =
12) of the decedents were male. The ages ranged from 24 to 66 years old
with an average age of 41 years.\6\
---------------------------------------------------------------------------
\6\ Krotulski AJ, Papsun DM, Kacinko SL, and Logan BK.
Isotonitazene Quantitation and Metabolite Discovery in Authentic
Forensic Casework. Journal of Analytical Toxicology, 2020,
44(6):521-530.
---------------------------------------------------------------------------
In another recent publication, 20 forensic postmortem cases were
reviewed and analyzed for the presence of metonitazine, NPS
benzodiazepines, and opioids. Results indicated that NPS
benzodiazepines were the most commonly identified substances found in
combination with metonitazene. Specifically, clonazolam was positively
identified in four cases, etizolam in two cases, flualprazolam in two
cases, and pyrazolam in one case.\7\ Law enforcement encounters of
etizolam, flualprazolam, clonazolam, flubromazolam, and diclazepam as
reported to NFLIS (Federal, State and local laboratories) include
34,781 drug reports since 2014 (queried 01/13/2022). NFLIS-Drug
registered three encounters of etizolam in 2012 (first year of
encounter) and 3,022 reports in 2021. Flualprazolam was first
encountered in 2017 when one report was identified in NFLIS-Drug, and
then in 2021, 1,305 encounters were reported. A similar trend was seen
with clonazolam. During 2015 (its first year of encounter), 57 cases
were reported in NFLIS-Drug, while 3,994 drug reports were identified
in 2021. NFLIS-Drug registered five diclazepam encounters in 2014 (its
first year of encounter) and 54 encounters in 2021. Flubromazolam
encounters totaled 14 in 2015 (its first year of encounter) and 414 in
2021.
---------------------------------------------------------------------------
\7\ Krotulski AJ, Papsun DM, Walton SE, and Logan BK.
Metonitazene in the United States-Forensic toxicology assessment of
a potent new synthetic opioid using liquid chromatography mass
spectrometry. Drug Testing Analysis, 2021, 13(10):1697-1711.
---------------------------------------------------------------------------
The population likely to abuse etizolam, flualprazolam, clonazolam,
flubromazolam, and diclazepam appears to be the same as those abusing
prescription benzodiazepines, barbiturates, and other sedative hypnotic
substances. This is evidenced by drug user reports associated with
these substances. Because abusers of etizolam, flualprazolam,
clonazolam, flubromazolam, and diclazepam are likely to obtain these
substances through unregulated sources, the identity, purity, and
quantity of these substances are uncertain and inconsistent, thus
posing significant adverse health risks to the end user.
The misuse and abuse of benzodiazepines have been demonstrated and
are well-characterized.\8\ According to the most recent data from the
National Survey on Drug Use and Health (NSDUH),\9\ as of 2020, an
estimated 4.8 million people aged 12 years or older misused
prescription benzodiazepines in the past year. This included 1.1
million young adults aged 18 to 25, 3.5 million adults aged 26 or
older, and 157,000 adolescents aged 12 to 17. This population abusing
prescription benzodiazepines is likely to be at risk of abusing
etizolam, flualprazolam, clonazolam, flubromazolam, and diclazepam.
Individuals who initiate
[[Page 78890]]
use of these five substances (i.e., use a drug for the first time) are
likely to be at risk of developing substance use disorder, overdose,
and death at rates similar to that of other sedative hypnotics (e.g.,
alprazolam, clonazolam, etc.). Law enforcement or toxicology reports
demonstrate that the five substances at issue are being distributed and
abused.
---------------------------------------------------------------------------
\8\ Votaw VR, Geyer R, Rieselbach MM, and McHugh RK. The
epidemiology of benzodiazepine misuse: A systematic review. Drug
Alcohol Dependence, 2019, 200:95-114.
\9\ The National Survey on Drug Use and Health (NSDUH), formerly
known as the National Household Survey on Drug Abuse (NHSDA), is
conducted annually by the Department of Health and Human Services
Substance Abuse and Mental Health Services Administration (SAMHSA).
It is the primary source of estimates of the prevalence and
incidence of nonmedical use of pharmaceutical drugs, illicit drugs,
alcohol, and tobacco use in the United States. The survey is based
on a nationally representative sample of the civilian, non-
institutionalized population 12 years of age and older. The survey
excludes homeless people who do not use shelters, active military
personnel, and residents of institutional group quarters such as
jails and hospitals. The NSDUH provides yearly national and state
level estimates of drug abuse, and includes prevalence estimates by
lifetime (i.e., ever used), past year, and past month abuse or
dependence. The 2020 NSDUH annual report is available at https://www.samhsa.gov/data/ (last accessed February 8, 2022).
---------------------------------------------------------------------------
Factor 6. What, if Any, Risk There Is to the Public Health
The increase in benzodiazepine-related overdose deaths in the
United States has been exacerbated recently by the availability of NPS
benzodiazepines in the illicit drug market. Etizolam, flualprazolam,
clonazolam, flubromazolam, and diclazepam have been described as
derivatives of other known benzodiazepines, each possessing various
degrees of potency. Evidence suggests these substances are being abused
for their sedative/hypnotic effects (see DEA 3-Factor Analysis). Public
health risks associated with the five substances at issue here relate
to their pharmacological similarities with known benzodiazepines. Thus,
risk to the public health is associated with adverse reactions in
humans, which are expected to include CNS depressant-like effects, such
as slurred speech, ataxia, altered mental state, and respiratory
depression.
Etizolam, flualprazolam, clonazolam, flubromazolam, and diclazepam
have been increasingly identified in toxicology reports, death
investigations, and driving under the influence of drugs (DUID) cases
since their first appearance in law enforcement seizures. According to
the Center for Forensic Science Research and Education (CFSRE), a non-
profit organization in collaboration with the Department of Justice and
Centers for Disease Control, between 2020 and 2021, etizolam was the
most identified NPS benzodiazepine accounting for 697 total toxicology
cases in 2020, many of which were co-identified with fentanyl. In 2021,
etizolam was identified in 1,012 toxicology cases, while flualprazolam,
clonazolam, flubromazolam, and diclazepam were associated with 432,
331, 170, and four toxicology cases, respectively (CSFRE Quarterly
Trend Reports: NPS Benzodiazepines in the United States).
Death investigations associated with four of the five NPS
benzodiazepines at issue here have increased in recent years. In a 2021
publication by the Orange County Crime Lab in Santa Ana, California,
flualprazolam was identified as serving a contributory role in the
death of 13 of 24 cases analyzed in the study.\10\ In another recently
published study, between August 2019 and January 2020, flualprazolam
and etizolam were identified in seven and six postmortem blood
specimens respectively, out of 18 deaths associated with the abuse of
isotonitazene, a schedule I opioid.\11\ Then, a study published in 2021
which compiled data from 254 reports published between 2008 and 2021,
identified: 33 deaths associated with etizolam, 20 flualprazolam-
related deaths, six emergency department (ED) visits associated with
clonazolam, 14 flubromazolam-related ED visits, and one death, 12 DUID
cases, and four ED visits associated with diclazepam.\12\ Additionally,
in 2020, the European Monitoring Centre for Drugs and Drug Addiction
reported 34 deaths associated with diclazepam use, which were
determined through the analysis of biological samples.\13\ Furthermore,
the National Poison Data System reported that between January 2014 and
December 2017, clonazolam was the second most common benzodiazepine
associated with poison control center calls, accounting for 50
incidents.\14\
---------------------------------------------------------------------------
\10\ Ha HH and Mata DC. Flualprazolam distribution in postmortem
samples. Journal of Forensic Sciences, 2022, 67(1): 297-308.
\11\ Krotulski AJ, Papsun DM, Kacinko SL, and Logan BK.
Isotonitazene Quantitation and Metabolite Discovery in Authentic
Forensic Casework. Journal of Analytical Toxicology, 2020, 44(6):
521-530.
\12\ Brunetti P, Giorgetti R, Tagliabracci A, Huestis MA,
Busard[ograve] FP. Designer Benzodiazepines: A Review of Toxicology
and Public Health Risks. Pharmaceuticals (Basel). 2021 Jun
11;14(6):560.
\13\ EMCDDA (2020). EMCDDA response to WHO request for
information on the new psychoactive substances, eutylone, [alpha]-
PHiP, 4F-furanylfentanyl, 2-methyl-AP-237, and, diclazepam.
\14\ Carpenter JE, Murray BP, Dunkley C, Kazzi ZN, Gittinger MH.
Designer benzodiazepines: a report of exposures recorded in the
National Poison Data System, 2014-2017. Clin Toxicol (Phila). 2019
Apr;57(4):282-286.
---------------------------------------------------------------------------
Impaired driving is another risk factor associated with the use and
abuse of etizolam, flualprazolam, clonazolam, flubromazolam, and
diclazepam. In a recent published report from the Sedgwick County
Regional Forensic Science Center in Wichita, Kansas, 12 DUID case
samples were analyzed. Etizolam was positively identified in three
cases, while flubromazolam was identified in nine of these cases.\15\
In a 2021 publication, similar involvement of flubromazolam in drug-
impaired driving was reported in Canada where flubromazolam was
detected in 10 percent of 113 case samples.\16\ Diclazepam has also
been implicated in DUID cases domestically and internationally. In a
Norwegian study conducted between July 2013 and May 2016, diclazepam
was identified in 15 of 77 analyzed samples taken from impaired drivers
and individuals involved in other criminal offenses. Then, in 2019, a
study of Norwegian drivers was conducted using 575 samples taken
predominantly from intoxicated drivers and individuals who committed
other criminal offenses.\17\ Notably, 334 samples were found to contain
diclazepam. Additionally, in a 2021 publication, researchers identified
22 samples that tested positive for flualprazolam in samples obtained
from DUID investigations between August 2018 and September 2020.\18\
---------------------------------------------------------------------------
\15\ Rohrig TP, Osawa KA, Baird TR, Youso KB. Driving Impairment
Cases Involving Etizolam and Flubromazolam. J Anal Toxicol. 2021 Feb
6;45(1):93-98.
\16\ Vaillancourt L, Viel E, Dombrowski C, Desharnais B,
Mireault P. Drugs and driving prior to cannabis legalization: A 5-
year review from DECP (DRE) cases in the province of Quebec, Canada.
Accid Anal Prev. 2021 Jan;149:105832.
\17\ Heide G, H[oslash]iseth G, Middelkoop G, and [Oslash]iestad
[Aring]ML. Blood concentrations of designer benzodiazepines:
Relation to impairment and findings in forensic cases. Journal of
Analytical Toxicology, 2020, 44(8): 905-914.
\18\ Ha HH and Mata DC. Flualprazolam distribution in postmortem
samples. Journal of Forensic Sciences, 2022, 67(1): 297-308.
---------------------------------------------------------------------------
Finding of Necessity of Schedule I Placement To Avoid Imminent Hazard
to Public Safety
In accordance with 21 U.S.C. 811(h)(3), based on the available data
and information summarized above, the uncontrolled manufacture,
distribution, reverse distribution, importation, exportation, conduct
of research and chemical analysis, possession, and abuse of etizolam,
flualprazolam, clonazolam, flubromazolam, and diclazepam pose imminent
hazards to public safety. DEA is not aware of any currently accepted
medical uses for these substances in the United States. As required by
21 U.S.C. 811(h)(4), the Administrator transmitted to the Assistant
Secretary for Health, via a letter dated October 25, 2021, notice of
her intent to place etizolam, flualprazolam, clonazolam, flubromazolam,
and diclazepam in schedule I on a temporary basis. HHS had no objection
to the temporary placement of these substances in schedule I.
Conclusion
This notice of intent provides the 30-day notice pursuant to 21
U.S.C. 811(h)(1) of DEA's intent to issue a temporary scheduling order.
In accordance with 21 U.S.C. 811(h)(1) and (3), the Administrator
considered
[[Page 78891]]
available data and information, herein set forth the grounds for her
determination that it is necessary to temporarily schedule etizolam,
flualprazolam, clonazolam, flubromazolam, and diclazepam in schedule I
of the CSA and finds that placement of these substances in schedule I
is necessary to avoid an imminent hazard to the public safety.
The temporary placement of etizolam, flualprazolam, clonazolam,
flubromazolam, and diclazepam in schedule I of the CSA will take effect
pursuant to a temporary scheduling order, which will not be issued
before January 23, 2023. Because the Administrator hereby finds this
temporary scheduling order is necessary to avoid an imminent hazard to
the public safety, it will take effect on the date the order is
published in the Federal Register and remain in effect for two years,
with a possible extension of one year, pending completion of the
regular (permanent) scheduling process. 21 U.S.C. 811(h)(1) and (2).
The Administrator intends to issue a temporary scheduling order as soon
as possible after the expiration of 30 days from the date of
publication of this document. Upon the temporary order's publication,
etizolam, flualprazolam, clonazolam, flubromazolam, and diclazepam will
then be subject to the CSA's schedule I regulatory controls and to
administrative, civil, and criminal sanctions applicable to their
manufacture, distribution, reverse distribution, importation,
exportation, research, conduct of instructional activities and chemical
analysis, and possession.
The CSA sets forth specific criteria for scheduling drugs or other
substances. Regular scheduling actions in accordance with 21 U.S.C.
811(a) are subject to formal rulemaking procedures ``on the record
after opportunity for a hearing'' conducted pursuant to the provisions
of 5 U.S.C. 556 and 557. 21 U.S.C. 811. The regular scheduling process
of formal rulemaking affords interested parties appropriate process and
the government any additional relevant information needed to make
determinations. Final decisions that conclude the regular scheduling
process of formal rulemaking are subject to judicial review. 21 U.S.C.
877. Temporary scheduling orders are not subject to judicial review. 21
U.S.C. 811(h)(6).
Regulatory Analyses
The CSA provides for expedited temporary scheduling actions where
necessary to avoid an imminent hazard to the public safety. Under 21
U.S.C. 811(h)(1), the Administrator (as delegated by the Attorney
General) may, by order, temporarily schedule substances in schedule I.
Such orders may not be issued before the expiration of 30 days from:
(1) The publication of a notice in the Federal Register of the intent
to issue such order and the grounds upon which such order is to be
issued, and (2) the date that notice of the proposed temporary
scheduling order is transmitted to the Assistant Secretary for Health
of HHS, as delegated by the Secretary of HHS.
Inasmuch as this section directs that temporary scheduling actions
be issued by order and sets forth the procedures by which such orders
are to be issued, including the requirement to publish in the Federal
Register a notice of intent, the notice-and-comment requirements of
section 553 of the Administrative Procedure Act (APA), 5 U.S.C. 553, do
not apply to this notice of intent. The APA expressly differentiates
between orders and rules, as it defines an ``order'' to mean a ``final
disposition, whether affirmative, negative, injunctive, or declaratory
in form, of an agency in a matter other than rule making.'' 5 U.S.C.
551(6) (emphasis added). The specific language chosen by Congress
indicates its intent that DEA issue orders instead of proceeding by
rulemaking when temporarily scheduling substances. Given that Congress
specifically requires the Administrator (as delegated by the Attorney
General) to follow rulemaking procedures for other kinds of scheduling
actions, see 21 U.S.C. 811(a), it is noteworthy that, in section
811(h), Congress authorized the issuance of temporary scheduling
actions by order rather than by rule.
Even assuming that this notice of intent is subject to section 553
of the APA, the Administrator finds that there is good cause to forgo
its notice-and-comment requirements, as any further delays in the
process for issuing temporary scheduling orders would be impracticable
and contrary to the public interest given the manifest urgency to avoid
an imminent hazard to the public safety.
Although DEA believes this notice of intent to issue a temporary
scheduling order is not subject to the notice-and-comment requirements
of section 553 of the APA, DEA notes that in accordance with 21 U.S.C.
811(h)(4), the Administrator took into consideration comments submitted
by the Assistant Secretary in response to the notice that DEA
transmitted to the Assistant Secretary pursuant to such subsection.
Further, DEA believes that this notice of intent is not a ``rule''
as defined by 5 U.S.C. 601(2), and, accordingly, is not subject to the
requirements of the Regulatory Flexibility Act. The requirements for
the preparation of an initial regulatory flexibility analysis in 5
U.S.C. 603(a) are not applicable where, as here, DEA is not required by
section 553 of the APA or any other law to publish a general notice of
proposed rulemaking.
In accordance with the principles of Executive Orders (E.O.) 12866
and 13563, this notice of intent is not a significant regulatory
action. E.O. 12866 directs agencies to assess all costs and benefits of
available regulatory alternatives and, if regulation is necessary, to
select regulatory approaches that maximize net benefits (including
potential economic, environmental, public health, and safety effects;
distributive impacts; and equity). E.O. 13563 is supplemental to and
reaffirms the principles, structures, and definitions governing
regulatory review as established in E.O. 12866. E.O. 12866 classifies a
``significant regulatory action,'' requiring review by the Office of
Management and Budget, as any regulatory action that is likely to
result in a rule that may: (1) have an annual effect on the economy of
$100 million or more or adversely affect in a material way the economy;
a sector of the economy; productivity; competition; jobs; the
environment; public health or safety; or State, local, or tribal
governments or communities; (2) create a serious inconsistency or
otherwise interfere with an action taken or planned by another agency;
(3) materially alter the budgetary impact of entitlements, grants, user
fees, or loan programs, or the rights and obligations of recipients
thereof; or (4) raise novel legal or policy issues arising out of legal
mandates, the President's priorities, or the principles set forth in
the E.O. Because this is not a rulemaking action, this is not a
significant regulatory action as defined in Section 3(f) of E.O. 12866.
This action will not have substantial direct effects on the States,
on the relationship between the national government and the States, or
on the distribution of power and responsibilities among the various
levels of government. Therefore, in accordance with E.O. 13132, it is
determined that this action does not have sufficient federalism
implications to warrant the preparation of a federalism assessment.
List of Subjects in 21 CFR Part 1308
Administrative practice and procedure, Drug traffic control,
Reporting and recordkeeping requirements.
[[Page 78892]]
For the reasons set out above, DEA proposes to amend 21 CFR part
1308 as follows:
PART 1308--SCHEDULES OF CONTROLLED SUBSTANCES
0
1. The authority citation for part 1308 continues to read as follows:
Authority: 21 U.S.C. 811, 812, 871(b), 956(b), unless otherwise
noted.
0
2. In Sec. 1308.11, add paragraphs (h)(63) through (67) to read as
follows:
Sec. 1308.11 Schedule I.
* * * * *
(h) * * *
(63) 4-(2-chlorophenyl)-2-ethyl-9-methyl-6H-thieno[3,2- 2780
f][1,2,4]triazolo[4,3-a][1,4]diazepine, its salts, isomers, and
salts of isomers (Other name: etizolam).........................
(64) 8-chloro-6-(2-fluorophenyl)-1-methyl-4H- 2785
benzo[f][1,2,4]triazolo[4,3-a][1,4]diazepine, its salts,
isomers, and salts of isomers (Other name: flualprazolam).......
(65) 6-(2-chlorophenyl)-1-methyl-8-nitro-4H- 2786
benzo[f][1,2,4]triazolo[4,3-a][1,4]diazepine, its salts,
isomers, and salts of isomers (Other name: clonazolam)..........
(66) 8-bromo-6-(2-fluorophenyl)-1-methyl-4H- 2788
benzo[f][1,2,4]triazolo[4,3-a][1,4]diazepine, its salts,
isomers, and salts of isomers (Other name: flubromazolam).......
(67) 7-chloro-5-(2-chlorophenyl)-1-methyl-1,3-dihydro-2H- 2789
benzo[e][1,4]diazepin-2-one, its salts, isomers, and salts of
isomers (Other name: diclazepam)................................
Signing Authority
This document of the Drug Enforcement Administration was signed on
December 12, 2022, by Administrator Anne Milgram. That document with
the original signature and date is maintained by DEA. For
administrative purposes only, and in compliance with requirements of
the Office of the Federal Register, the undersigned DEA Federal
Register Liaison Officer has been authorized to sign and submit the
document in electronic format for publication, as an official document
of DEA. This administrative process in no way alters the legal effect
of this document upon publication in the Federal Register.
Scott Brinks,
Federal Register Liaison Officer, Drug Enforcement Administration.
[FR Doc. 2022-27278 Filed 12-22-22; 8:45 am]
BILLING CODE 4410-09-P