Evaluating bromazolam trends in toxicological and seized drugs casework from 2021 to second quarter 2025 in Virginia.

Although not federally scheduled, bromazolam became a Schedule I substance in the Commonwealth of Virginia in 2021. As a result, the Virginia Department of Forensic Science added it to the scope of the Controlled Substance Section in 2021 and to the Toxicology Section at the end of 2022. To establish trends in bromazolam detection, data mining was performed on reports produced by both sections since its addition to the scopes to the second quarter of 2025. Between 2021 and 2024, bromazolam trends in Virginia have been consistent with those observed nationally and internationally, with increases in detection in both sections, especially co-detection with fentanyl. However, in the first quarter of 2025, Virginia observed an increase in bromazolam detection in contrast to a decrease observed nationally. Trends both nationally and in the Commonwealth have increased in the second quarter of 2025, but to different extents. Alongside this increase in bromazolam detection is an increase in the percentage of cases containing both fentanyl and bromazolam. In antemortem and postmortem toxicology specimens in the second quarter of 2025, fentanyl was present in 68% and 88% of bromazolam cases, respectively. Of the seized drug cases in which bromazolam was identified during the same quarter, 52% also contained fentanyl. Among those cases, 33 individual items detected both bromazolam and fentanyl, highlighting the deliberate combination of the two substances. A robust understanding of individual drug trends and co-detection trends at the state and local level can assist in the intervention and subsequent prevention measures employed.