Counterfeit pills / designer benzodiazepines

Clinical contraindication: Relative; Substantial clinical concern; the literature treats it as a reason for caution or deferral.
Best available evidence: Case reports
Half-life: Not recorded

Named in state rules?

CONot named

ORNot named

NMPending

Cite asPsilodex: counterfeit-pills-designer-benzodiazepines · v2026.10.02

Clinical data and state rules are separate facts. Both are shown; neither is a decision.

01 Interaction with psilocybin

Pressed pills sold as Xanax or oxycodone may contain designer benzodiazepines, fentanyl or other opioids at unknown doses. Benzodiazepines plus opioids deepen sedation and slow breathing; illicit benzodiazepines rose sharply in overdose deaths, mostly with fentanyl.

Human data with psilocybin: Case reports or surveys only

Evidence types on this record

CRCase reports or online surveys

02 Pharmacology relevant to psilocybin

1 listed · counted on reports

Sedating or CNS depressant: Slows the central nervous system: drowsiness, slower reactions and impaired coordination, and slowed breathing at high doses. Effects add with other sedating substances. Sources [1][2]

03 State rules

Plain-language summary · official text governs

CO4 CCR 755-1

Not named

No provision names this medication or its class.

Colorado · checked 2026-09-30

OROAR 333-333

Not named

No provision names this medication or its class.

Oregon · checked 2026-09-30

NM7.35.3 NMAC (proposed)

Pending

New Mexico's clinical rules (proposed 7.35.3 NMAC) are not final. No provision naming this medication has been found.

New Mexico · checked 2026-09-30

04 Conditions to ask about

None linked

No condition named in state rules is linked to this medication.

05 Sources

US Drug Enforcement Administration. Drug Fact Sheets (per-entry link). — CNS slowing; opioid combination causes respiratory depression
National Institute on Drug Abuse (NIDA), NIH. Research-topic pages (per-entry link). — counterfeit pills containing fentanyl
Liu S, O'Donnell J, Gladden RM, McGlone L, Chowdhury F. Trends in nonfatal and fatal overdoses involving benzodiazepines — 38 states and the District of Columbia, 2019–2020. MMWR 2021;70(34):1136–1141. — illicit benzodiazepine deaths up 520% 2019–2020; 92.7% also involved opioids
Bazydlo LAL, Larkey NE. Testing strategies and the emergence of designer benzodiazepines. Clin Lab Med 2025;45(2):305–314. — designer benzodiazepines incl. bromazolam, etizolam; routine immunoassays may miss them

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