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An unknown opioid, deadlier than fentanyl, has been linked to a rise in overdose deaths in recent years.
Nitazenes, a group of synthetic opioids, were initially created as pain relievers in the 1950s but were never approved for use due to the high risk of overdose, according to a report from the Inter-American Drug Abuse Control Commission (CICAD).
Since 2019, nitazenes (benzimidazole-opioids) have started appearing in the illicit drug market in Europe, with reports emerging from almost every continent.
CICAD’s report indicates that “nitazene use is a growing trend in North America and that availability is likely spreading across the Americas.”
The most common type of nitazene is isotonitazene (ISO), with at least a dozen others identified, as per the report.
An unknown opioid, deadlier than fentanyl, has been linked to a rise in overdose deaths in recent years. (iStock)
The U.S. Drug Enforcement Administration (DEA) categorizes ISO as a Schedule 1 drug, along with seven other nitazenes.
“Nitazenes are being manufactured in illegal labs overseas, primarily in countries like China and India, and are being smuggled into the U.S. through the same channels used for fentanyl,” stated Corey Gamberg, a licensed alcohol and drug counselor and executive director at the Massachusetts Center for Addiction.
Due to their synthetic nature and cost-effectiveness, nitazenes have become a popular choice for illegal producers, Gamberg explained.
“As law enforcement cracks down on fentanyl, traffickers are turning to new synthetic opioids like nitazenes to bypass enforcement,” Gamberg added.
“These substances are inexpensive to produce and easy to traffic. It’s a familiar pattern that is recurring.”
Some types of nitazenes are several times stronger than fentanyl, experts say. (U.S. Customs and Border Protection)
Nitazenes are available in various forms such as pills, powders, sprays, and can be consumed through different methods like snorting, smoking, injecting, or orally.
The main danger lies in their potency, as some nitazenes are significantly stronger than fentanyl.
“These substances are inexpensive to produce and easy to traffic. It’s a familiar pattern that is recurring.”
Dr. Jonathan Avery, vice chair of addiction psychiatry at NewYork-Presbyterian/Weill Cornell Medical Center, affirmed that nitazenes can be hundreds of times more potent than morphine and up to 10 times stronger than fentanyl, posing a risk of fatality even with small doses.
In addition to potentially fatal overdoses, nitazenes are known to lead to addiction, dizziness, nausea, vomiting, disorientation, loss of consciousness, cardiac arrest, and seizures, according to the CICAD report.
Nitazenes are available in various forms such as pills, powders, sprays, and can be consumed through different methods like snorting, smoking, injecting, or orally. (iStock)
Another concern is that individuals are often unaware that they are consuming nitazenes.
“Nitazenes are frequently mixed into heroin, pressed pills, or even stimulants – leading individuals to believe they are taking one substance when they are actually ingesting something completely different,” warned Gamberg. “This unpredictability is what makes them so lethal.”
Testing for nitazenes is extremely limited, stated Dr. Ryan Marino, a medical toxicologist at Case Western University in Cleveland, Ohio.
“While test strips are available for screening powdered drugs and pills for nitazenes, more definitive testing is restricted to advanced toxicology labs, hindered by cost and turnaround time,” Marino explained.
“Naloxone (Narcan) can reverse nitazene overdoses, but multiple doses may be needed because of their potency,” an expert said. (AP Photo/Leah Willingham)
“While test strips are helpful, they are not foolproof in detecting nitazenes in drugs, and comprehensive testing for nitazenes is not widely available, even in post-mortem examinations.”
Standard hospital and workplace drug screens do not consistently identify nitazenes, according to Avery.
“Enforcement poses challenges as producers constantly alter chemical structures to evade regulations and standard tests,” he emphasized.
To prevent fatal overdoses, Avery stressed the need for specialized testing and rapid drug-checking tools to detect nitazenes in the street supply.
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“Naloxone (Narcan) can reverse nitazene overdoses, but multiple doses may be needed because of their potency,” he concluded.
“Public awareness, widespread naloxone distribution, and rapid drug-checking are crucial in preventing deaths.”
