Nitazene: Understanding the New Fentanyl

By Alison Adduono, Director of Marketing

A drug even more potent than Fentanyl is making the rounds. Scary thought, right? But the United Nations drug agency has just issued a warning about that very thing after Nitazene (nicknamed the Frankenstein Opioid) has been popping up in countries all over the world.

Nitazene, or Benzimidazole-Opioids, is a synthetic opioid Schedule I drug that was created in the 1950s by Swiss company CIBA Aktiengesellschaft as an alternative to Morphine. It contains more than 20 unique compounds, including isotonitazene (street name: ISO), protonitazene, metonitazene and etonitazene. After quickly discovering its heightened risk for overdose, researchers and developers shelved it and as such it never received approval from the U.S. Food and Drug Administration for medical use in humans.

Is Nitazene the New Fentanyl?

In 2019, it first resurfaced on the streets, but with the crackdown on Fentanyl in recent years, it appears that it is becoming even more a drug of concern. Not only is Nitazene cheaper to manufacture than Fentanyl or Heroin but depending on the formulation it is also 2 to 40 times stronger prompting an unprecedented amount of overdose deaths — leading some to speculate if this is the new Fentanyl.

And just like Fentanyl, many users have no idea they are taking it. In fact, Australian Health officials are cautioning that it is being seen cut into many drugs ranging from Heroin to MDMA, Ketamine, Cocaine and counterfeit pharmaceutical products.

The true scope of Nitazene’s role in overdose deaths is still unclear at this point since most health care systems are unable to detect it. But officials so far have linked about 200 overdose deaths to it since 2019. Given the heightened Nitazene potency, the CDC indicated that it was of vital importance to raise awareness of this drug, implement strategies to reduce harm and increase testing.

What are the Signs of a Nitazene Overdose?

Well, the signs are pretty much similar to that of a Fentanyl or another opioid overdose:

Unresponsive or unconscious
Vomiting
Limp appendages
Slowed respiratory/shallowed breathing
Respiratory arrest
Small/constricted pupils
Cold and clammy skin
Slurred speech or inability to speak
Bluish lips and/or nails
Etc.

Nitazene potency though, does result in those symptoms developing rapidly leading to death if immediate medical care is not obtained. It is also important to note that while Naloxone (Narcan) is found to be effect in reversing these overdoses, multiple larger doses are required.

Concerning Reports

In looking at some of the recent news coverage on Nitazene here are some troubling revelations:

An Australian needle and syringe exchange clinic has reported that this past Easter weekend they opened up to a line-up of clients around the corner of the block — many of which had experienced overdose issues that required multiple doses of Naloxone (Narcan) to revive the drug user. They were all there to get more take-home Naloxone — a medication that quickly reverses the effects of an opioid overdose. A clinic worker was quoted as saying: “They were telling me it happened very quickly, that people were going down very quick, and that it was taking multiple doses of naloxone to bring them back … anywhere up to five.”
The United Kingdom has reported finding the drug being smuggled into the country inside dog food supplies and being sold via social media.

What About Testing?

While there are instant tests currently available for Fentanyl and other synthetic opioids like Oxycodone, there are none for Nitazene. Specialized lab testing is required to detect it in toxicology samples. The limited testing means that the true scope of Nitazene’s usage is unknown.

Summary

While Fentanyl continues to be the primary cause of overdose deaths here in the US, Nitazene could very well be considered the new Fentanyl. With an increased street presence comes a growing concern. While not routinely tested for in overdose deaths, we can expect that detection of the synthetic opioid Nitazene will grow as screening is expanded and awareness grows.