Emergence of a New Threat in the Opioid Crisis

A potent class of synthetic opioids, known as nitazenes, is raising alarm among health experts due to its rapid spread across the Americas. Originally developed in the 1950s as pain relievers, nitazenes were never approved for medical use because of their high overdose risk. According to a report from the Inter-American Drug Abuse Control Commission (CICAD), these opioids have been entering the illicit drug market since 2019, initially appearing in Europe and now spreading globally.

The Growing Presence of Nitazenes in North America

CICAD’s report highlights a concerning trend: nitazene use is increasing in North America, with availability likely expanding throughout the Americas. The most common variant, isotonitazene (ISO), along with several others, has been identified. The U.S. Drug Enforcement Administration (DEA) classifies ISO as a Schedule 1 drug, indicating its high potential for abuse and lack of accepted medical use.

Production and Trafficking Concerns

Nitazenes are primarily produced in illicit laboratories overseas, particularly in countries like China and India. These drugs are trafficked into the United States through channels similar to those used for fentanyl. Corey Gamberg, a licensed alcohol and drug counselor, notes that as authorities intensify efforts against fentanyl, traffickers are shifting to nitazenes to circumvent enforcement.

Health Risks and Challenges in Detection

The potency of nitazenes poses significant health risks. Some variants are several times stronger than fentanyl, making even small doses potentially lethal. Dr. Jonathan Avery from NewYork-Presbyterian/Weill Cornell Medical Center warns that nitazenes can be up to 10 times more potent than fentanyl and hundreds of times stronger than morphine. This extreme potency increases the risk of fatal overdoses and other severe health issues such as dependency, dizziness, nausea, and cardiac arrest.

Limited Testing and Public Awareness Efforts

Testing for nitazenes remains limited, complicating efforts to detect these substances in drugs. Dr. Ryan Marino from Case Western University emphasizes that while test strips can screen for nitazenes, more advanced testing is costly and not widely available. Routine drug screens often fail to detect these opioids, making enforcement challenging as producers alter chemical structures to evade detection.

Preventive Measures and Public Health Initiatives

To combat the rising threat of nitazenes, experts advocate for increased public awareness and distribution of naloxone (Narcan), which can reverse overdoses but may require multiple doses due to the drugs’ potency. Dr. Avery calls for specialized testing tools to identify nitazenes in street drugs promptly. Public education on the dangers of these opioids is crucial to preventing further deaths.