More than 70% of all drug overdoses now involve the mixture of fentanyl with cocaine, heroin, or methamphetamine. And now an old, but new synthetic opioid class called nitazenes, is adding to the kill list of overdoses. The nitazenes class of substances is creeping into the illicit drug supply chain as a non-fentanyl opioid analogue drug class that is 20 times stronger than fentanyl. The real concern is that this represents another drug bonanza for drug cartels in Mexico to start ordering the precursors from China to begin mass production - if it's not already occurring.
Origins of nitazenes go back to 1957 with attempts to develop a stronger opiate alternative to morphine. Unfortunately, due to a significantly higher risk for potential addiction and abuse, which lead to predictable overdoses in human trials, ended with them being classified as "not suitable for human consumption" and denied approval for clinical use. Fentanyl and Schedule 1 illegal drugs are now a highly regulated chemical class of opioids that continue to be in great demand by substance abusers. Drug users, and more so drug cartels - such as the Sinaloa or CJNC, -have now discovered this "holy grail of drug addiction" with a synthetic opioid 20 times more addictive than fentanyl. Nitazenes have take the spotlight front and center as a new "super high" that's potentially more addictive than fentanyl and in some cases much harder to detect by drug treatment programs and analysis technology.
Isotonitazene is the prototypical, most frequently encountered member of the nitazenes class. It is considered a mu opioid receptor agonist and is structurally unrelated to fentanyl or traditional opioids. It made its debut in August 2019, but quickly transitioned to the illicit drug market by April 2020. By October 2020, isonitazene was identified as the killer in more than 200 overdose investigations. Isotonitazene found its way onto the DEA’s 2020 Annual Emerging Threat Report Opioid/Analgesics List, identified as a significant designer drug, and thus a threat to public health in the United States.
Traffickers have become more sophisticated utilizing laboratories and can forever adapt the molecular structure of these compounds. Creating new and more addictive combinations of NPS’s results in greater addiction, as well makes it more difficult for law enforcement to detect and regulate.
This is the same way fentanyl crept into the illicit opioid drug market supply chain. Fentanyl is 100 times more potent than morphine, and now, nitazenes are 20 times more potent than fentanyl. My concern is that users in search of a better high will mix fentanyl and nitazenes together. Experts believe that almost 75 percent of overdose deaths involve fentanyl use or mixing it with a drug such as cocaine or methamphetamines. The introduction of nitazenes will most likely increase that number.
Nitazenes are like a slow train moving towards us with red lights flashing. We know nitazenes are out there and growing in popularity among the cartels and users. The question is - what will we do about it?