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When a man died of a drug overdose in Colorado, it took time to figure out which drug. Because it wasn’t fentanyl but another opioid called nitazene. Even though nitazenes have been around for decades, they haven’t been widely used. But amid a raging opioid epidemic and a national crackdown on fentanyl, nitazenes may become more common.
Nitazenes were developed in the nineteen fifties and sixties and were meant to be a substitute for morphine. But they were so powerful that the FDA didn’t approve them. Now they’re a schedule one drug and illegal just like heroin and LSD. Nitazines are made in the lab and are inexpensive to produce. They block pain signals in the brain by binding to opioid receptors in the brain, spinal cord, and other sites in the body.
Depending on the chemical formulation, some nitazenes are 800 times more potent than morphine and 40 times more than even fentanyl! They come in liquids, pills, and powder form. And just as illegal street drugs can be laced with fentanyl, they can also contain nitazenes without the user knowing.
According to the CDC, a record ninety-two thousand people died of drug overdoses in 2020 and nearly two-thirds were from synthetic opioids, mostly from fentanyl.
Up to 2,000 people may have died from nitazene since two thousand nineteen. The concern is that number will grow unless people are educated about the dangers they pose.
We are Drs. David Niesel and Norbert Herzog, at UTMB and Quinnipiac University, where biomedical discoveries shape the future of medicine. For much more and our disclaimer go to medicaldiscoverynews.com or subscribe to our podcast. Sign up for expanded print episodes at www.illuminascicom.com or our podcasts at: Medical Discovery News (buzzsprout.com)
More Information
Old Drugs and New Challenges: A Narrative Review of Nitazenes
Nitazenes are a group of compounds developed in the 1950s as opioid analgesics, but they were never approved to market. As such, they are not well known outside of academic research laboratories. A characteristic of nitazenes is their high potency (e.g., hundreds to thousands fold more potent than morphine and other opioids and tenfold more potent than fentanyl). In the past few years, several nitazenes, including "designer analogs," have been detected in the illicit drug supply and have been implicated in overdose mortality, primarily due to their exceptionally high potency.
Notes from the Field: Nitazene-Related Deaths — Tennessee, 2019–2021
The prevalence of nitazene deaths in the United States is unknown and the frequency of nitazene involvement in overdose deaths in Tennessee has not yet been assessed. However, of concern is that nitazenes are increasingly recorded in toxicology reports and death certificate cause-of-death fields.
What to know about the drug that can be 10 times as potent as fentanyl.

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