While the COVID-19 crisis still looms over the public, a newcomer in the opioid class has hit the streets called nitazine, short for Protonitazene, or Isonitazene. The drugs have been found in user syringes around the U.S.

Nitazene drugs are up to 20 times more powerful than fentanyl, which is 50 times more potent than other opioids. Moreover, the drug class is 80 to 100 times more powerful than morphine. The findings were made after overdose investigations.

Synthetic Opioid Dangers

Initially, the opioid epidemic was associated with the taking of pain medications. As the crisis evolved, it triggered many users to graduate to heroin. Now, nitazene-based narcotics, a new synthetic form of opioid  has arrived in the street. These next-generation opioids have been regularly showing up in overdose cases around the country.

According to Dr. Rebecca Donald, who serves as an assistant professor of anesthesiology and pain medicine at Tennessee’s Vanderbilt University, “Opioids have evolved as people’s addictions have changed.” She adds that each time a more potent and cheaper drug enters the illegal drug trade, overdose deaths increase as well.

What are Nitazenes?

According to the World Health Organization (WHO), the nitazene family of medications was developed more than 60 years ago as a possible pain-relief medicine.

Nitazene pain relievers, when first developed, lacked the addiction-inducing properties of other opioids. However, they were never a green light for clinical use in the U.S.

Nevertheless, synthetic opioids have emerged, in recent months, in the U.S. and Germany, the UK, and Canada. Nitazene abuse has been documented recently, in Maryland, Toronto, and Washington, D.C.

An attending doctor at Zucker Hillside Hospital in Glen Oaks, New York, Dr. Scott Krakower emphasizes that people’s lack of knowledge about the drugs can lead to unanticipated fatalities. In fact, the Centers for Disease and Control and Prevention (CDC) states that e are in the midst of a drug overdose epidemic that is claiming 270 lives per day in this country.  Drug overdoses now outnumber car accidents as the primary cause of preventable mortality in the United States.

Reviewing the Statistics

Provisional data from CDC’s National Center for Health Statistics indicate that there were an estimated 100,306 drug overdose deaths in the United States during 12-month period ending in April 2021, an increase of 28.5% from the 78,056 deaths during the same period the year before.  Fentanyl is thought to be partially responsible for 75% of these fatalities, according to experts.

The making of synthetic opioids, such as nitazenes, contributes to increasing deaths from opioids each year.  Experts have connected the recent rise in overdoses with the COVID pandemic. Shutdowns, isolation, and job losses have kept many drug users from the support they need both medically and personally.

Fentanyl continues to be the principal cause of opioid abuse in the United States today. This fact raises further concerns, however, since persons with substance use disorder (SUD) seek increasingly stronger substances to fulfill their addiction cravings.

Most drugs, under the nitazene class, do not receive the same scrutiny like other opioids because they are not currently regulated. Drug traffickers like nitazene-based drugs as they can manufacture them cheaply from legal substances.

Will Narcan Work on Nitazenes?

Forensic professionals are unclear about whether or not Narcan will work in reversing an opioid overdose from nitazene. In this case, doctors may need to administer a greater dose of the medicine.


Addressing the current drug epidemic is paramount to combat the problem. Because of the pandemic, drug users have lost much of the support they received previously. As their addictions worsen, so will the ease of getting more potent synthetic opioids. To address the problem, both medica l professionals and legislators need to rewrite some of the laws currently in place.

About the Author

Scott H. Silverman has been fighting against addiction for almost 40 years. He is the author of The Opioid Epidemic and the CEO of Confidential Recovery, an outpatient drug treatment program in San Diego.