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The Rising Threat of Nitazenes: The New Synthetic Opioids More Potent Than Fentanyl

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Mason Walker
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The Rising Threat of Nitazenes: The New Synthetic Opioids More Potent Than Fentanyl

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The opioid crisis continues to evolve, taking on a new and more dangerous face with the rise of nitazenes, a class of synthetic opioids. Notably more potent than fentanyl, nitazenes have been increasingly implicated in fatal overdoses in the U.S. and globally. These potent drugs, often produced in Mexico and China and then sold on the black market, have raised alarm among healthcare professionals and policymakers.

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The Emergence of Nitazenes

Originally developed in the 1950s as an alternative to morphine, nitazenes were never approved by the FDA. Yet, they have found their way into the illicit drug market and have been increasingly involved in deaths across the globe. Reports of fatalities involving nitazenes have been cropping up across the U.S., with notable increases in states like Tennessee and Colorado, and in the U.K., where 54 deaths were attributed to the drug in a recent six-month period.

The Danger of Nitazenes

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Nitazenes pose an exceptional risk due to their high potency, which is estimated to be ten times that of fentanyl. The risk of addiction and fatal overdose is significantly increased with nitazenes, and many substance use disorder treatment centers are not adequately prepared or aware of this emerging threat. Nitazenes have been found mixed into other drugs, such as MDMA and heroin, as well as counterfeit pills, adding to their danger. Overdose symptoms can vary, but often include loss of consciousness, skin turning blue or grey, snoring, and drowsiness.

The Response to Nitazenes

The Department of Homeland Security's Strategy for Combating Illicit Opioids has interdicted significant amounts of fentanyl and synthetic drug precursor chemicals in the last five years. Alongside this, the Science and Technology Directorate (S&T) and the Chemical Security Analysis Center (CSAC) are researching opioids, focusing on synthetic versions like nitazenes. Efforts are being made to improve opioid detection and curb the flow of substances like fentanyl into the country.

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Despite these efforts, the problem of nitazenes persists. Access to these potent synthetic opioids remains, and regulatory scheduling of these drugs is often reactive and slow. Moreover, while nitazene overdoses can be reversed with the opioid overdose reversal agent naloxone, multiple doses are often required due to the drug's high potency.

The Call to Action

While healthcare professionals need to be aware of the rising tide of nitazene use and offer the necessary treatment to patients with opioid use disorder, the power to make a significant change lies with policymakers. An overhaul of the treatment system for opioid use disorder is needed, alongside a public health campaign to raise awareness about the threat of nitazenes.

Experts are also emphasizing the need for drug-checking services, particularly in places like Australia, where nitazenes have been detected in multiple jurisdictions. In response to recent hospitalizations linked to nitazenes, there have been renewed calls for pill testing at music festivals and other events.

The opioid crisis is a complex and evolving issue. With the emergence of nitazenes, it is clear that the strategies to combat it must also evolve. Policymakers, healthcare professionals, and the public must be aware of this escalating threat and take comprehensive action to address it.

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