Nitazenes are a group of synthetic opioids in the mid-1950s in Switzerland created by researchers in an attempt to replace opioids like morphine, it never got approved for market sales though and was instead posing a risk for financially leeching into the illicit drug marketplace. Researchers at first saw potential for a pain relief medication; it has now found its way in the illegal hands of the online pharmacy system.
Nitazene analogs are noted to have extremely high drug potency to cause an overdose mortality. Nitazenes are estimated to be hundreds to thousands fold more potent than morphine and other opioids and tenfold more potent than fentanyl. To make matters worse, nitazenes are not investigated for in post-mortem or urine toxicology. 89% out of the 179 toxicology cases since 2019 involve nitazenes. Few nitazenes are butonitazenes, etodesnitazenes, ISO-the most common nitazene, N-pyrrolidino protonitazenes, N-pyrrolidino etonitazenes. Nitazenes are also found in the counterfeit medicines and adulterated medicines in the UK. Irregular drug supply is not regulated, this makes it challenging to control the restrictions placed on nitazenes. Nitazenes causes dizziness, nausea, vomiting, disorientation, loss of consciousness and seizures. Signs of nitazene overdose are decreased consciousness, respiratory depression with very slow/shallow breathing, blue/pale tingeing of knees, hands and lips, fitting, confusion, difficulty breathing, and pin point pupils, might include nausea, vomiting, paleness, low blood pressure/decreased heart rate. Naloxone is a recommended drug for treatment however its still unclear as to the amount of the dose required and that fentanyl test strips don’t work when it comes to detecting this drug.
The general public, especially those who have access to these drugs need to be made aware of the nitazene contaminated drugs available.

Drug Testing Services in the UK: https://www.crew.scot/drugs-information/what-you-need-to-know/drug-testing-and-checking/
Credit: https://pharmaceutical-journal.com/article/feature/everything-you-need-to-know-about-nitazenes, www.oas.org , www.drugsandalcohol.ie, www.ccsa.ca, www.unodc.org, www.deadiversion.usdoj.gov, https://www.crew.scot/drug-market-update-nitazenes/, BBC News.
Image Credit: https://www.dailymail.co.uk/health/article-12457999/nitazines-fentanyl-illicit-drug-dangerous.html






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