Isotonitazene and Protonitazene Found in D.C. Drug Supply
Analysts in the District of Columbia identified benzimidazole opioids, which are significantly more potent than fentanyl, in the District’s drug supply.
Analysts with the D.C. Department of Forensic Sciences (DFS) identified protonitazene and isotonitazene in the District’s illicit drug supply in September and October. Analysts identified the drugs during an analysis of used needles.
“The DFS Public Health Lab discovered two nitazenes - synthetic opioids - in used syringes submitted to the lab as part of the District’s Needle Exchange Program. Studies show nitazenes are more potent than fentanyl, which means additional doses of Naloxone may be needed to treat overdoses.”
Benzimidazole opioids, including protonitazene and isotonitazene, are often significantly more potent than morphine and some are more potent than fentanyl. As extremely potent mu-opioid receptor agonists that are unrelated to fentanyl or traditional opioids, these novel substances pose a threat to users of illicit opioids. As regulators and law enforcement crackdown on the production of potent fentanyl analogues such as carfentanil and furanyl fentanyl, chemists in some countries are evading drug laws by producing benzimidazole opioids which are largely uncontrolled research chemicals. For the most part, the only countries with regulations prohibiting such opioids are those with laws similar to the Federal Analogue Act in the United States.
Alex Krotulski, associate director at the Center for Forensic Science Research and Education in Willow Grove, Pa., said protonitazene is three or four times more powerful than fentanyl — whose extreme potency has helped drive record-breaking overdose deaths in the United States — and isotonitazene is about 10 times more powerful. Krotulski, who has studied the nitazene substances closely in conjunction with forensic labs across the country, said they have been identified in the Midwest, South, and Southwest, as well as on the Eastern Seaboard.
In the United States, some benzimidazole-derived opioids are explicitly identified as Schedule I drugs by the Drug Enforcement Administration. Etonitazene, one of the most well-known benzimidazole-derived opioids, is scheduled in the U.S. In animals, etonitazene is up to 1,500 times more potent than morphine. Isotonitazene, which is more potent than fentanyl, was added to Schedule I of the Controlled Substances Act in August 2020. Compared to more traditional opioids, very little is known about these opioids. Swiss researchers discovered etonitazene and its related compounds in the 1950s. Due to the potency of the drug, researchers conducted few, if any, tests on humans (alternatively, they conducted studies and did not publish the findings for obvious reasons).
Starting in late 2018, etonitazene analogues and related benzimidazole opioids started showing up in the United States, Canada, and Europe, and elsewhere. Manufacturers in China created batches of isotonitazene in 2020. Those batches of isotonitazene ended up in Canada and the United States where law enforcement agencies reported seizures of the substance in multiple forms.
The Royal Canadian Mounted Police issued a notice that in November 2020, police in Nova Scotia had seized a small number of counterfeit Dilaudid pills that contained isotonitazene. The DEA had multiple seizures of the drug in 2020, including a seizure of a powder containing a mixture of isotonitazene, heroin, and bromazolam. Additionally, the DEA reportedly received isotonitazene instead of a different opioid after purchasing the drug from a source on the internet.
China is no longer the sole source of fentanyl in the United States.
Reddit users have suggested that there will not be a significant increase in the number of seizures or deaths involving isotonitazene in the United States as a result of the legislation targeting the drug. Instead, they suggest, that manufacturers have already moved on to different benzimidazole opioids.
Recreational drug users who source opioid products on darkweb marketplaces risk receiving counterfeit pills that contain a much more potent substance, such as fentanyl or carfentanil. As manufacturers in China and elsewhere shut down their fentanyl and fentanyl analogue operations and start producing benzimidazole opioids, the same recreational drug users risk receiving a much more potent product. “Given the potency of the drug, a person may need several doses of Naloxone to counter an overdose caused by isotonitazene,” the Halifax Police in a statement.
“Studies show nitazenes are more potent than fentanyl, which means additional doses of Naloxone may be needed to treat overdoses,” a spokesperson for the DC Department of Forensic Sciences said in a statement to The Hill.
It is only a matter of time before law enforcement catches a vendor producing and distributing counterfeit opioids laced with isotonitazene or a more potent variant. Consequently, it is only a matter of time before the list of arrested vendors on this site gets updated to include said vendors.