NITAZENES FOUND IN 5 OVERDOSE DEATHS IN PHILLY – HERE'S WHAT THEY ARE AND WHY THEY'RE SO DEADLY
Nitazenes Found in 5 Overdose Deaths in Philly – Here's What They Are and Why They're So Deadly
April 12th, 16PM April 12th, 16PM(The Conversation is an independent and nonprofit source of news, analysis and commentary from academic experts.)
Christopher P. Holstege,
University of Virginia
(THE CONVERSATION) The Philadelphia Medical Examiner's Office found that nitazenes, a synthetic opioid
up to 40 times more powerful than fentanyl, were connected to
at least five overdose deathsin Philadelphia in the past two years.
The nitazene deaths are just a small part of a much bigger problem. A record
1,413 people diedfrom overdoses on illicit drugs in the city in 2022, the latest year for which complete data is available. The
vast majority involved other forms of opioids, including heroin, fentanyl and
xylazine, also known as "tranq."
The Conversation interviewed
Dr. Christopher Holstege, a professor of emergency medicine and pediatrics at the University of Virginia School of Medicine and director of the
Blue Ridge Poison Center, about this emerging threat. He explains what nitazenes are and why they're so deadly.
What are nitazenes?
Nitazenes are a class of synthetic opioids that contains more than 20 unique compounds,
including isotonitazene, which was first identified in 2019 and is known on the streets as ISO. It also includes protonitazene, metonitazene and etonitazene.
Nitazenes are psychoactive substances, or
"designer drugs,"that aren't controlled by any laws or conventions but
pose significant health risksto the public. These substances have recently surfaced as illegal street drugs.
Researchers have relatively little information on how the human body reacts to nitazenes because the drugs have never gone through clinical trials. But lab tests show certain nitazenes could be
hundreds to thousands of times more potentthan morphine and 10 to 40 times stronger than fentanyl.
The U.S. Drug Enforcement Agency has classified many formulations of nitazenes as
Schedule 1 drugs under the Controlled Substances Act, meaning they have no medical use and have a high risk of abuse.
When were nitazenes first developed?
Nitazenes were initially
developed in the 1950sby the pharmaceutical research laboratories of the Swiss chemical company CIBA Aktiengesellschaft. It synthesized numerous substances in the drug class to be used as painkillers.
However, nitazenes were never approved by the U.S. Food and Drug Administration
for medical use in humans. They were nearly forgotten outside of specialized research circles until they reemerged as street drugs in 2019. As law enforcement has cracked down on other drugs such as fentanyl, illegal labs have used
historical pharmacology researchto formulate analogs of nitazenes as street drugs.
Since 2019,
at least six formulashave come from the original patent, but others, are brand new.
Specialized lab testingis required to identify nitazenes in toxicology samples, and
fentanyl test strips can't detect nitazene analogs.
But since
first being detected, nitazenes have been blamed for
200 drug-related overdose deathsin Europe and the United States. Although nitazenes are now identified as illegal street drugs in numerous countries, many medical providers aren't
even aware they exist.
What types of nitazenes are showing up on the streets?
Nitazene first appeared in 2019 in the Midwest as a
white powdery substancesimilar to cocaine.
It later appearedon the streets of Washington, D.C., as yellow, brown and white powders. Since 2022, the DEA has found other types of nitazenes in both
powder and blue tablet forms.
Nitazenes are also
mixed with other street drugssuch as heroin and fentanyl, and with fake oxycodone pills, without users knowing it.
The Justice Department has indicted several
companies in China, alleging that they ship the raw chemicals to make nitazenes to Mexico and the U.S., where they get mixed by cartels and traffickers, then distributed on the streets.
What are signs of a nitazene overdose?
The toxic effects of nitazene resemble those associated with other classic opioids such as morphine and fentanyl and include small pupils and slowing of the respiratory and central nervous systems, which can lead to death.
Because of the potency of the nitazenes, symptoms can develop rapidly after someone is exposed, killing them before they can get medical care.
Does naloxone counteract the effects of overdose?
Naloxone, commonly
known as Narcan, is
reportedly effectivein reversing overdoses due to nitazene, but larger and
multiple doses might be required.
This is an updated version of an
article originally publishedon Feb. 15, 2024.
This article is republished from The Conversation under a Creative Commons license. Read the original article here:
2024-04-12T13:03:08Z dg43tfdfdgfd