What are Nitazenes?

Nitazenes (benzimidazole-opioid substances) are a class of non-fentanyl-related synthetic opioids that first made their appearance in the illicit drug market in the United States in 2019.  However, nitazenes have been in existence for much longer. Three nitazenes (isotonitazene, etonitazene, clonitazene) were developed by a pharmaceutical research company in the 1950s as potential alternatives to pain relievers such as morphine but were never approved for medical use. Of these, isotonitazene was the first nitazene to make its way into the nation’s illicit drug supply. Since then, several other nitazenes and nitazene analogs have emerged on the illicit drug market in the United States. In the Houston Metropolitan Area, nitazenes were newly identified by crime laboratories in 2022 in seized counterfeit oxycodone, hydrocodone, and alprazolam (Xanax) tablets, and also in powder form.

Some nitazenes are even more potent than fentanyl. Multiple doses of naloxone (Narcan) may be needed to reverse a nitazene-involved overdose. Because of their high potency and the increase in the nation’s illicit drug supply, the Drug Enforcement Administration temporarily placed several nitazenes in Schedule I of the Controlled Substances Act (CSA).

Click on the links below to learn more about nitazenes.

Novel Psychoactive Substances: Nitazenes
Legislative Analysis and Public Policy Association, 9-23
https://legislativeanalysis.org/wp-content/uploads/2023/09/Nitazenes-Fact-Sheet-FINAL.pdf

New Opioids are Joining the Illicit Drug Supply and They are More Potent than Fentanyl
U.S. News and World Report, 9-6-23
https://www.usnews.com/news/health-news/articles/2023-09-05/new-opioids-are-joining-the-illicit-drug-supply-and-theyre-more-potent-than-fentanyl

Emerging Group of Synthetic Opioids May Be More Potent than Fentanyl, Study Warns
CNN, 8-29-23
https://www.cnn.com/2023/08/29/health/nitazenes-synthetic-opioids-naloxone/index.html

Group of Novel Synthetic Opioids May Require More Naloxone to Reverse an Overdose
Partnership to End Addiction, 9-2023
https://drugfree.org/drug-and-alcohol-news/group-of-novel-synthetic-opioids-may-require-more-naloxone-to-reverse-an-overdose/

New Opioid is Stronger than Fentanyl
National Public Health Information Coalition, 2-28-23
https://www.nphic.org/news/featured-topics/1316-new-opioid-is-stronger-than-fentanyl

Benzimidazole-Opioids, Other Name: Nitazenes
Drug Enforcement Administration, 11-22
https://www.deadiversion.usdoj.gov/drug_chem_info/benzimidazole-opioids.pdf

Nitazenes: What to Know about the Illegal Opioids that can be More Potent than Fentanyl
Good Rx, 12-15-22
https://www.goodrx.com/classes/opioids/nitazene-synthetic-opioid