Could Nitazenes Be The Next Opioid Threat Pushing Europe Toward A Public Health Crisis?

Health experts are sounding the alarm over nitazenes, a powerful class of synthetic opioids, driving a deadly wave of overdoses across Europe and slowly appearing in the United States.For years, fentanyl has been blamed for the worst drug crisis in the West. But nitazenes, first developed in the 1950s and never approved for medical use, are emerging as an even deadlier substitute. Many of these compounds are 50 to 250 times stronger than heroin and up to five times more potent than fentanyl. Even trace amounts can cause a fatal overdose.A Hidden Killer in the Drug SupplyNitazenes are rarely taken intentionally. More often, they are laced into heroin, counterfeit painkillers, anxiety medications like Xanax and Valium, and even recreational drugs such as cocaine, ketamine, and ecstasy. Users often have no idea they are consuming them, which makes the risk of overdose even higher.In the United Kingdom, reports the Wall Street Journal (WSJ), at least 400 people died from nitazene-related overdoses in just 18 months leading up to January 2024. Vicki Markiewicz, executive director for the treatment provider Change Grow Live, calls it “the biggest public health crisis for people who use drugs in the U.K. since the AIDS crisis in the 1980s,” reports WSJ. When a batch of contaminated drugs hits the streets, the result is often clusters of overdoses. In Dublin late last year, about 80 people needed emergency care over a single weekend. In March, 31 overdoses were reported in just a few days in north London.Families Searching for AnswersThe human toll is devastating. In north Wales, police knocked on Anne Jacques’s door to tell her that her 23-year-old son, Alex Harpum, a healthy, rising opera singer, had died in his London apartment, reports the Journal. Initially ruled as sudden adult death syndrome, further testing revealed nitazenes in counterfeit Xanax he had purchased illegally.“I basically had to investigate my own son’s death,” Jacques said. “You feel like your child has been murdered.”Similar tragedies are emerging worldwide. In May, two young Londoners died after taking what was believed to be oxycodone laced with nitazenes following a night out.Why the Drug Is Spreading So FastMost nitazenes are manufactured in China and sold online, often openly advertised on global trade websites. Dealers mix them with bulking agents like caffeine to stretch supplies and increase profits. The drug’s extreme potency makes it easy to smuggle in small quantities, appealing to criminal networks.While the U.S. has reported nitazenes in at least 4,300 drug seizures since 2019, often in fentanyl mixtures, testing remains inconsistent, and official death counts are almost certainly underreported.Experts warn that the Taliban’s 2022 ban on poppy cultivation, which slashed heroin production, could push traffickers toward synthetic opioids. Countries like Estonia, already battling nitazene-linked overdoses, are bracing for what could become a repeat of fentanyl’s deadly grip in the early 2000s.A Race Against TimeAuthorities say this is a global problem. Nitazenes have been detected on every continent, and without swift action, the death toll could escalate sharply. Health agencies are urging expanded drug testing, public education, and widespread distribution of naloxone, the opioid overdose antidote.For people like Tina Harris, a long-time heroin user in London who survived a nitazene overdose thanks to naloxone, a medicine that rapidly reverses an opioid overdose, notes the National Institutes of Health, US, the danger is clear. “It’s a devil’s trap,” she said. “You never know what’s really in what you’re taking, and by the time you find out, it can be too late.”What Are Nitazenes?As per the Alcohol and Drug Foundation, Nitazenes are a powerful class of synthetic opioids, drugs that act on opioid receptors in the brain and are chemically related to compounds derived from the opium poppy. They were first developed about 60 years ago as a possible alternative to morphine.How They AppearNitazenes can be sold as a white or brownish-yellow powder, crystalline solid, or pressed into counterfeit pills that resemble prescription painkillers like oxycodone. They have also been detected in heroin, ketamine, synthetic cannabinoids, and other recreational drugs.Common types include:IsotonitazeneMetonitazeneEtonitazeneProtonitazeneThey are sometimes referred to as benzimidazole opioids, synthetic opioids, or new psychoactive substances (NPS).How They’re UsedNitazenes can be injected, inhaled, or swallowed in tablet form. The effects vary from person to person, depending on factors such as body weight, overall health, tolerance, whether other substances are taken, the dose, and the potency of the batch.Short-Term EffectsLike other opioids, nitazenes can produce:Euphoria and relaxationDrowsiness and clumsinessPain reliefReduced stressItchinessNausea and vomitingFever and sweatingSlowed breathing and heart rateOverdose RisksBecause nitazenes can be as potent, or even more potent, than fentanyl, the risk of overdose is extremely high. Signs of overdose include:Slow or shallow breathingBlue or gray lips and skinLoss of consciousnessComaDeath

Could Nitazenes Be The Next Opioid Threat Pushing Europe Toward A Public Health Crisis?

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