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 Supply

Nitazenes 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 Answers

The 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 Fast

Most 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 Time

Authorities 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 Appear

Nitazenes 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:

• Isotonitazene
• Metonitazene
• Etonitazene
• Protonitazene

They are sometimes referred to as benzimidazole opioids, synthetic opioids, or new psychoactive substances (NPS).

How They’re Used

Nitazenes 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 Effects

Like other opioids, nitazenes can produce:

• Euphoria and relaxation
• Drowsiness and clumsiness
• Pain relief
• Reduced stress
• Itchiness
• Nausea and vomiting
• Fever and sweating
• Slowed breathing and heart rate

Overdose Risks

Because 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 breathing
• Blue or gray lips and skin
• Loss of consciousness
• Coma
• Death

Cholesterol problems have become so common today. And all thanks to the greasy, fried food that we devour every now and then. For those who rely on medications, statins work like magic, lowering cholesterol by blocking an enzyme called HMG-CoA reductase, responsible for cholesterol production. Yet, there is a baffling group of people who, despite popping their statin pill religiously, find their cholesterol stubbornly refusing to budge.

For this, nutritionist Anjali Mukerjee has a theory and it has less to do with your medicine cabinet and more to do with what’s on your plate.

How Statins Are Supposed To Work

Statins are designed to block HMG-CoA reductase, an enzyme responsible for cholesterol synthesis. The job of this enzyme is to synthesise cholesterol. So, it blocks this enzyme so your body cannot synthesise cholesterol, and therefore the cholesterol comes down.

Ideally, the process is simple, wherein the enzyme is blocked, cholesterol is lowered and heart health is safeguarded. But the human body is anything but straightforward, and your diet can play a big role.

What Role Do Carbs Play?

According to Mukerjee, one major reason statins fail to deliver results is the carb overload and not just the obvious food items like cakes or chocolates. “It could be a lot of refined carbs in the sugars, desserts, pastries, and chocolates. Some people are not even eating too many refined carbs, but they are just eating too many carbohydrates, even if they are complex carbs.”

Here is what happens: when you eat a carb-heavy meal, whether it is white bread or whole grains, your body produces insulin to manage the glucose surge. “Insulin activates HMG-CoA reductase and now this enzyme can again do its job of synthesising more cholesterol.”

In other words, you might be blocking the enzyme with statins in one hand but reactivating it with a plateful of rice, rotis, or pasta in the other.

The Inflammation Factor

Carbs are not the only reason. The second reason could be chronic inflammation. Mukerjee explains that persistent low-grade inflammation prompts your liver to churn out more cholesterol. Inflammation can override medication. Diets high in processed foods, poor sleep, chronic stress, and lack of physical activity all fuel inflammation, making your cholesterol harder to control.

Understanding The Role Of Cholesterol

Mukerjee is quick to point out that cholesterol is not all bad. Your body needs cholesterol for repair and lots of other activities. However, too much cholesterol can be harmful to your body. It is a balancing act, enough for healthy cell function and hormone production, but not so much that it clogs arteries.

What Can You Do?

If you are on statins and your cholesterol is still high, Mukerjee recommends looking beyond the pill.

• Reconsider your carb intake

• Reduce inflammation

• Address the root cause

Relying solely on medication without adjusting lifestyle factors can lead to frustration and missed health goals. Mukerjee’s message is that statins are a tool, not a magic bullet. Understanding how diet, especially carbohydrate consumption, can override their effects puts more control back in your hands. Your cholesterol history does not solely depend on your genes or your prescription; it is heavily influenced by your daily food choices and overall health habits.

We have all unintentionally or out of simple curiosity picked our noses as kids, which was immediately followed by an adult telling us that it is bad habit to do so.

Nose-picking is a very common habit, and most people think it's harmless, even if it's considered impolite. However, a study from Griffith University in Australia suggests that this simple act could be riskier than we think.

The study looks at how picking your nose might actually increase your risk of getting Alzheimer's disease. The research, which was published in Nature Scientific Reports, explores how certain bacteria can travel from the nose directly to the brain. Once there, they might trigger the kind of biological changes that lead to Alzheimer’s.

Can Nose Infections Affect Your Brain?

Your nose has a special connection to your brain through the olfactory nerve, which is responsible for your sense of smell. This nerve provides a direct pathway, allowing bacteria to bypass the body's normal defenses that would typically stop them from reaching the brain.

In a study on mice, scientists found that a bacterium called Chlamydia pneumoniae, which can cause respiratory infections like pneumonia, used this exact route to get into the central nervous system.

Once the bacteria entered the brain, the brain's cells responded by creating a substance called amyloid beta protein. This protein is a key part of the plaques that build up in the brains of people with Alzheimer's disease.

These plaques are thought to cause many of the disease's symptoms, such as memory loss and confusion. This research shows how a simple action like damaging the inside of your nose could create an opening for these harmful bacteria to get into your brain.

Could Your Nose And Brain Disorders Be Connected?

The study adds to a growing amount of evidence that links infections caused by pathogens (like bacteria and viruses) to dementia. In the past, other studies have found C. pneumoniae in the brains of people who had Alzheimer's. However, this new research in mice is the first to show how these bacteria might actually get there and start the disease process.

The researchers believe that it's likely not just this one bacterium that can cause problems. It could be a combination of different germs and a person's genetics. For example, some studies have also connected the herpes simplex virus to Alzheimer's.

The researchers also think that this isn't a quick process. Getting bacteria in your brain today doesn't mean you'll get dementia next week. Instead, it's believed to set off a very slow progression of changes that might take decades before any symptoms appear.

Why You Should Stop Picking Your Nose

While we still need more research to fully prove a direct link between nose-picking and Alzheimer's, the habit can cause other health issues. When you pick your nose, you can easily introduce germs, like viruses and bacteria, into your nasal cavity. You can also spread those germs to other surfaces.

Most importantly, picking your nose and even plucking nose hairs can damage the delicate tissues inside your nose. This damage can create tiny openings, which, as the research shows, could make it easier for bacteria to travel to your brain.

We all have body aches and pains from time to time, be it from a grueling workout, a small fall, or just the wear and tear of life. Most of the time, these pains subside with rest or mild treatments, and we go on. But what if that nagging ache in your bone isn't "just an injury"? What if it's your body's way of telling you something much more sinister, a warning sign easily ignored?

Bone cancer is one of those hidden yet serious conditions that tends to cloak itself with frequent symptoms. Its beginnings can disguise themselves as anything from an athletic injury to arthritis, so it's intensely difficult to detect until it's quite far along. This stealthiness causes millions of people to unknowingly overlook vital symptoms, postponing detection and treatment.

Bone cancer is usually eclipsed by more common cancers, but its early diagnosis is a make-or-break issue. The problem is that it quietly develops and exhibits symptoms that look exactly like common injuries or orthopedic problems. What may begin as a nagging pain could really be the body's initial indication of something much more sinister. Being aware of these underappreciated signs and knowing the value of early diagnosis can alter the treatment course—and save lives.

How Bone Cancer Hurts More Than a Pain of an Injury

One of the greatest challenges with bone cancer is that its beginning signs are too readily confused with normal injuries.

• Ongoing pain
• Swollen areas around joints
• Pain that is believed to be a result of sports or daily activities

These tend to make individuals and sometimes physicians write off the issue as trivial. The discomfort is dull, sporadic, and does not necessarily affect movement right away, thus slowing down the urgent seeking of medical help.

Dr. Ashish Bangar, a Surgical Oncology Assistant Professor at D. Y. Patil Hospital, points to the importance of pain patterns. "Bone pain that isn't relieved by rest or regular painkillers, especially if it increases at night, should never be taken lightly. What may appear to be a minor injury may turn out to be an initial warning sign of bone cancer," he says. This nighttime rise in pain is an indication or red flag that is many times ignored.

Aside from pain, swelling around joints without apparent injury or trauma is also a sign of malignancy. Even fractures caused by low-impact incidents—something that would not otherwise crack bones—can be signs of cancer-caused bone weakening. However, these signs usually go undetected or are blamed on less severe conditions until the disease has advanced.

Why Early and Correct Diagnosis Is Critical?

Early diagnosis of bone cancer is not merely about finding it but doing so with accuracy and comprehensiveness. Advanced technologies for imaging, such as MRI (Magnetic Resonance Imaging) and PET (Positron Emission Tomography) scans, have advanced the diagnostic process, enabling doctors to identify suspicious lesions with greater precision. It is not merely the removal of barriers to such technology that is required.

Expert opinion is key. Biopsies or misdiagnosis by nonspecialized personnel can drastically curtail treatment options. A botched biopsy, for instance, may disqualify the patient for limb-salvage procedures that attempt to save as much of the patient's limb as possible instead of resorting to amputation.

Multidisciplinary treatment including radiologists, surgical oncologists, pathologists, and medical oncologists is the need of the hour. This kind of integration guarantees that imaging, biopsy, and systemic treatment modalities are optimized to suit the patient's individual condition. In D. Y. Patil Hospital in Pune, a tertiary care center, this has resulted in improved survival and overall quality of life for patients through more successful, limb-sparing treatments.

Why Are Bone Cancer Patients Diagnosed Late?

One of the biggest challenges to bone cancer treatment is delayed access to specialist cancer centers. Although urban tertiary hospitals are well-endowed with good diagnostics and multidisciplinary expertise, a lot of patients do not get referred to specialists in time. The reasons are diverse—poverty of information, attribution of symptoms to benign conditions, or distance and cost.

This delay frequently results in patients seeking care with advanced disease, when the choices are fewer and the prognosis is poorer. Extensive bone destruction or metastasis has already taken place in many instances by the time patients come to specialized centers.

Closing this access gap involves system changes—not only in health infrastructure, but in education of the public. Individuals must appreciate that chronic or unexplained bone pain is not something to be ignored or waited out.

Promisingly, therapeutic and diagnostic advances are revolutionizing the prognosis for bone cancer patients. Limb-conserving surgeries are now much more possible, thanks to advanced imaging and refined surgical methods. Targeted systemic treatments and chemotherapy regimens specific to certain bone cancers have further increased survival rates.

Early detection is still the foundation of these advances. If detected early, treatment can be minimally invasive, more efficient, and greatly enhance patients' quality of life. This improvement emphasizes the need for vigilance—both by patients and healthcare professionals.

Bone Cancer Awareness is a timely reminder that ongoing bone pain and swelling should never be taken lightly. If you or someone you know has ongoing or unexplained bone pain, swelling around joints, or fractures from minor trauma, it's important to have evaluation beyond the general practitioner level. Orthopedic or oncology specialists have the training to pick out subtle warning signs and get appropriate tests started.

Bolstering public awareness and education initiatives can break the cycle of delayed diagnosis. No less vital is empowering the primary care physician to recognize such signs early and refer patients to specialists in a timely manner.

Bone cancer is uncommon, but the consequences are high. What might start as a seemingly harmless pain can be the initial sign of a critical illness. Early identification of symptoms, professional diagnosis, and coordinated treatment plans can be the difference between disability and health.

From chronic pain to a potentially life-saving diagnosis, the word is out: don't ignore the pain. Early detection saves lives, saves limbs, and gives patients their best hope at a healthy future. If your bone pain doesn't resolve or gets worse without good reason, seek out a specialist. Your bones could be saying something more than mere injury.