Nitazene

What are Nitazenes?

Nitazenes are a class of high-potency synthetic opioids originally developed in the 1950s but never approved for medical use. They are structurally unrelated to fentanyl yet can be far stronger—some analogs estimated to be 20–40x more potent than fentanyl. Nitazenes such as isotonitazene, protonitazene, metonitazene, and etonitazene have re-emerged in illicit drug markets in recent years, often found in counterfeit pills, powders, or mixed with heroin or fentanyl without the user’s knowledge. They typically appear as off-white, beige, or brown powders but can be pressed into tablets or blended into other substances.

Because they were never developed for clinical use, nitazenes have no legal medical applications and are considered illicit in all forms. Their extreme potency greatly increases the risk of overdose, respiratory depression, and death—even in very small quantities. Many users unknowingly consume nitazenes when contaminants are present in counterfeit opioid pills or “heroin” mixtures. Due to their rising prevalence and high mortality risk, nitazenes have become a growing concern for public health agencies, law enforcement, and toxicology programs.

For point-of-care testing environments, nitazenes present a challenge because standard opioid or fentanyl panels may not detect them, prompting the development of specialized assays. Their legal classification and rising presence in overdose cases have made nitazene screening increasingly relevant for workplaces handling safety-sensitive roles, medical environments, corrections, and treatment programs.

Effects:

• Extreme respiratory depression

• Sedation and impaired consciousness

• Pinpoint pupils

• Euphoria (in some cases, but much less predictable than other opioids)

• Profound drowsiness or “nodding off”

• Reduced blood pressure and slowed heart rate

• High risk of overdose even at very small doses

• Loss of coordination and slowed motor skills

• Severe physical dependence potential

• Withdrawal symptoms similar to—but often more intense than—other opioids