Nitazenes are a rapidly emerging and highly dangerous class of synthetic opioids that are increasingly contributing to fatal drug poisonings.
First developed in the 1950s as potential pain relievers but never approved or studied for medical use, nitazenes are illegal Schedule I substances that can be more than twenty times stronger than fentanyl and hundreds to thousands of times more potent than morphine. Since at least 2019, they have appeared in liquid, pill, and powder forms and are frequently found in counterfeit pills or mixed into other illicit drugs sold through social media and underground markets. Because of their extreme potency, individuals may need higher or repeat doses of naloxone to reverse drug poisonings involving nitazenes. Nitazenes’ increasing spread in illicit drug channels, difficulty of detection with standard drug tests, and resistance to reversal during drug poisonings underscore the urgent need for greater public awareness, early identification, and expanded access to harm‑reduction tools such as naloxone.
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