What Are Nitazenes? Drug 10 Times Stronger Than Fentanyl Linked To Overdose Surge

Fatal overdoses from a group of synthetic drugs have been rising in Tennessee over the past years, recently published data showed.

Tennessee's State Unintentional Drug Overdose Reporting System (SUDORS) identified a total of 42 nitazene-related fatal drug overdoses in 2021, according to a study conducted with the assistance of the SUDORS team, the Tennessee Department of Health and the Office of the State Chief Medical Examiner.

The same system identified 10 cases in the previous year and zero in 2019, the study published on the website of the Centers for Disease Control and Prevention (CDC) Friday indicated.

All the cases involved other substances, such as fentanyl and methamphetamine, among others, researchers noted. They were mostly identified in Knox County.

Nitazenes were developed 60 years ago as potential pain relief medication, but they were never approved for clinical use, according to the Canadian Centre on Substance Use and Addiction.

The fatal nitazenes-related overdoses in Tennessee from 2020 to 2021 were attributed to the metonitazene, isotonitazene, protonitazene and etonitazene varieties.

Nitazenes can be up to 10 times stronger than fentanyl, which is already 50 times more powerful than heroin, NBC News reported, citing experts.

Naloxone, a medication used to reverse the effects of opioids sold under the brand name Narcan, among others, has been effective in countering nitazene-related overdoses, the study said.

However, multiple doses may be needed because of the potency of nitazenes, researchers pointed out.

"Given their potency, raising awareness about nitazenes and implementing strategies to reduce harm through increased testing, surveillance and linkage to treatment for substance use disorders are of vital importance," they wrote.

The CDC estimated that 108,886 drug overdose deaths occurred in the U.S. in 2021, according to data from the agency.

While Fentanyl remains the primary source of opioid misuse throughout the U.S., the emergence of nitazenes has created additional concern as people with substance use disorder seek more potent drugs to satisfy their addiction.

"Since most nitazenes are largely unregulated, they are not subject to the same scrutiny by law enforcement officials as other controlled substances," Dr. Rebecca Donald, an assistant professor of anesthesiology and pain medicine at Vanderbilt University Medical Center, was quoted as saying by Healthline.

"This, along with the fact that they can be made inexpensively from legal substances, makes them very appealing for drug traffickers," the doctor added.