A New Synthetic Opioid is Pushing Up Drug Overdoses in America

By Jonathan Walker | December 28, 2021
Jonathan loves talking politics, economics and philosophy. He carries unique perspectives on everything making him a rather odd mix of liberal-conservative with a streak of independent Austrian thought.
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PHILADELPHIA, PENNSYLVANIA - JULY 19: People gather on a street overtaken by heroin users in Kensington on July 19, 2021 in Philadelphia, Pennsylvania. According to data from the US Centers for Disease Control and Prevention's National Center for Health Statistics, over 93,000 people died from a drug overdose last year in America. Nitazenes are far more fatal than fentanyl. (Image: Spencer Platt/Getty Images)

A new class of opioids is spreading havoc across the United States, worsening the opioid abuse that is already killing thousands of Americans annually. The new nitazene class of opioids is said to have an even stronger effect than the popular fentanyl opioid that is responsible for a majority of overdose deaths in the country.

Nitazenes were created roughly six decades ago as a medication to relieve pain. However, these drugs never received approval in the United States. Of late, nitazenes have been cropping up in various cities like Maryland and Washington D.C. According to experts, netizene class opioids are two to ten times more fatal than fentanyl.

“There’s probably about five to 10 drugs that make up this medicine class right now that have been identified on the market… They’re really spread through all areas throughout the U.S. Usually, we see them epicentered around places in the Midwest and then, they sort of proliferate out from there,” Alex Krotulski, an expert in nitazenes at the Center for Forensic Science, told the Washington Examiner.

In places like New York, Indiana, Texas, New Jersey, and Ohio, the most commonly found nitazene class drugs are protonitazene, isotonitazene, and metonitazene. The outbreak of the COVID-19 pandemic and the resultant lockdowns, quarantines, and social distancing have created the perfect environment for a spike in opioid use.

According to data from the U.S. Centers for Disease Control and Prevention (CDC), over 93,300 fatal drug overdoses were registered in 2020, which is around 30 percent more than the previous year. The majority of these deaths were linked with opioid use in every single state. Between 2019 and 2020, fatal opioid overdoses rose from 50,963 to 69,710.

According to CDC data from November this year, drug overdose deaths between May 2020 and April 2021 were the highest in a 12-month period at over 100,000. Roughly 64 percent of these deaths were synthetic opioid deaths. Though fentanyl is the largest killer among opioid users, nitazenes could soon take that place as people suffering from substance use disorders seek out drugs with more potency.

“Since most nitazenes are largely unregulated, they are not subject to the same scrutiny by law enforcement officials as other controlled substances. This, along with the fact that they can be made inexpensively from legal substances, makes them very appealing for drug traffickers,” Rebecca Donald, assistant professor of anesthesiology and pain medicine at Vanderbilt University Medical Center in Tennessee, told Healthline.

Efforts to control the opioid crisis are being undertaken at various levels. In an interview with Healio, Nora Volkow, MD, director of the National Institute on Drug Abuse (NIDA), said that a common factor in many such strategies is increasing physician and patient access to buprenorphine. Citing several studies, Volkow stated that buprenorphine is one of the most effective and safest drugs that have been proven to treat opioid use disorder.

“If concerns about the potential for misuse of buprenorphine are keeping clinicians from prescribing medications for opioid use disorder, I would point out that a NIDA-funded study found that in 2019, nearly three-fourths of U.S. adults reporting buprenorphine use did not misuse the medication in the past 12 months… Buprenorphine misuse among people with opioid use disorder trended downward between 2015 and 2019, even though more people received buprenorphine treatment during this time,” Volkow said.