Alarm has been sounded in the United States: the use of nitazenes, a class of synthetic opiates, is increasing.[1] This situation should lead to rethinking treatment and response policies for this type of drug. The drug can be found in powder, pills or liquid form and can be mixed with other drugs such as heroin, fentanyl or benzodiazepines.

The response to fentanyl use had already raised problems because the doses of naloxone needed to correct fentanyl overdoses must be much higher than in the case of heroin. Now, nitazenes pose an even greater challenge, because they are more potent opiates than fentanyl. The use of this new drug has already led to several overdose deaths in the United States. The most potent class of nitazenes is forty times stronger than fentanyl and thousands of times stronger than morphine. The danger of this new opioid has meant that its therapeutic use has not been admitted in any case, unlike fentanyl, which has been admitted for clinical use.
There is an unconscious use of nitazenes, as people are unaware that it is present in other drugs they take. There are no tests that detect nitazene levels as there are for fentanyl. Like the latter opioid, nitazenes weaken people who take them. Thus, we can find people who use heroin and have a stable job, meanwhile this situation is much more difficult to find in the case of fentanyl and nitazenes.
Currently, instruments to detect nitazenes are inadequate or non-existent, especially in the United States, where analysis of wastewater is not carried out, as is done in the countries of the European Union. Detection in the blood of people who ingest it is difficult because it disappears very quickly, so detection in wastewater is extremely necessary.
China seems to be the main source of nitazene precursors, which are shipped to Mexico and then illegally entered into the United States.
[1] Vid. ‘Even worse than fentanyls’: nitazenes in the USA – The Lancet
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