Synthetic Opioid 10 Times More Dangerous Than Fentanyl Linked to Overdose Deaths

A drug user displays his hit of fentanyl in the Tenderloin District of San Francisco on Feb. 23, 2023. John Fredricks/The Epoch Times

A synthetic opioid called nitazene, which is several times more potent than fentanyl, is contributing to rising cases of drug overdoses in the United States, according to a new study.

“Synthetic opioids, such as the fentanyl analog and nitazene drug class, are among the fastest growing types of opioids being detected in patients in the emergency department (ED) with illicit opioid overdose (OD),” the Aug. 29 study published on JAMA Network said. Analog drugs are similar in chemical structure to a controlled drug. Fentanyl is legal in the United States, while fentanyl analogs are the illicit version. Nitazenes, developed in the 50s, were never approved for the market.

While fentanyl is 100 times stronger than morphine, Nitazines are hundreds to thousands of times more powerful than morphine and ten times stronger than fentanyl. Just two milligrams of fentanyl, roughly 10-15 grains of table salt, is considered to be a lethal dosage.

In the study, researchers looked at data from 537 patients who overdosed between 2020 and 2022. While 11 patients, or 2 percent, tested positive for fentanyl, nine individuals, or 1.7 percent, tested positive for nitazenes, also referred to as novel potent opioids (NPOs).

Patients who overdosed on nitazenes were found to have received “a higher number of naloxone doses administered in-hospital.” Naloxone is a medication used to rapidly reverse an opioid overdose.

“The majority of patients with ODs that involved NPO received [two] or more doses of naloxone, whereas most of the patients who OD from fentanyl only received [one] dose of naloxone,” it said.

“These findings suggest that NPOs may have a higher potency than fentanyl due to the observed naloxone administration in the clinical setting of overdose.”

The study suggested that clinicians should be aware of these opioids in the drug supply so that they are “adequately prepared” to care for overdose patients and realize that multiple doses of naloxone may be required to deal with the issue.

Nitazenes in America

Though extremely dangerous, nitazenes are not well-known. Many users may not even realize they are exposed to these opioids, as evidenced by some of the cases covered in the study.

“The [two] patients who tested positive for brorphine reported using what was believed to be a parenteral opioid, such as heroin or fentanyl,” it said. Brorphine is a synthetic opioid that belongs to the nitazenes class.

An officer from the U.S. Customs and Border Protection, Trade and Cargo Division finds Oxycodone pills in a parcel at John F. Kennedy Airport's US Postal Service facility in New York on June 24, 2019. Johannes Eisele/AFP via Getty Images

The study pointed out that “the exact motivation to produce nitazenes and brorphine are unclear.” It suggested that “increased regulation of fentanyl and fentanyl analogs throughout the last decade” may be a reason.

In an interview with CBS News, Sheila Vakharia, deputy director of the Department of Research and Academic Engagement at the nonprofit Drug Policy Alliance, agreed with this assessment.

“Nitazene and analogs entered the drug supply within the past few years because distributors and suppliers cut opioid drugs with them. One reason why this new class of drugs has entered the fentanyl supply is because we have passed harsher fentanyl and fentanyl analog penalties at the state and federal level,” Ms. Vakaharia said.

“This has led suppliers and sellers to try and stay one step ahead of the law by adding in drugs that will have similar effects for the drug user, but that could avoid the harsh penalties of fentanyl since some of these nitazenes are not currently scheduled.”

In some regions of the United States, the use of nitazenes has increased, she said. This includes states like Ohio and Tennessee.

In April last year, Ohio Attorney General Dave Yost issued a warning about the “increased prevalence of nitazenes.” In the first quarter of 2022, 143 nitazene cases were reported in Ohio, up by over four times from 27 cases during the same period in 2021.

“Frankenstein opioids are even more lethal than the drugs already responsible for so many overdose deaths,” Yost said, according to an April 20, 2022, news release. “Law enforcement and the public need to pay attention to these emerging hazards.”

Fentanyl Crisis

Worries about opioids like nitazenes come as the United States is already struggling with the fentanyl crisis. According to the U.S. Centers for Disease Control and Prevention (CDC), synthetic opioids like fentanyl are the primary driver of overdose deaths in the country.

More than 68 percent of the reported 107,081 drug overdose deaths in the United States last year involved synthetic drugs, “principally illicitly manufactured fentanyls,” the CDC said in June.

A poster of candy-like fentanyl sits in Irvine, Calif., on April 28, 2023. John Fredricks/The Epoch Times

Enough illicit fentanyl is crossing the U.S. border to kill every single American. In June alone, the U.S. Customs and Border Protection (CBP) seized around 2,100 pounds of illicit fentanyl at the southern border. Just a kilogram (2.2 pounds) is enough to potentially kill 500,000 people.

“I don’t think the public is really aware of what a challenge this is,” Donna Nelson, an organic chemist and professor at the University of Oklahoma, told The Epoch Times. “You have to assume that the border agents are not catching everything that’s coming into our country.”

“And the amount that’s coming in keeps increasing—not steadily, but it is increasing over time.”

In May, the House passed the Halt All Lethal Trafficking (HALT) of Fentanyl Act, which seeks to place fentanyl-related substances into schedule I of the Controlled Substances Act.

“A schedule I controlled substance is a drug, substance, or chemical that has a high potential for abuse; has no currently accepted medical value; and is subject to regulatory controls and administrative, civil, and criminal penalties under the Controlled Substances Act,” says the bill summary.

“Under the bill, offenses involving fentanyl-related substances are triggered by the same quantity thresholds and subject to the same penalties as offenses involving fentanyl analogs (e.g., offenses involving 100 grams or more trigger a 10-year mandatory minimum prison term).”

The bill was passed by a vote of 289-133 on May 25.