Experts are raising alarm over a synthetic opioid called nitazenes, which they say is about 20 times more powerful than fentanyl. The drug is causing a new public health crisis, because many users do not know they are taking it.
Dr. Shravani Durbhakula, an anesthesiologist and director of comprehensive pain services at Vanderbilt Medical Center in Nashville, warns that nitazenes were developed more than 70 years ago. Though originally studied many years back, they are now back in illegal drug supplies.
One major concern is that there are no standard drug tests that detect nitazenes. When someone overdoses, multiple doses of the antidote naloxone may be needed. Because tests don’t always show nitazenes, doctors might misdiagnose or miss the cause of the overdose.
Durbhakula says many people who consume nitazenes don’t know they are taking something so dangerous. It may be mixed into other drugs, or misrepresented. She says this increases risk because users and medical responders are not prepared.
Medical experts are calling for better awareness among doctors, first responders, law enforcement, and the public. They say more education is needed so people can recognize the signs of overdose, know how to respond, and understand what substances might be involved.
Some of the symptoms of an overdose include difficulty breathing, unconsciousness, and other opioid-type signs. Because nitazenes are so strong, these signs can come on quickly. Using naloxone may save lives, but responders may need to give several doses.
There is also concern about regulations: better screening tools, or more sensitive tests, are needed to detect nitazenes in biological samples or in street drugs. Law enforcement agencies also need to track where nitazenes are being sold or mixed.
In essence, nitazenes represent a hidden danger, a very potent drug that is more powerful than fentanyl, often undetected, and capable of triggering fatal overdoses. Experts stress that quick action is needed to prevent more deaths through education, better detection, and stronger public health responses.
