More deaths can likely be attributed to opioids than previously thought, and that’s largely thanks to a substance called nitazene. The synthetic drug can be five to nine times stronger than fentanyl, which is already approximately 25 to 50 times stronger than heroin. Nitazene is often hidden in other products and difficult to test for, so it goes undetected most of the time.
How prevalent is it? Nitazene was first developed in the 1950s as an analgesic but was never approved for medical use. Instead, it was “limited to those researching opioid pharmacology,” said Rolling Stone. It mostly remained that way until 2019, when the drug emerged on the street drug market in the U.S. and Europe.
In the U.S., 320 overdose deaths in 2023 reportedly involved nitazenes, according to the 2025 World Drug Report. However, this number is very likely understated. The country still mostly “relies on toxicology panels built for yesterday’s drug supply,” said Time. This means that while they can “reliably identify heroin, oxycodone and fentanyl,” they “fail to catch nitazenes, brorphine or other new synthetic analogs.” Without proper identification, “policymakers and public health professionals chase outdated trends.”
Fentanyl is still the number-one cause of opioid deaths, accounting for 48,422 deaths in the U.S. in 2024, but there have been “reported signs of a declining fentanyl market.” The rise in nitazenes may be a “response to efforts to reduce the supply of other opioids,” said toxicologist Ryan Marino to Rolling Stone. “In almost every case where nitazenes are found, they are added to other drugs, primarily fentanyl, and not advertised as containing nitazenes when sold.”
How dangerous is it? Even very small doses of nitazene can be deadly. The lethality of fentanyl is “anywhere between 10 and 20 grains of salt,” said Frank Tarentino, the special agent in charge of the Drug Enforcement Administration’s New York lab, to CBS News. With nitazene, “we are talking about anywhere from one grain or less.” In smaller amounts, it can also cause paralysis and seizures.
Alarmingly, much of the exposure to nitazene comes inadvertently. It has been found in “vapes sold as containing cannabis, in pills shaped as teddy bears supposed to be MDMA, in powder trafficked as cocaine, and in counterfeit pain medication,” said The Guardian.
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