A recent international symposium on synthetic drug threats has highlighted a concerning rise in deaths linked to nitazene use in multiple countries, including North America, Brazil, Australia, New Zealand, and several European nations.

Nitazenes, a potent class of synthetic opioids known as benzimidazoles, can be between 1.5 and 20 times more potent than fentanyl, making them highly dangerous even in small amounts. The Colombo Plan and the Center for Forensic Science Research and Education (CFSRE), which sponsored the symposium, released new data showing the increasing prevalence of nitazenes worldwide.

North America

CFSRE reports that the most commonly detected nitazenes in the United States during the third quarter of 2024 include protonitazene, metonitazene, and N-pyrrolidino protonitazene. In 2023, U.S. authorities intercepted shipments of nitazene tablets destined for Florida, Connecticut, and Brazil. The seized tablets contained an average of 29 milligrams of metonitazene per dose, highlighting the significant risk posed by these substances.

Brazil

Between July 2022 and April 2023, São Paulo recorded 140 opioid seizures, with nitazenes detected in 95 percent of cases. Metonitazene alone was found in 125 samples, making up 72 percent of seizures. Some samples were mixed with other substances, including the synthetic cannabinoid MDMB-4en-PINACA, which appeared in 30 percent of cases. The remaining five percent of opioid seizures in São Paulo involved other opioids, primarily morphine and fentanyl.

Europe

The European Union Early Warning System detected six new nitazene compounds in the region’s drug supply in 2023. These substances were primarily found in Lithuania, Latvia, Estonia, Poland, Sweden, and Finland. In Sweden, nitazenes were discovered in a counterfeit oxycodone seizure, while Finland reported cases of counterfeit buprenorphine tablets containing nitazenes.

Australia

The Victorian Institute of Forensic Medicine at Monash University has documented deaths linked to isotonitazene (2021) and etodesnitazene (2022). Reports indicate a rise in nitazene-related fatalities across Australia in 2023 and 2024. The most commonly detected nitazenes include protonitazene, metonitazene, and N-pyrrolidino etonitazene, with some cases involving multiple nitazenes, such as butonitazene. The Australian Alcohol and Drug Foundation has also reported counterfeit drugs containing nitazenes, often mixed with designer benzodiazepines like bromazolam.

New Zealand

A New Zealand drug-checking service identified N-desethyletonitazene in May 2024 in a counterfeit tablet being sold as a benzodiazepine. Reports of metonitazene in yellow tablets and powders date back to 2022, while more recent findings in 2024 detected N-pyrrolidino protonitazene or N-pyrrolidino isotonitazene in an orange powder.

United Kingdom

Between June 2023 and May 2024, the UK’s National Crime Agency confirmed over 179 deaths linked to nitazenes. The most frequently detected substances included protonitazene, N-desethyl isotonitazene, metonitazene, and N-pyrrolidino protonitazene.

Ireland

In 2023, N-pyrrolidino protonitazene was linked to 77 cases in Dublin and Cork, with 57 of these resulting in fatalities and 20 classified as non-fatal overdoses. In 2024, additional fatal and non-fatal outbreaks related to protonitazene were reported, including one in a prison. Some seized samples contained protonitazene in yellow counterfeit tablets packaged in blister packs labelled as alprazolam.

Global Concerns and Next Steps

The widespread presence of nitazenes across multiple regions underscores the growing risk associated with these synthetic opioids. Their extreme potency, combined with their presence in counterfeit pills, increases the likelihood of accidental overdoses. The data presented at the symposium highlights the urgent need for increased public awareness, forensic monitoring, and harm reduction strategies to mitigate the dangers posed by nitazenes.

Republished courtesy of Forensic Mag

Original authors: Michelle Taylor

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