What are nitazenes? 

Nitazenes are illicit opioids that have been growing in popularity across the US. This synthetic drug is raising concerns amongst experts because little is known about it. While nitazenes are similar to fentanyl, they are much stronger and more research needs to be done to fully understand their effects.  

Nitazenes were first developed by researchers around 60 years ago. They were originally designed to be used as an alternative for morphine, but nitazenes were never released to the public because of their high potential for overdose. 

What do nitazenes look like? 

Nitazenes come in several different formulations. They have been found in white, or brown/yellow powder. They can also take the shape of crystalline solids, or tablets that resemble oxycodone. Nitazenes can be injected, inhaled, or swallowed (when in tablet form). 

How do nitazenes affect you? 

These drugs influence everyone differently, based on size, weight, health, tolerance, amount taken, and the strength of the drug. The short term effects are generally similar to that of opioids, and includes things like euphoria, relaxation, drowsiness, pain relief, nausea, vomitting, fever, and slowed/irregular breathing and heartrate. 

The long term effects of nitazenes still need more research to be fully understood. Many experts believe the long term effects include dependence, increased tolerance, and damage to vital organs like the lungs, brain, and heart. 

Are nitazenes deadly? 

Unfortunately, nitazenes are growing in popularity in the illicit drug market, and have been connected to a number of overdose deaths worldwide. Since 2019, 749 nitazene-involved deaths have occurred in the US alone. 

The true impact of nitazene, and how far it has infiltrated the drug supply is not readily apparent. This is because many police and medical examination labs do not routinely test for them. 

Are nitazenes really more dangerous than fentanyl? 

Experts describe nitazenes as being very potent. However, their risk varies depending on the different formulations. Two types of nitazenes, N-Desethyl etonitazene and etonitazene, about 10 times as potent as fentanyl. 

Nitazenes can also be mixed into other drugs that are sold illicitly, meaning people may not know they’re consuming something so dangerous. Nitazenes are often mixed into other drugs to increase potency or lower costs. 

There also hasn’t been much research into how nitazenes interact with other substances, so there many be unexpected side effects from combining it with drugs or alcohol. 

Does naloxone work on nitazenes? 

Naloxone is a medication used to reverse opioid overdoses. This medicine can also reverse an overdose that involves nitazenes. This is because naloxone is an opioid antagonist, that binds to the same receptors in the brain that are affected by nitazenes. 

Anyone who experiences a nitazene overdose and is treated with naloxone, should seek additional medical treatment because some nitazenes can be long-lasting. Once the naloxone wears off, there is a risk they can fall back into a coma. 

If you want to know how to administer naloxone during an overdose, check out this guide. 

What does nitazene withdrawal look like?

Giving up nitazenes after prolonged use can be challenging because the body has to get used to functioning without them. Reports from people who use nitazenes suggest withdrawal is comparable to opioid withdrawal. 

Some anecdotal reports suggest that withdrawal can include symptoms like: 

• Excessive sweating
• Restless legs
• Fever
• Dizziness
• Flu-like symptoms
• Blackouts
• Anxiety
• Panic attacks 

How to get help 

If nitazene use is affecting your health, family, relationships, work, school, or daily life, you can find help and support. Use Treatment Atlas to find a service in your local area. Simply type in your location and filter by service type, insurance accepted, and much more. 

How to reduce harm if you use nitazenes

Start with a low dose. Try a small amount first to see how you are affected. It’s important to remember that if you’re swallowing the drug, it will take longer to reach its full effect. This means there may be more time to get medical help if needed. 

Avoid using alone. Have a sober person around who is able to help if needed. Avoid taking nitazenes with other substances. It especially shouldn’t be mixed with opioids, alcohol, and benzodiazepines. 

If you aren’t sure whether someone is overdosing, call 911 and request an ambulance. Do not leave the person alone.