What are Nitazenes? Everything You Need to Know

What are nitazenes? 

A dangerous drug more common that you might think.

Nitazenes are powerful, man-made opioids sold illegally. First developed in the 1950s as possible painkillers, they were never approved for medical use because of their high overdose risk. 

They work in a similar way to fentanyl but can be much stronger — some types are hundreds of times more potent than morphine. This makes them especially dangerous, particularly because they’re sometimes mixed into other drugs without people knowing and often can’t be detected in routine drug tests. 

What do nitazenes look like? 

Nitazenes appear in many different forms:

• White or brown/yellow powder 

• Crystals 

• Counterfeit pills that resemble prescription opioids such as oxycodone 

• Liquids, nasal sprays, or vape solutions 

They can be swallowed, snorted, smoked, vaped, or injected — sometimes without the person realizing they’ve taken them. 

How do nitazenes affect the body? 

Even a small amount can be harmful.

The effects depend on factors like body size, health, tolerance, dose, and the specific type of nitazene. 

Short-term effects are similar to other opioids and can include: 

• Euphoria or a deep sense of relaxation 

• Pain relief 

• Drowsiness 

• Nausea or vomiting 

• Fever 

• Slowed or irregular breathing and heart rate 

Because nitazenes are so strong, dangerous breathing problems can happen quickly.

Long-term effects aren’t fully known, but may include: 

• Needing larger doses over time to get the same effect 

• Dependence or addiction 

• Possible damage to the brain, heart, and lungs 

Are nitazenes deadly? 

Yes, they can be fatal.  

Nitazenes have been linked to hundreds of overdose deaths worldwide. In the U.S., deaths have risen sharply since 2019. Some states have gone from zero cases to dozens in just a few years. 

The actual numbers are likely higher because many drug tests don’t detect them. 

Are nitazenes really more dangerous than fentanyl? 

Some types can be stronger and last longer.

For example: 

• Isotonitazene: up to 500× stronger than morphine (about 5× stronger than fentanyl) 

• Protonitazene: about 200× stronger than morphine 

Nitazenes are often mixed — without the buyer’s knowledge — into drugs like heroin, MDMA, ketamine, fake pills, or vape liquids. Combining them with other substances, especially alcohol or other depressants, increases the risk. 

Does naloxone work on nitazenes? 

Naloxone can save a life, but more than one dose may be needed.

Because some nitazenes are very strong and long-lasting, overdose symptoms can return after the naloxone wears off. Always seek medical care right away after administering.

What does nitazene withdrawal look like?

Withdrawl can be intense. Symptoms can include: 

• Heavy sweating
• Restless legs
• Fever
• Dizziness
• Flu-like symptoms
• Blackouts
• Anxiety or panic attacks

How to get help 

Support is available, and recovery is possible.  

If nitazene use is affecting your health, relationships, work, or daily life, help is available. Visit Shatterproof Treatment Atlas to find services near you, filter by type, and see which ones accept your insurance. 

How to reduce harm - Test your supply

Steps that can lower your risk:

• Test with fentanyl/nitazene strips if you can. 

• Never use alone — have someone nearby who can help. 

• Avoid mixing with alcohol, other opioids, or anxiety medications like Xanax.

• If swallowed, effects take longer to kick in — but the risk is still high. 

• If you think someone is overdosing: 

  • Call 911 immediately. 

  • Administer naloxone if you have it. 

  • Stay until help arrives.