Nitacenes: This is the drug 40 times more potent than fentanyl.

Nitacenes are "superopioids" 40 times more potent than fentanyl, and the WHO warns of their spread; what they are, types, how they are used, and their effects.

Mérida, Yucatán.- The World Health Organization (WHO) and the U.S. Drug Enforcement Agency, among other organizations, warn that this new synthetic drug , which is becoming increasingly widespread around the world, poses significant risks to the health of users and represents a serious new challenge for drug control policy.

Nitacenes ( benzimidazole opioids ) are a new class of highly potent synthetic opioids.

And the Inter-American Drug Abuse Control Commission ( Cicad ) indicates that they were first developed in the 1950s by Swiss researchers as an opioid analgesic alternative to morphine, but nitacenes were never approved for medical use.

For many years, nitacenes (also called nitazenes ) were not a regular part of the illicit drug market, and the most notable reports of recreational use before 2019 involved ten deaths in Moscow in 1998 and a single incident in Utah in 2023 due to manufacturing.

In addition, the United Nations on Drugs and Crime ( Undoc ) recorded 54 deaths in the United Kingdom between June 1 and December 7, 2023, who did not know they were consuming them because they were mixed.

As nitacenes have appeared around the world, illicit manufacturers have continually synthesized new, chemically distinct types .

Currently, at least 13 different types of nitacenes have been identified .

• The most widely used nitacene is isonitacene (ISO)
• But other common nitacenes include: Metonitacene
• Protonitacene
• Butonitacene
• Ethodesnitacene
• Flunitacene
• N-pyrrolidinium etonitacene

People may use nitacenes for the same reasons they use other opioids, as nitacenes are synthetically designed to mimic the effects of traditional opiates .

Nitacene use may be motivated by self-medication for physical, mental, or emotional disorders or by the desire to experience the effects of opioids.

Those who consume nitacenes feel euphoria, relaxation, drowsiness and pain reduction.

However, the Organization of American States ( OAS ) warns that some people may inadvertently consume nitazenes, as they are often mixed with other drugs or counterfeited as such (for example, heroin, fentanyl, benzodiazepines or other synthetic drugs) to increase their potency and lower their cost.

Many consumers may be unaware that they are consuming nitacenes, making them especially vulnerable to the risks posed by their consumption. This unintentional consumption is also one of the factors that makes it difficult to collect comprehensive data on nitacene consumption.

Nitacenes are available in many forms, including pills, powders, and sprays , both in “pure” form and mixed with other drugs.

Routes of administration of nitazen include:

• Intravenous
• Intranasal route
• Oral route
• Sublingual route
• Inhalation (vaping)

The WHO warns that niacins are highly addictive and continued use can lead to dependence and may cause dizziness, nausea, vomiting, disorientation , and loss of consciousness.

Like other opioids, they carry a high risk of central nervous system or respiratory depression , as well as cardiac arrest.

They also present a particularly high risk of overdose and overdose mortality due to their high potency.

The potency of nitacenes varies considerably, but all of them are much more potent than natural (non-synthetic) opiates, such as morphine.

And although studies on dependence are limited, it is known that withdrawal symptoms have a high potential to be severe and painful.

Fentanyl itself is typically 25 to 50 times more potent than heroin , which is about twice as potent as morphine.

The most common nitacene (ISO) is 250 to 900 times more potent than morphine, while the most potent nitacene is up to 4,300 times more potent than morphine, according to a Cicad study .

As an emerging substance of concern, there is no complete picture of nitazene use because of insufficient data. There are no databases, surveys, or clinical studies, reports Cicad.

In the Americas, only Brazil, Canada, and the United States have consumption-related data , and these are largely incomplete or indirect measures of actual consumption.

In examining the information available in the region, UNDOC acknowledges that no data were found on nitazen consumption in Central America or the Caribbean.

The UNDOC 's Early Warning System (EWS) on New Psychoactive Substances (NPS) indicates that NPS are spreading throughout the Americas and Europe.

It says they were first detected in 8 countries in 2019 and then increased to 19 countries in 2022 .

The most frequent reports were (in order) from the United States, Canada, Latvia, Estonia, the United Kingdom, Sweden, and Germany. According to the UNODC early warning system, nitacenes were reported from Asia, Europe, North America, Oceania, and South America as of February 2024.

However, detailed reports are still lacking. While a review of available literature on nitacenes in Latin America found only one reference specific to Brazil , nitacenes could be present in many other countries in the region that have not yet detected or reported them.

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The manufacture, trafficking, and consumption of nitacenes pose a significant risk to the health of the population and represent a new and serious challenge for drug control policy.

Meanwhile, illicit producers have continued to develop new forms of nitacenes for more than fifty years, since they were first synthesized.

Although data remain limited, nitacene consumption appears to be increasing , especially in Canada and the United States.