More potent than fentanyl…

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In the recent years, the opioid epidemic has been getting worse by the advent of street fentanyl, an illicit version of a powerful prescription painkiller.

Presently experts warn that the threat posed by fentanyl may eventually pale in comparison to the emergence of an even more dangerous type of synthetic opioid which now tainting the illegal drug supply: nitazenes.

That’s because a new investigation concluded that nitazenes are 1,000 times more potent than morphine, which makes them 10 times more power than fentanyl.

Nitazenes are very dangerous, because it takes a smaller amount of these drugs to have the same effect and patients could overdose more easily, explained Alexandra Amaducci, an emergency medicine and medical toxicology expert with Lehigh Valley Health Network-USF Morsani College of Medicine in Bethlehem, Pa. 

In addition to the risk, Amaducci’s team further found that when a nitazenes overdose happens its most likely to be more severe- and more difficult to treat- than an overdose attributed to fentanyl.

In 1950s it was first developed as a pain medication. Nitazenes were never approved for medical use. In the decades since, the drugs basically fell off the radar.

To gain understanding into the risk posed by nitazenes, a medical data was reviewed by the Amaducci’s team concentrating on a small group of patients who were treated at an emergency department for a nitazenes overdose at some point between 2020 to 2022.

The patients were four men and five women- ranged in age between 20 to 57.

All were a part of a larger group of roughly 2,300 overdose patients of whom 537 underwent full lab testing. Just under 2% (nine patients) tested positive for one of a number of nitazenes opioids (including brorphine, isotonitazene, metonitazene and/or N-piperidinyl etonitazene)

At the same time, 11 patients tested positive for fentanyl. Provided via injection or nasal spray, naloxone is an opioid antagonist, which can quickly reverse and block the impact of opioids, thereby rescuing a patient whose breathing has slowed or even stopped.

Dr. Ramin Mojtabai is a mental health professor with Johns Hopkins School of Public Health in Baltimore said, that the challenge is that people who consume illicit opioids are not aware that heroin or other drugs they think they’re taking are, in effect, poisoned with something as powerful as nitazenes.

He also mentioned that higher doses of opioids can cause respiratory and cardiac arrest and be fatal.

Mojtabai’s prescription:This problem should be seen as a public health issue. Harm reduction methods- such as wider distribution and public education about naloxone- can be lifesaving.

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