The New Synthetic Opioid, Isotonitazene 

There is a new and dangerously potent drug making its way into street opioids, and most people have never even heard of it. It is called N-desethyl isotonitazene, and it is part of a growing class of synthetic opioids known as nitazenes. Unlike fentanyl, which has already made headlines for its deadly strength, nitazenes like N-desethyl cause even more intense effects. Isotonitazene is estimated to be 20 times stronger than fentanyl. 

Originally, Isotonitazene was a byproduct of another synthetic opioid, N-desethyl. However, it is now showing up as the primary ingredient of some street drugs, often without users knowing. This drug was first flagged in Florida in late 2022 and has already found its way to Philadelphia drug samples. The way it is quietly spreading is alarming and potentially deadly.

How Does Isotonitazene Work?

Isotonitazene works by targeting the same system in the brain as drugs like fentanyl and morphine. Specifically, it binds to and activates the mu-opioid receptor. This receptor is basically a switch in your brain that controls not just pain and pleasure but also breathing. What makes isotonitazene especially risky is how strongly it flips that switch, even at very low doses.

But that potency comes with a steep price. When isotonitazene activates the mu-opioid receptor, it also brings along a protein called β-arrestin-2. This protein has been linked to some of the most dangerous side effects of opioids, including life-threatening respiratory depression. It can slow or stop your breathing before you even realize you are in danger. The strength of isotonitazene's depressive actions means the window to intervene can be dangerously short. 

What Group of People is Most at Risk of Using Isotonitazene?

The people who are at most risk of abusing isotonitazene belong to the same population already vulnerable to opioid misuse. These include those who use prescription painkillers, heroin, tramadol, fentanyl, and similar synthetic opioids. LGBTQ people are at risk because they are often compelled by systemic discrimination and healthcare access to turn to illicit substances to cope. 

In many overdose cases involving isotonitazene, other opioids or depressants are also found. These findings lend credence to the idea that isotonitazene is often taken alongside or mistaken for other drugs. Because it is obtained from unregulated sources, users have no way of knowing how strong, pure, or even what exactly they are taking. Its growing presence in toxicology reports and post-mortem exams highlights how serious the threat really is.

How is Isotonitazene being Distributed?

Isotonitazene is not approved for medical use in the United States, and so its distribution completely occurs on the illicit drug market. The synthetic opioid has shown up mainly in powder form and is being seized by U.S. authorities in small but dangerous amounts. For example, 1.6 grams were confiscated in California back in 2019. Since then, forensic labs across the country have flagged nearly 900 cases involving this drug, either alone or mixed with others. Its potency, combined with its unpredictable presence in street drugs and lack of awareness about it, makes isotonitazene a public health threat.

Effects of Isotonitazene

As a Schedule I drug, it has no accepted medical use and an extremely high potential for abuse. People often take it recreationally or mix it with other substances like cocaine, trying to soften the crash. But the risks quickly outweigh the high.

Like other opioids, isotonitazene can cause: 

• Dizziness
• Drowsiness
• Confusion
• Sedation
• Dangerously slowed breathing 

Isotonitazene unpredictability is one of the biggest threats it poses. The drug’s purity, potency, and ingredients vary from batch to batch, even within the same local supply. This makes it so easy to overdose on, even for someone who’s used it before. Some users have reported needing vastly different doses to feel the same effect, a gamble that could cost them their lives.

Reach Out to Q Space Detox for Isotonitazene Abuse Treatment 

Staying safe around this new kind of opioid epidemic starts with awareness. This drug is even harder to detect than conventional opioids. Even though there is an antidote for opioid overdose, isotonitazene’s strength and unpredictability make people need multiple doses of the antidote. Even then, a positive response is not guaranteed. 

At Q Space Detox, we understand how substance use often overlaps with trauma, stigma, and identity struggles. Our care is LGBTQ+-affirming, trauma-informed, and judgment-free. It is meant for people who have been made to feel unsafe or invisible elsewhere. Whether you need a safe space for opioid detox or just someone to talk to, we are just one call away. Contact us at 305-537-7127 for more information on isotonitazene.