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Isotonitazene: A New and Potentially Deadly Synthetic Opioid

The epidemic of opioid addiction and overdose deaths might not be in the headlines as much as it used to be, but the crisis continues to ravage parts of the United States. A deadly new synthetic opioid called Isotonitazene has now been added to the mix and is showing up in the Midwest.

Isotonitazene Synthetic Opioid in the Midwest

The nation has seen a slight decrease in the number of fatal overdoses, with approximately 67,000 Americans losing their lives in drug-related deaths in 2018.

Nearly 70 percent of those overdose deaths involved prescription painkillers or other illegal opioids, according to the Centers for Disease Control and Prevention (CDC).

The new and powerful synthetic opioid called Isotonitazene is sometimes referred to as simply “iso” on the streets. Sadly, iso is starting to show up in the toxicology reports of some people who have recently succumbed to opioid addiction.

Law enforcement and health care experts are scrambling to learn more about the new drug before it reaches too many more people.

“We should always be anticipating a new version of a drug,” Newtown, Ohio, Police Chief Tom Synan told USA Today.

In his statement, Chief Synan was referencing the 2016 rash of overdose deaths due to fentanyl and carfentanil that flooded the illegal opioid market.

“We will always be reacting when it comes to changes in the drug supply. It’s why we have to make sure we have the resources needed to keep people alive and connect them to services – so that we can reduce deaths and reduce harm,” he added.

What is Isotonitazene?

Derived from an illegal opioid analgesic called etonitazene, “iso” generally appears as a white or off-white powder. It can also come as a pressed, imitation opioid painkiller in pill form. Etonitazene has been around since the 1950s and is considerably more potent than morphine, although there isn’t an estimate yet as to the potency of isotonitazene.

There is little doubt, according to law experts, that the synthetic opioid is being made and shipped overseas from labs in China.

Isotonitazene is not a fentanyl analog and, therefore, not technically illegal. So far, it’s not even on the U.S. government’s radar either. The federal Drug Enforcement Administration (DEA) failed to identify or mention isotonitazene in its first 2020 quarterly report.

One reason medical experts are concerned is that little is known about this new synthetic opioid. Often times, new drug analogs are created by changing one or two molecules in the chemical structure to circumvent drug laws so it appears as a drug that isn’t illegal. This might be the case with Isotonitazene.

So far, isotonitazene has been mixed with cocaine and has been linked to a spike in overdose deaths in the Midwest. Isotonitazene has also shown up in overdose toxicology reports in Canada and Europe.

“The toxicity of isotonitazene has not been extensively studied but recent association with drug user deaths lead professionals to believe this new synthetic opioid retains the potential to cause widespread harm and is of public health concern,” as FilterMag contributor Sessi Kuwabara reported.

Isotonitazene is a New and Potentially Deadly Synthetic Opioid

What are Typical Isotonitazene Side Effects?

Because so little research has been done on isotonitazene, there are possible side effects that medical experts are still unaware of, but they are sure that “iso” can lead to potentially deadly symptoms.

Some of the Isotonitazene side effects include the following:

  • Can cause respiratory failure and death
  • Leads to increased tolerance and addiction
  • Nausea and vomiting
  • May require more than just one dose of Naloxone, a life-saving medication that can reverse opioid overdoses
  • Harm reduction advocates urge users to avoid knowingly taking the drug if they are alone, in case of a potentially deadly overdose

Why is Iso a Cause for Concern?

As with other drugs, it can be impossible for users to know exactly what they’re ingesting without testing the drug first. Because isotonitazene is so new, harm reduction organizations have not come up with a way to effectively test drugs like heroin or cocaine for this synthetic opioid, making them particularly dangerous.

In the past few years, fentanyl was the drug causing the most concern because it was being added to heroin, cocaine, and methamphetamine to give users a more powerful high. Eventually, fentanyl was added to Xanax and Norco forming a dangerous cocktail on the streets.

Since users didn’t know they were ingesting fentanyl, they were overdosing because it is up to 100 times more powerful than morphine. It is thought that isotonitazene is even stronger than fentanyl and it could be mixed in almost any types of drugs purchased illegally.

The most effective way to guard against overdose from isotonitazene, prescription painkillers or other opioids like heroin and fentanyl is to avoid using them in the first place.

Being unable to stop taking drugs, like cocaine, opioids, or heroin, is a clear sign of a physical addiction and not a lack of willpower or a moral failure.

Addiction is a chronic, relapsing disease of the brain and it is treatable. Anyone suffering from cocaine or opioid addiction, or a dependency to other substances deserves compassion, respect and effective treatment.


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