New Synthetic Opioids Spreading - 145x More Deadly Than Fentanyl

The Colombo Plan has issued a health alert pertaining to the growing global threat of Benzimidazole (Nitazene) opioids. These synthetic compounds are highly potent and far exceed the strength of fentanyl, and are causing a great increase in overdose deaths and public health crises across many regions.

Nitazene tablets containing 29 mg of metonitazene are the equivalent of 145 times the lethal dose of fentanyl were seized en route to Florida, Connecticut, and Brazil via international express mail.

Key Insights:

• Potency and Risk: Nitazenes, also known as Benzimidazoles, are synthetic opioids estimated to be 1.5–20 times more potent than fentanyl. A single tablet seized in 2023 contained metonitazene levels equivalent to 290 mg of fentanyl — 145 times the estimated fatal dose.

• Global Spread: Reports from North America, Brazil, Europe, Australia, New Zealand, and West Africa reveal a sharp rise in nitazene-related deaths.

• Distribution and Adulteration: Nitazenes are typically found in tablet or powder form, often mixed with fentanyl, other synthetic drugs, or designer benzodiazepines like Bromazolam, further compounding the risks.

• Sample Testing: U.S. Crime Lab data shows 2.6% of analyzed cases (55 exhibits) contained 19 or more substances in addition to the principal nitazene compound.

• Adverse Effects: Like other synthetic opioids, nitazenes cause profound sedation and respiratory depression, often leading to fatal overdoses.

Naloxone and Treatment:

Naloxone remains effective in reversing nitazene overdoses but may require multiple doses due to the drug’s extreme potency.

Emerging Analogs:

Since 2019, a range of nitazene analogs has surfaced in the U.S., including metonitazene, isotonitazene, protonitazene, and N-pyrrolidino protonitazene. The NPS Discovery program at CFSRE tracks these trends quarterly, with protonitazene, metonitazene, and N-pyrrolidino protonitazene among the most common in late 2024.

You can help spread awareness of this growing threat by sharing this article. If you or someone you love are struggling with addiction, New Horizons of the Treasure Coast & Okeechobee have the resources to help you. Visit NHTCinc.org for more information.