On January 30th, 2024, the online journal Addiction Treatment Business interviewed our Midwest Corporate Medical Director Dr. Daniel Brown about the serious danger posed by a new class of opioids that are ten times more powerful than fentanyl – nitazenes.
The article – Clinicians Lack Sufficient Awareness of Novel Synthetic Opioid 10 Times More Potent Than Fentanyl – suggests the majority of substance use disorder (SUD) treatment centers around the country are not ready to handle to increased risk of addiction and overdose presented by nitazenes.
According to Dr. Brown:
“This class of opioids has the potential to become a rising tide of multiple different analogs of similar substances that have greater potency.”
Nitazenes are ten times more powerful than fentanyl, which is itself about 100 times more potent than morphine, which means nitazenes are up to 1,000 times more potent than morphine.
That increase in potency means an increased risk of addiction and fatal overdose. The risk increased significantly because of how drug traffickers use nitazenes. They use them to “cut” or increase the volume/weight of drugs like heroin and fentanyl, and also use them in counterfeit versions of prescription medications like Dilaudid and oxycodone.
We’ve published two articles on this topic recently. One, by our Chief Clinical Officer, Lori Ryland:
Nitazenes: A New Factor in the Opioid Crisis
And one article with the basic facts about nitazenes, which are also known as “ISO”:
What is ISO? Illicit Drugs and Opioid Overdose
The Next Wave of The Opioid Crisis
Experts from the Centers for Disease Control (CDC) discuss three waves associated with the opioid crisis. The first was the result of overprescribing of opioids, the second was the result of the prescription to addiction pathway, and the third was the result of fentanyl and fentanyl analogs. We may now be in the beginning of a fourth wave, characterized by a mix of opioid and methamphetamine use, co-occurring mental health disorders, and the presence of new substances like nitazenes in the illicit drug supply.
The warnings about a fourth wave are supported by data. In 2021, the CDC reported a total of 106,699 overdose fatalities. For 2022, preliminary data indicates a total of 109,360 overdose fatalities. Treatment specialists like Dr. Brown and Dr. Ryland understand the role nitazenes are playing in the opioid crisis now. They also understand the role they may play over the next several years.
The Addiction Treatment Business article tells us that nationwide, “clinicians lack sufficient awareness” about nitazenes. However, we can confirm that our clinical and medical directors, including Dr. Brown and Dr. Ryland, share important information with all our clinicians about new developments in the opioid crisis – such as nitazenes – and clinicians at all our facilities understand the new risks, and how to face them as we move forward.