An emerging class of opioids in the United States appears to be even more powerful than fentanyl. Nitazenes have never been approved for medical use, but according to the U.S. Drug Enforcement Administration (DEA), they’re being sourced from China and mixed into other drugs.
In a new study published this week in JAMA Network Open, researchers noted a concerning trend: patients who overdosed on nitazenes required more doses of the opioid overdose reversal drug naloxone than those who overdosed on fentanyl.
Researchers also found that nitazenes had higher rates of cardiac arrest and death than overdoses involving other substances.
“Given the alarmingly high cardiac arrest rate for nitazene overdose, this study should energize harm-reduction policies. And given the emergence of dangerous toxic drugs in the illicit opioid supply in the United States, future research should examine clinical outcomes from new potent opioids as the supply continues to evolve,” Dr. Alex Manini, an author of the study and professor of emergency medicine at the Icahn School of Medicine at Mount Sinai, said in a news release.
The DEA says that nitazenes were first identified around 2019 in the Midwest, and they’ve since moved into the Southern states and, more recently, along the Eastern seaboard.
Currently, nitazene reports are still relatively low, but the DEA warns the public to be alert. In fact, researchers found that most people who tested positive for the powerful opioid didn’t know they were exposed to it.
“Many patients may believe they are using heroin; however, the number of deaths caused by heroin is declining, while the overall number of opioid-related deaths is increasing,” researchers wrote in the study.
The DEA explains that drug manufacturers are mixing nitazenes into drugs because they’re more potent and cheaper to produce.
For the study, researchers analyzed data from 2,298 patients admitted with opioid overdoses to emergency departments across the country between 2020 and 2022.