Synthetic opioids such as fentanyl and oxycodone have become major drugs of abuse over the last decade. One of the newest drugs to emerge is Isotonitazene, which can be deadly for first-time users. Read more to learn why some are calling this synthetic pain medication the “new fentanyl.”

What is Isotonitazene?

Since the late 80’s, the US has faced a growing opioid crisis, characterized by fatal overdoses in the tens of thousands each year. For most of the last decade, synthetic opioids like fentanyl and oxycodone have been the most prominent drugs of the crisis.

Since the Chinese ban on fentanyl production in 2019 and increasing US regulation on Oxycodone production, new drugs have emerged. One of the newer synthetic opioids to emerge is Isotonitazene.

Isotonitazene, commonly referred to as ISO, is part of a growing trend of synthetic opioids appearing on the black market. It poses a significant challenge for public health and law enforcement agencies due to its potency and the difficulty in its detection.

ISO is significantly more potent than morphine and has been associated with risks of overdose and addiction, similar to other opioids. Due to its potency and increasing availability, some have labeled it the “new fentanyl.”

Since its appearance in the US in 2019, at least several hundred deaths have been attributed to Isotonatizene. It’s currently listed as a Schedule I substance in the United States.

Why is Isotonitazene Dangerous?

Isotonitazene has been called the new fentanyl due to how potent it is. Some reports have called it 20 to 100 times more potent than fentanyl. While direct comparisons are difficult, it’s  safe to say it’s much more potent than both morphine and oxycodone. A fatal opioid overdose is very possible when taking ISO.

Like other opioids, isotonitazene can cause respiratory depression, where breathing becomes shallow or stops altogether. This is the primary cause of fatal opioid overdoses. The risk is higher with more potent synthetic opioids like isotonitazene.

This high potency, combined with the fact it’s often marketed by dealers as being some other, less potent opioid, means an unsuspecting user runs a high risk of overdose.

Adding to all this is the fact that Narcan (naloxone), a medication that can prevent a fatal opioid overdose, doesn’t work on ISO. ISO can thus be disguised as conventional heroin and taken by an unsuspecting user, and first-responders have no way of helping.

What Are the Signs and Symptoms of Synthetic Opioid Abuse?

Abuse of synthetic opioids like Isotonitazene can lead to various signs and symptoms, both physical and behavioral. It’s important to recognize these signs, as synthetic opioids can be particularly dangerous due to their high potency.

Here are some of the signs and symptoms of ISO abuse:

• Drowsiness or sedation
• Shallow, slow, or difficult breathing
• Constricted (small) pupils
• Nausea and vomiting
• Itching or flushed skin
• Constipation
• Slurred speech
• Poor coordination
• Mood swings, anxiety, irritability, or euphoria
• Decreased motivation
• Withdrawal from social activities or responsibilities
• Doctor shopping (visiting multiple doctors to obtain prescriptions)
• Illicit drug-seeking behaviors, such as buying drugs from non-medical sources
• Financial problems related to drug procurement

Signs of an ISO overdose include:

• Blue nails
• Clammy skin
• Breathing trouble
• Unconsciousness
• Blue or purple fingernails
• Vomiting
• Pinpoint pupils
• Drowsiness

If you see someone suffering an overdose from Isotonitazene, call medical authorities immediately.