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Nitazenes are a class of synthetic 2‐benyzl‐benzimidazole opioid receptor agonists that can be several hundred times the potency of morphine. Clonitazene and etonitazene were initially developed in the 1950s as potential analgesics, but were never approved for therapeutic purposes due to their high potency. Isotonitazene was first notified as a drug of concern to the United Nations Office on Drugs and Crime (UNODC) in 2019. By the beginning of 2024, 13 different nitazene analogues across six global regions had been reported, highlighting the potential for continued proliferation of chemically modified structures into the drug market. Nitazene‐associated harms and deaths have been reported in North America and Europe, with toxicity symptoms being similar to those from other opioids, including respiratory depression and decreased level of consciousness.

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Authors: Brendan Clifford, Amy Peacock, Krista J Siefried, John Gobeil, Jennifer L Smith and Nadine Ezard

Article Type: Perspective