One Pill Can Kill: Understanding the Risks of Nitazene Overdose

Despite originating in the last century, Isotonitazene, a synthetic opioid known as nitazene, or “ISO,” has recently emerged as a deadly substance in the ongoing opioid epidemic capable of killing in just one dose. The DEA Washington Division even warned residents that nitazines are being sourced from China and being mixed into other drugs, making them more potent and cheaper to produce. DEA regional forensic laboratories have reported identifying nitazenes being mixed into heroin and fentanyl, increasing the risk of a nitazene overdose as even tiny amounts can be fatal.
Some estimates suggest certain nitazene analogues can be up to 20 times stronger than fentanyl. The extreme potency of nitazenes creates a severe risk of fatal overdose, particularly because users may be unaware of their presence in other substances. Even tiny amounts can cause severe respiratory depression, leading to death if not treated promptly with naloxone. The emerging novelty of the drug also means that many standard drug tests may not detect them, making it harder for medical professionals to identify and properly treat overdose cases. To better understand this drug and help prevent abuse, we’ll explore its origins and how its potency can be deadly.
What Is the History of Nitazene and Why Was It Created?
Nitazenes were originally developed in the 1950s by a team of medical researchers looking to create new opioid pain medications but were never approved for medical use. The lead compound, etonitazene, and its related analogues were created as part of a broader research initiative to find alternatives to morphine that could potentially offer better pain relief with fewer side effects. The scientists specifically explored benzimidazole-based compounds, which showed promising analgesic properties in early laboratory studies.
Despite their high potency and effectiveness at pain relief, nitazenes were never approved for medical use due to their dangerous side effects and a high potential for drug abuse. During the development process, researchers discovered these compounds had an extremely low difference between an effective and lethal dose. This made them too risky for clinical use, and the pharmaceutical industry ultimately pursued other directions for pain medication development.

Is Nitazene a Substitute for Morphine?
Due to its extreme potency levels and initial creation as a morphine alternative, nitazene is not considered a substitute for morphine. It was never approved for medical use since it can be up to 20 times more potent than fentanyl, which is much stronger than morphine, making accurate dosing nearly impossible and creating an extremely high risk of opioid overdose and addiction. Unlike morphine, which has been extensively studied and has well-understood effects and dosing protocols, nitazenes have not undergone rigorous clinical testing. Their effects can be highly unpredictable, especially when mixed with other substances. While both nitazenes and morphine work on opioid receptors in the body, morphine is a regulated medication that has established medical protocols for safe use. Anyone seeking pain management should work with licensed healthcare providers who can prescribe legal medications like morphine when medically necessary, rather than turning to dangerous substances like nitazenes.
Are Nitazenes More Potent Than Fentanyl and Morphine?
Yes, nitazenes are significantly more potent than fentanyl and morphine. Morphine serves as the baseline reference for opioid potency. Fentanyl is already 50 to 100 times more potent than morphine, making it extremely dangerous. However, certain nitazene compounds can be up to 20 times more potent than fentanyl. This extreme potency makes accidental overdose highly likely, especially since the substances are often mixed into other drugs without users’ knowledge.
The extreme potency of nitazenes means they often require multiple doses of naloxone to reverse an overdose, unlike traditional opioids. They’re so strong that they can be dangerous not just to users but also to others who might accidentally come into contact with the substance. This is why they were deemed too dangerous for medical use despite their pain-relieving properties.

Do Nitazines Come in Liquid or Pill Form?
Nitazenes can come in powders, tablets, or liquids, but they are often sold in powder form or pressed into counterfeit pills and mixed in with other substances or combined with other drugs like heroin, fentanyl, and benzodiazepines. The risk of taking nitazines is that the user is often unaware the substance has been mixed in with other drug products.
Don’t Fall Victim to Nitazene Overdose and Seek Help at WhiteSands Treatment
A nitazene overdose is particularly dangerous due to these synthetic opioids being significantly more potent than traditional opioids. This potency level makes the presence of nitazenes in the drug supply very concerning because many users may not know they’re consuming these potent substances.
To avoid the dangers of falling victim to a nitazene overdose while addicted to opioids, WhiteSands Treatment is a professional addiction treatment center offering comprehensive care that begins with medically supervised detox to safely manage withdrawal symptoms. We provide individual and group therapy sessions that help address underlying trauma, develop coping strategies, and build a strong support network. Our opioid addiction treatment facilities offer additional services like family therapy and aftercare planning to support long-term recovery.
WhiteSands Treatment treats every patient as an individual, allowing each person to access the personalized treatment needed to overcome their addiction. Our structured environment and professional support significantly increase the chances of successful recovery compared to trying to quit alone. To learn more about overcoming opioid addiction in a professional addiction treatment facility, please call WhiteSands Treatment at 877-855-3470 today.
External Sources
- National Library of Medicine: Old Drugs and New Challenges: A Narrative Review of Nitazenes
- DEA: New, Dangerous Synthetic Opioid in D.C., Emerging in Tri-State Area
- Alcohol and Drug Foundation: Drug Facts: Nitazines
If you or a loved one needs help with abuse and/or treatment, please call the WhiteSands Treatment at (877) 855-3470. Our addiction specialists can assess your recovery needs and help you get the addiction treatment that provides the best chance for your long-term recovery.