Deadly “Nitazenes” - 800 Times More Potent Than Morphine - Have Now Been Detected in RI

Deadly “Nitazenes” - 800 Times More Potent Than Morphine - Have Now Been Detected in RI

The new illegal drug raising concerns is nitazenes — which can be 800 times more potent than morphine and far deadlier than fentanyl.

Nitazenes are a class of extremely potent synthetic opioids originally developed in the 1950s as painkillers, but never approved for medical use due to their high risk of overdose and severe side effects.

The progression of drugs from OxyContin to heroin to fentanyl, and now, to nitazenes continues, and the number of deaths is beginning to mount.

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“Nitazenes have been detected in the drug supply in Rhode Island. When they are found here, it is often in combination with fentanyl. These findings are consistent with findings in drug samples across the country,” said Joseph Wendelken, the spokesperson for the Rhode Island Department of Health, who wrote in an email to GoLocal.

“We have not had any nitazene-involved fatalities in Rhode Island,” he added.

There are some early indications that the spread is beginning. Three non-contiguous states, Tennessee, Pennsylvania, and Colorado, are seeing spikes, according to the CDC.

In 2024, there were approximately 320 nitazene-related deaths in the United States, according to the latest available reports and statistical summaries.  A tiny fraction compared to 54,000 opioid deaths and 80,000 total drug overdoses in 2024.

One worry is that Narcan (naloxone) can be effective in reversing nitazene overdoses, but often requires higher or repeated doses due to the extreme potency of these synthetic opioids. 

 

Some States Are Tracking Wastewater

One effective way to track the spread is through wastewater samples.

But, detection is inconsistent.

According to a study published by the National Institute of Justice, Nitazenes are now detectable in U.S. wastewater, confirming their use and spread in communities. Wastewater-based epidemiology (WBE) has emerged as an effective early warning method for tracking emerging drugs like nitazenes.

"U.S. Wastewater Monitoring Results were found in studies in 2023-2024, which analyzed samples from eight sites across seven states (Arizona, Oregon, New Mexico, Illinois, New Jersey, Washington, and Georgia)," according to the report.

Narragansett Bay Commission, Rhode Island's largest wastewater facility, does not do sampling for the drug.

As worries about nitazenes are growing, fentanyl appears to be increasing too.

The Wall Street Journal reported on Tuesday, "More Americans are testing positive for fentanyl use in randomized workplace drug tests, highlighting a persistent challenge for employers."

"The positive rate for urine tests indicating the presence of the synthetic opioid fentanyl was 1.13% in 2024. That is up from 0.91% in 2023 and double the rate in 2020, according to a recent analysis of more than eight million drug tests by Quest Diagnostics, one of the U.S.’s largest drug-testing labs," added WSJ.

 

Tools in Rhode Island

"We have sent out an advisory to clinicians alerting them to the dangers of nitazenes specifically," according to RIDOH. "We encouraged clinicians to take time to talk to patients about the drug supply, including nitazenes and fentanyl. This includes patient education on harm reduction practices like testing their supply with fentanyl test strips, trying to use with others, and having naloxone on hand in the event of an emergency."

Learn more about safer opioid prescribing, naloxone, buprenorphine, and substance use resources.