A deadly synthetic opioid named Nitazene is sending London clubland into a panic as two more were killed by the drug.
The drugs, believed to be up to 500 times stronger than heroin, is said to be “spreading like wildfire” around the capital on the party scene, and now warnings have been made after two further people died in suspected drug overdoses from the highly potent drugs.
So what exactly are nitazenes and what symptoms can people look for in an overdose?
Nitazenes are a class of designer drugs that emerged in the 2010s. They are derivatives of benzodiazepines, which are a class of psychoactive drugs used primarily for treating anxiety, insomnia, and other related conditions.
They gained popularity in the recreational drug scene due to their sedative and anxiolytic effects, but they also pose significant risks. They can be much stronger than other opiate substances such as heroin, fentanyl, and morphine.
The BBC reported they can be several hundred times more potent than these substances. Nitazenes are typically sold on the illicit drug market and are often found in various forms such as powders, pills, or liquids.
They are also often missold as oxycodone tablets or laced with substances such as heroin, ketamine, or cannabinoids.
Nitazenes, particularly certain derivatives such as flualprazolam and flubromazolam, have been associated with numerous deaths worldwide.
How do nitazenes compare to fentanyl?
Nitazenes and fentanyl are types of synthetic opioids but are not related structurally. They belong to different classes of compounds and have distinct pharmacological properties.
Nitazenes primarily act on gamma-aminobutyric acid (GABA) receptors in the brain, leading to enhanced inhibitory neurotransmission and producing sedative, hypnotic, and anxiolytic effects. Fentanyl, as an opioid, primarily acts on mu-opioid receptors, leading to analgesia, euphoria, and respiratory depression.
Fentanyl is one of the most potent opioids available for medical use, with a potency estimated to be 50 to 100 times that of morphine. Nitazenes vary in potency depending on the specific compound, but they are generally less potent than fentanyl.
Fentanyl is a controlled substance in most countries and is available by prescription for medical use, primarily as a pain reliever and anesthetic. However, illicitly manufactured fentanyl and its analogs have been implicated in a significant number of overdose deaths worldwide. Nitazenes, being designer drugs, often fall into legal grey areas and are frequently sold on the illicit drug market.
Taking nitazenes can pose several dangers, especially when used without medical supervision or in high doses. Some of the risks associated with nitazene use include:
- Respiratory depression: Like benzodiazepines, nitazenes can cause respiratory depression, where breathing becomes slow and shallow. In severe cases, this can lead to hypoxia (lack of oxygen) and potentially be life-threatening.
- Sedation and unconsciousness: Nitazenes are central nervous system depressants, so they can cause profound sedation and even unconsciousness — particularly when taken in high doses or combined with other depressant drugs such as alcohol or opioids.
- Memory impairment: Benzodiazepines, including nitazenes, can impair memory and cognitive function. This causes confusion, forgetfulness, and difficulty concentrating.
- Risk of dependence and withdrawal: Chronic use can lead to physical and psychological dependence. People may experience cravings and withdrawal symptoms when attempting to stop or reduce their use. Withdrawal from benzodiazepines can be severe and may include symptoms such as anxiety, insomnia, tremors, and seizures.
- Drug interactions: Nitazenes can interact with other drugs, including prescription medications and illicit substances, leading to unpredictable effects or dangerous interactions. Combining nitazenes with other depressants, such as opioids or alcohol, can increase the risk of respiratory depression and overdose.
- Overdose: Taking high doses of nitazenes can result in an overdose, characterised by extreme sedation, respiratory depression, loss of consciousness, and potentially death.
- Quality and purity concerns: Because nitazenes are often sold on the illicit drug market, there is a risk of variability in quality and purity. Substances sold as nitazenes may contain other undisclosed ingredients or contaminants, increasing the risk of adverse effects or overdose.
What are the signs of a nitazene or fentanyl overdose?
According to the UK charity, We Are With You, signs that someone has had an overdose can include:
- They don’t wake up when you talk loudly to them or shake them by the shoulders.
- Their lips and fingernails have a bluish tinge (if they have lighter skin) or a greyish tinge (if they have darker skin).
- The pupils of their eyes are very small.
- They look pale and clammy.
- They are making a rasping noise as they breathe, or choking sounds.
- Their breathing is slow, shallow, or irregular, or they are not breathing at all.
- There are signs that they have vomited.
- They are unable to speak.
If you suspect that someone is having an overdose, try to wake them by talking loudly, check that they are breathing, and call 999 for an ambulance.
Visit the NHS website if you need help or support with nitazene dependence.
The UK has several helplines that provide confidential advice, support, and information to individuals struggling with drug or alcohol dependence. These helplines are staffed by trained professionals who can offer guidance on treatment options and local support services. Examples include:
- Talk to Frank: 0300 123 6600 (or text 82111).
- Release: 020 7324 2989 (for drug-related legal advice and support).