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Even Worse than Fentanyl

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Old Drugs and New Challenges: A Narrative Review of Nitazenes
Nitazenes are a group of compounds developed in the 1950s as opioid analgesics, but they were never approved to market. As such, they are not well known outside of academic research laboratories. A characteristic of nitazenes is their high potency (e.g., hundreds to thousands fold more potent than morphine and other opioids and tenfold more potent than fentanyl). In the past few years, several nitazenes, including "designer analogs," have been detected in the illicit drug supply and have been implicated in overdose mortality, primarily due to their exceptionally high potency. 

Notes from the Field: Nitazene-Related Deaths — Tennessee, 2019–2021
The prevalence of nitazene deaths in the United States is unknown and the frequency of nitazene involvement in overdose deaths in Tennessee has not yet been assessed. However, of concern is that nitazenes are increasingly recorded in toxicology reports and death certificate cause-of-death fields. 

What are nitazenes?
What to know about the drug that can be 10 times as potent as fentanyl.