Nitazenes, a class of synthetic opioid analgesics found in the illicit drug supply, have been implicated in overdose deaths due to their high potency. As schedule 1 substances, these new synthetic opioids have a high potential for abuse, dependence, and addiction. The long-term effects of nitazene abuse can lead to severe respiratory issues, organ damage, cognitive impairments, and potentially fatal overdose.
Nitazenes: The “New Old” Synthetic Opioids
Benzimidazole opioids, also known as nitazenes, have not been approved for medical use in the United States. Nitazenes are Schedule 1 drugs under the Controlled Substances Act (CSA), alongside heroin, LSD, marijuana, and MDMA (ecstasy). These highly potent synthetic opioids are hundreds to thousands of times more powerful than morphine and other opioids. They are labeling nitazenes “the new old synthetic opioids” and for being tenfold more potent than fentanyl. Fentanyl has been responsible for a significant amount of drug overdose deaths in the United States.
Benzimidazole opioids’ effects are reported to be similar to that of fentanyl, making them extremely dangerous and lethal. Different types of benzimidazole opioids (nitazenes) include:
- Etonitazene
- Clonitazene
- Metonitazene
- Isotonitazene
- Butonitazene
Benzimidazole opioids and their derivatives were initially used to treat nematode and trematode infections in humans and animals. Benzimidazole’s derivatives, etonitazene and clonitazene, produce morphine-like effects on the central nervous system (CNS). Nitazenes failed to receive commercial approval and were long forgotten until they appeared in the illicit street drug market. Nitazenes and other designer analogs in the illegal drug supply have been involved in overdose mortality.
The Long-Term Consequences of Nitazene Abuse
As an illicit opioid analgesic, nitazene’s short and long-term effects can be unpredictable and potentially lethal, like fentanyl. Nitazene in the street drug supply has been reportedly mixed with fentanyl, heightening their fatal consequences. The immediate effects of nitazenes, much like fentanyl, can result in severe confusion, nausea and vomiting, pupillary constriction, respiratory depression, and overdose. A nitazene overdose can lead to clammy skin, coma, respiratory failure, and death. The long-term consequences of nitazene abuse can result in severe physical health issues, psychological and neurological responses, addiction, and overdose death.
Respiratory Problems
Chronic opioid use, specifically nitazene abuse, can cause severe respiratory issues such as opioid-induced respiratory depression. Nitazenes, as a potent opioid, can lead to dose-dependent respiratory depression and arrest. These opioids act as mu-opioid receptor agonists, depressing the central nervous system (CNS) as well as the respiratory areas in the brain.
Long-term nitazene abuse can lead to persistent respiratory depression, potentially inducing hypoxia. Hypoxia is a condition in which there is an insufficient amount of oxygen in the body’s tissues, which can lead to irreversible brain and other organ damage.
Cardiovascular Complications
The high potency of nitazenes exacerbates the cardiovascular issues associated with excessive opioid abuse. Similar to that of fentanyl, these synthetic opioids can lead to slowed heart rate (bradycardia) and severely low blood pressure (hypotension). This heightens the risk of cardiovascular disease and heart failure. Individuals who abuse nitazenes may experience multiple overdoses as a result of the drug’s unpredictably high potency. Multiple nitazene overdoses can cause long-term damage to cardiovascular health.
Organ Damage
Long-term nitazene abuse can cause significant organ damage, including the liver and kidneys. Benzimidazole opioids are metabolized and excreted within the liver and kidneys, which can suffer from opioid toxicity. Chronic nitazene abuse can prompt liver damage, cirrhosis, and kidney failure. The damage caused by illicit opioid abuse on the organs can be life-threatening without appropriate medical attention.
Mental Health Disorders
As an opioid analgesic, nitazene abuse can lead to the development of multiple mental health issues. For those with existing mental health disorders, nitazenes can exacerbate feelings of anxiety, depression, and other mood disorders. Nitazene’s high potency can alter brain chemistry, which may precipitate incessant psychological issues requiring comprehensive treatment.
Cognitive Impairment
Long-term opioid abuse, like any drug addiction, impairs cognitive function and health. Nitazene addiction may alter the domains responsible for attention, inhibition, regulation, memory, and decision-making. Cognitive deficits with opioid use disorder (OUD), such as memory loss, reduced problem-solving skills, and trouble concentrating, can impact daily functioning. These cognitive impairments can ultimately reduce overall quality of life and complicate opioid rehabilitation and addiction recovery.
Relationship Conflict
People with opioid use disorder (OUD) from nitazenes often experience relationship conflict with their family and friends. The behavioral changes associated with drug abuse and addiction can significantly strain personal relationships and social interactions. As individuals prioritize their drug use and neglect other aspects of their lives, they may experience social isolation, conflict, and a lack of support. While these consequences are often a result of their addictive behaviors and decisions, this can usually exacerbate their cycle of addiction.
Employment and Financial Instability
Another social consequence of drug abuse and addiction is poor job or educational performance. Maintaining a job or academic program while struggling with an opioid addiction can be challenging. Benzimidazole opioid abuse can precipitate reduced productivity, job loss, dropping out of school, and financial instability. The cost of purchasing illicit opioids like nitazenes, alongside potential healthcare expenses and legal issues, can become a severe economic burden.
Dependence and Addiction
Like any other opioid, illicit or prescription, nitazenes have a high potential for abuse and addiction. Individuals abusing benzimidazole opioids and its derivatives may develop a physical and psychological dependency on nitazenes. Opioid dependencies make it extremely difficult for individuals to quit using without professional help and treatment.
The opioid withdrawal process can be severe and uncomfortable, requiring medical detoxification at a drug rehab facility. Nitazene withdrawal symptoms may be similar to fentanyl withdrawal, including intense cravings, nausea and vomiting, sweating, restlessness, and muscle pain.
Opioid Detox and Addiction Treatment in Stuart, FL
Seeking professional drug rehabilitation for nitazene abuse can help facilitate long-term recovery from nitazene addiction. Our South Florida opioid detox program in Stuart, FL, guides patients through the opioid detox and withdrawal process, safely managing withdrawal symptoms.
Medication-assisted treatment (MAT) can be employed to assist the withdrawal process and reduce cravings using methadone or buprenorphine. Other addiction treatment modalities, such as cognitive behavioral therapy (CBT), holistic treatment, and addiction services, ensure holistic healing in addiction recovery.
For 24/7 drug detox programs in Stuart, FL, reach out to Coastal Detox now. Take the step and choose to get sober today.
References:
- Drug Enforcement Administration, 2024. Benzimidazole-Opioids Other Name: Nitazenes.
- Cureus, 2023. Old Drugs and New Challenges: A Narrative Review of Nitazenes.
- National Institute on Drug Abuse, 2024. Drug Overdose Death Rates.
- United States Drug Enforcement Administration. Drug Scheduling.
- GoodRx Health, 2022. Nitazenes: What to Know About the Illegal Opioids That Can Be More Potent Than Fentanyl.
- United States Drug Enforcement Administration. Facts About Fentanyl.
- StatPearls, 2024. Hypoxia.
- CNS Spectrums, 2018. Cognitive Impairment in Substance Use Disorders.
- WebMD, 2024. What to Know About Fentanyl Withdrawal.