Isotonitazene: The Deadly Synthetic Opioid You’ve Never Heard Of

man researching Isotonitazene

A deadly synthetic opioid, Isotonitazene is 500 times more powerful than morphine and has now made its way to the U.S. drug market. The synthetically manufactured opioid is linked to multiple deaths in the United States and Europe.

While initially considered a designer drug, isotonitazene has now become more widely available and poses a real public health threat.

Given its extreme potency, the US Drug Enforcement Administration lists isotonitazene as a Schedule I substance. But many in the U.S. have not heard of it.

What is Isotonitazene?

synthetic drugsIsotonitazene is a relatively new synthetic opioid. It was first developed in the mid-1950s by a Swiss pharmaceutical firm in an attempt to develop a safer opioid painkiller.

Isotonitazene is an analogue of its banned parent compound, etonitazene. Even though it’s structurally different, isotonitazene is thought to be just as powerful. Because it’s so potent, isotonitazene has never been approved for medicinal or commercial use.

The deadly synthetic opioid is primarily used recreationally, much like opioid painkillers, fentanyl, heroin, and other prescription opioids.


Isotonitazene is no longer considered a “designer drug”. It’s now commonly mixed with heroin. Most users would be unaware they’re taking the deadly synthetic opioid.


Since 2019, isotonitazene has been identified and seized in drug supplies in Europe, Canada, and the U.S. The DEA has become increasingly concerned about the public health threat that the strong opioid poses.

It has been linked to seizures and fatal overdoses in hundreds of cases.

How Common is Isotonitazene Use?

According to U.S. law enforcement, isotonitazene has been implicated in scores of deaths.

person with effects of deadly synthetic opioidBarry K. Logan, a leading international authority on forensic toxicology and chief scientist at forensic firm NMS labs, told Vice that isotonitazene “is the most persistent and prevalent new opioid in the U.S.”

Logan reported that regulators and drug enforcement agencies are now seeing 40-50 isotonitazene-related deaths per month in the U.S, compared to around six per month in the previous year.

Isotonitazene has also been found in Canada, in the form of 1,900 fake hydromorphone pills.

It’s been suggested that the rise in isotonitazene in the U.S. is in response to Trump’s ban on China’s production and distribution of fentanyl. Recent reports suggested that isotonitazene is legal to export from China, and the deadly synthetic opioid is not banned in the U.S. or Europe.

Chinese suppliers appear to be incentivizing online (and legal) bulk purchases of isotonitazene and its variants.

What Are the Risks of Isotonitazene?

Like fentanyl, isotonitazene is a deadly synthetic opioid much stronger than morphine and heroin. It doesn’t take much to experience its adverse (and potentially fatal) effect.

Use of isotonitazene can cause:

  • Breathing problems (including respiratory failure)
  • Risk of dependency and withdrawal
  • Seizure
  • Death

If you or someone you love is experiencing a substance use disorder, help is available. Call 800-936-1348Who Answers? today.


Get Help TodayPhone icon800-850-4127 Info iconWho Answers?