What Is Isotonitazene?

Isotonitazene, also known as “ISO,” is a very powerful and novel drug that has become a growing public health concern in the United States.

Isotonitazene, classified as a benzimidazole opioid, is estimated to be up to 20 times more potent than fentanyl, according to some analyses, but the exact potency comparisons between novel synthetic opioids can vary.

A small amount of ISO can be deadly to ingest, whether intentionally or by accident. Toxicology reports in parts of the U.S. show it’s infiltrating the already-dangerous illicit drug market.

Here you can find more information about what isotonitazene is, its effects, its dangers, and how to find an addiction treatment program for illicit drug misuse near you.

What Does Isotonitazene Look Like?

In the United States, ISO is primarily distributed in powder form, according to the U.S. Drug Enforcement Administration (DEA).

Law enforcement in Canada, however, has encountered this drug in tablet form, as a white triangular tablet, and as a blue tablet in fake Dilaudid pills (hydromorphone) sold on the street.

In other parts of the world, including Sweden, Germany, Estonia, and Latvia, the drug has also been identified in liquid form.

What Does Isotonitazene Do?

Isotonitazene belongs to the opioid drug class, which is known for its depressant effects on the central nervous system (CNS), composed of the brain and the spinal cord.

This potent synthetic opioid affects opioid receptors in the brain, releasing chemicals associated with well-being and euphoria.

It’s also associated with several adverse health risks, including respiratory depression (slowed, labored, or stopped breathing), addiction, and fatalities.

Is Isotonitazene A Scheduled Drug?

In 2020, the DEA issued an order to make ISO a Schedule I drug under the federal Controlled Substances Act (CSA).

Schedule I drugs have the highest potential for misuse, a high risk of dependence, and have no currently accepted medical use in the United States.

The illicit opioid heroin, and two other drugs chemically similar to ISO known as etonitazene and clonitazene, are also classified as Schedule I substances.

What Are The Side Effects Of Isotonitazene?

The pharmacological effects of isotonitazene are not very well-known, due to the fact that the drug has not formally been studied in humans.

As an opioid, however, the new drug has been associated with a high risk for misuse, addiction, and sedative effects, such as slowed breathing, drowsiness, and decreased heart rate.

Where Has Isotonizane Been Found?

Nitazenes, including isotonitazene, have been detected by federal, state, and local forensic laboratories across multiple U.S. regions. Given the rapidly evolving nature of the illicit drug supply, current geographic distribution data is best obtained from the DEA’s most recent drug threat assessments.

What Are The Dangers Of Isotonitazene?

Isotonitazene has gained increasing notoriety in the United States in recent years, largely because it, along with fentanyl and drug analogs, has been associated with a rising number of fatal overdoses.

It’s also being mixed in, or laced, with other illicit drugs to make them cheaper to produce, including drugs such as heroin, fentanyl, and counterfeit pills (e.g., benzodiazepines).

Overdose

ISO drugs such as fentanyl and its derivatives/analogs can be lethal in small amounts.

Accidental ingestion can cause respiratory depression and death. Effectively treating an ISO overdose may also require greater medical resources.

Signs of overdose may include:

• slowed or stopped breathing
• mental confusion
• dizziness
• impaired coordination
• sedation
• unresponsiveness
• bluish skin, lips, or fingertips
• loss of consciousness

According to health experts, treating an overdose involving this new synthetic opioid may require multiple doses of the drug naloxone to prevent life-threatening consequences.

Naloxone, the primary treatment for opioid overdose, can be administered by way of a nasal spray (Narcan) or by way of an intramuscular injection.

Naloxone is available without a prescription at most major pharmacies. However, because nitazene overdoses may require multiple doses to reverse, calling 911 immediately is critical even if naloxone is administered. Do not wait to see if a single dose works.

Who’s At Risk Of Isotonitazene Overdose?

People with a history of opioid use disorder may be at increased risk of isotonitazene misuse and/or drug overdose, because it’s been found laced with other illicit opioids.

Illicit drug use in general may also be a risk factor. One of the greatest dangers of the illicit drug market is that it’s hard to know what exactly is in the drugs you buy without a drug test.

This can place anyone who buys illegal drugs, such as cocaine, methamphetamine, or even marijuana in states where it’s not legal, at risk for buying drugs laced with substances such as ISO.

Addiction Treatment Services For Substance Use Disorder

Isotonitazene is one of the most dangerous drugs that has infiltrated the illegal drug market. If you or someone you know is misusing or addicted to illicit drugs, don’t wait to seek help.

The following drug and alcohol treatment options are available at rehab centers throughout the United States.

Treatment programs may include:

• medication-assisted treatment (MAT)
• support groups
• inpatient rehab programs
• intensive outpatient programs (IOP)
• individual and group therapy
• medical detox
• cognitive behavioral therapy (CBT)
• aftercare services

Getting Help For Illicit Drug Use Disorder And Addiction

Browse our directory or reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) for more information about addiction recovery.

Written by the Addiction Resource Editorial Staff