‘Nitazenes’ (2-benzyl benzimidazole opioids)
nitazenes- Isotonitazene
- Clonitazene
- Metonitazene
- 5-aminoisotonitazene
- N- pyrrolidino-etonitazene
- Butonitazene
- Protonitazene
- Etodesnitazene (etazene)
- Flunitazene
- Metodesnitazene (metazene)
Scientific Names: 2-benzyl benzimidazole opioids
Generic Names: New synthetic opioids (NSO). Known as ‘Nitazenes’.
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Desired Effects:
Although evidence of the effects of some is limited, potency between nitazenes varies greatly and they are often mis-sold as other drugs, desired effects are thought to include:- Intense high
- Euphoria
- Relaxation
- Pain relief
- Suppression of opioid withdrawal
Side Effects:
- Drowsiness
- Confusion
- Sedation
- Sweating
- Itching
- Nausea
While evidence of the effects of some nitazenes is limited and potency between them varies greatly harm reduction advice similar to that given for fentanyls and other potent synthetic opioids is appropriate:
If you are knowingly using nitazenes:
- Don’t use alone.
- Always have naloxone available. Nitazenes are opioids. Naloxone reverses the effect of an opioid overdose.
- Use slow/less. Because nitazenes can be so strong, a little goes a long way (compared to heroin!) and overdoses can occur quickly, sometimes before you’ve finished injecting the dose.
- Try snorting or smoking instead of injecting. Injecting carries the highest risk for overdose, so shifting to snorting or smoking may help reduce risk. You can still OD by smoking/ snorting, especially with the more potent nitazenes, so start slow.
- Use test strips to detect nitazenes and other unwanted adulterants in heroin and other street drugs.
- Don’t use alone.
- Always have naloxone with you. You may need more naloxone to recover from a nitazene overdose than you would from heroin.
- Smoke a small amount on foil before attempting to inject. You are less likely to die from smoking adulterated heroin because you would usually fall unconscious before inhaling a lethal amount.
- If you’re injecting, start with a dose that is a quarter of what you usually use.
- Don’t ‘slam’ your hit. Depress the plunger slowly, pausing to allow the familiar dose to take effect. If you feel it is unusually strong or sedating, pull it out.
- Be aware of the signs of overdose and make sure anyone you live with or use with knows them too. In case of emergency, use naloxone and ring for an ambulance.
Long term risks:
Although evidence is limited, long term risks are likely to be similar to other potent opioids such as fentanyl and include tolerance and dependence.Short term risks:
Although evidence of the health harms of nitazenes is limited, short term risks are likely to be similar to other potent opioids such as fentanyl, so may include overdose and injecting related injuries and infections (Hepatitis B, C and HIV, septicaemia). As ‘nitazenes’ are most commonly found as unwanted adulterants in heroin, oxycodone and street benzodiazepines the risk of overdose is greatly increased.Since 2023 there have been over 500 deaths linked to ‘nitazenes’ and other potent synthetic opioids.
2-Benzyl benzimidazoles are synthetic opioids and act by interacting with a series of opioid receptors within the brain and nervous system.
2-Benzyl benzimidazole opioids are commonly known as ‘nitazenes’. They are potent synthetic opioids with opioid (heroin-like) effects. It is thought they vary in potency from equal potency to morphine for flunitazene to 500 times more potent for isotonitazene and 1000 times more potent for etonitazene.
They have been sold as drugs in their own right, have also been used to fortify heroin, and mis-sold as other drugs such as oxycodone and alprazolam. The adulteration of opioids and other street drugs with nitazenes has a severe and potentially fatal overdose.
2-Benzyl benzimidazole opioids are commonly known as ‘nitazenes’. They are potent synthetic opioids with opioid (heroin-like) effects. It is thought they vary in potency from equal potency to morphine for flunitazene to 500 times more potent for isotonitazene and 1000 times more potent for etonitazene.
They have been sold as drugs in their own right, have also been used to fortify heroin, and mis-sold as other drugs such as oxycodone and alprazolam. The adulteration of opioids and other street drugs with nitazenes has a severe and potentially fatal overdose.
Most 2-benzyl benzimidazole opioids are Class A drugs, however legislation is regularly updated as newer variants that may not be covered are detected.
Injected, sublingually, swallowed, sprayed, snorted and vaped.
None of the ‘Nitazenes’ have ever been authorised in the UK as medicines.
2-Benzyl benzimidazole (‘nitazene’) opioids were originally developed in the 1950s as analgesics. Several were shown to have potent opioid (heroin-like) effects but none were subsequently marketed anywhere as human or veterinary medicines. It is believed that some of nitazenes sold in Europe were manufactured by chemical companies based in China. Recent Chinese legislation has led to a wider range of variants being produced and production in some European countries.
