This week (March 18), Toronto’s Drug Checking Service released two alerts regarding high-potency synthetic nitazene opioids circulating in the city's unregulated opioid supply.
The following information is summarized from their website:
Alert 1: Two new nitazene opioids identified and circulating
- N-desethyl etonitazene (considered to be up to 10 times stronger than fentanyl) and Protonitazepyne, also known as N-pyrrolidino protonitazene (considered to be more than 20 times stronger than fentanyl)
- Nitazene opioids have been found in samples that were expected to be hydromorphone (Dilaudid), hydrocodone, and Percocet.
- Nitazene opioids are far stronger than oxycodone, Percocet, hydromorphone, and hydrocodone. For example, protonitazepyne is considered to be more than 20 times stronger than fentanyl and fentanyl is considered to be more than 50 times stronger than oxycodone.
- Since N-desethyl etonitazene and protonitazepyne are so strong, the risk of overdose in increased and greater than normal doses of naloxone may be required to rouse individuals experiencing an overdose.
- The risk of overdose may be further increased for people who use oxycodone (OxyContin), Percocet, hydromorphone (Dilaudid), or hydrocodone, as compared to people who use fentanyl, because their opioid tolerance may be lower.
Other key highlights from TDCS:
- In expected fentanyl samples, high-potency opioids are often found in combination, likely increasing the strength of the opioids being used and, therefore, increasing the risk of overdose. For example, between January 1 and March 8, 2024, 42% of the expected fentanyl samples checked by Toronto’s Drug Checking Service contained more than one high-potency opioid.
- In expected fentanyl samples, high-potency opioids are often found in combination with other central nervous system and/or respiratory depressants, such as benzodiazepine-related drugs and veterinary tranquilizers. For example, between January 1 and March 8, 2024, 58% of the expected fentanyl samples checked by Toronto’s Drug Checking Service contained at least one benzodiazepine-related drug and/or veterinary tranquilizer. Using high-potency opioids in combination other central nervous system and/or respiratory depressants increases the risk of dangerous suppression of vitals (e.g., slowing down of breathing, blood pressure, heart rate).
CP24 News article published March 18: 6 suspected overdose deaths reported in Toronto over 4 days as new potent drugs found in unregulated supply