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As drug regulations continue to tighten worldwide, illicit manufacturers are finding new ways to create products that aim to skirt around existing laws. Nitazenes are a group of strong synthetic opioids manufactured for this exact reason. One of the newest nitazene drugs on the market is N-desethyl isotonitazene.
N-desethyl isotonitazene is a relatively new drug with limited factual research availability. Some of the information below is based on anecdotal evidence (this will be clearly highlighted in the text).
- N-Desethyl Isotonitazene is a highly potent synthetic opioid, estimated to be 20–40 times stronger than fentanyl based on early evidence.
- Its presence in illicit drug markets, often mixed unknowingly with other substances, poses a serious overdose risk and evades standard drug tests.
- The DEA placed N-Desethyl Isotonitazene in Schedule I in 2024 due to its high addiction potential, overdose risk, and lack of accepted medical use.
What is N-desethyl isotonitazene?
N-desethyl isotonitazene, also referred to as “N-des-iso” or just “iso”, is a potent synthetic opioid drug. Unlike traditional opioids (such as heroin and morphine), iso is not manufactured by processing the opium poppy. Instead, it is created directly from chemical precursors in an illicit laboratory setting.
In the U.S., N-des-iso was first formally identified in Pennsylvania and Florida in late 2022. At that time, it was (and continues to be) found mixed into bags containing other drugs, such as fentanyl, bromazolam, and xylazine. Most people consuming iso are likely unaware.[1]
Is N-desethyl isotonitazene stronger than fentanyl?
Based on a combination of anecdotal and limited laboratory evidence, N-des-iso seems to be stronger than fentanyl.
Laboratory studies suggest that, gram-for-gram, N-des-iso is approximately 20x stronger than fentanyl. However, anecdotal evidence suggests that this difference may be even higher at around 40x the potency. [2][3]
It’s important to remember that drug purity changes from batch to batch, and information online cannot account for individual tolerance. Overdose is always a risk when taking illicit substances.
How is N-des-iso taken?
Anecdotal evidence suggests that N-des-iso is most commonly found in 2 preparations: gel tabs and mixed with other substances in powder form. Tabs are usually taken orally, whereas powder can be taken in several ways:
- Snorted
- Smoked
- Boofed (rectally administered)
- Injected into a vein or muscle when mixed with liquids
Understanding nitazenes and synthetic opioids
Synthetic opioids represent a group of drugs created in a laboratory, which act on the opioid receptors of the brain, creating pain-relieving effects. Nitazenes (or “zenes”) were first developed in the 1950s as a new form of pain killer to replace traditional morphine based preparations. However, most were never released and were quickly shelved due to their high overdose potential. [4]
Since 2019, nitazenes have continued to pop up in the illicit drug market as a relatively simple-to-manufacture alternative to other opioids in efforts to dodge drug regulations. [5]
The threat nitazenes pose to the overdose epidemic
The rise of nitazenes in the drug market poses a significant threat of overdose for a number of reasons: [6]
- They are commonly found mixed with other drugs (often just sold as “dope”), meaning that people don’t know what they are consuming.
- There can be potentially lethal variations in potency and purity.
- The tiny amounts needed to produce a powerful high are difficult to measure accurately, making it easy to accidentally take more than intended.
- They can be made from legal-to-purchase precursors, making it much harder to clamp down on manufacturers.
- Traditional drug tests (including those for fentanyl) will not detect N-des-iso, making it almost impossible to know if a supply of drugs contains nitazenes.
Effects of N-desethyl isotonitazene use
Much of the evidence for N-des-iso effects comes from anecdotal reports and inferences from other synthetic opioid studies. Some known effects include: [7]
- Pain relief
- Feeling high or euphoric
- Relaxation and stress relief
- Drowsiness
- Itchiness
- Slowed and shallow breathing
- Increased heart rate
- Fever and sweats
- Nausea and vomiting
Effects and risks vary from person to person. Weight, previous use (tolerance), taking it alongside other drugs, the amount taken, and the individual drug strength all modify the effects of nitazenes. [7]
Is N-desethyl isotonitazene abused in the same way as fentanyl and other opioids?
Although N-des-iso is an opioid with similar properties to opioid drugs like fentanyl, its use in the drug market seems to be slightly different.
Anecdotal reports from dedicated forums (such as Reddit) suggest that only a tiny niche of individuals are looking to try iso. The majority of people who have consumed the drug have likely done so unknowingly, as it’s mixed with other substances when buying dope.
A 2024 UN report was only able to identify 14 confirmed post-mortem cases with N-des-iso involvement (however, its contribution to the cause of death was unknown in all cases). They also highlight that the U.S. National Forensic Laboratory system had only recorded 11 detections in samples tested nationally over 2 years. However, these numbers are likely a gross underestimate of the current use levels due to the lack of testing availability. [8]
Is N-desethyl isotonitazene illegal?
In the United States, the Drug Enforcement Administration (DEA) published a temporary scheduling order on July 29, 2024, making N-des-iso a Schedule I controlled substance. This means that it is illegal to possess, consume, sell, or manufacture it (without a special license). [9]
N-desethyl isotonitazene addiction and overdose potential
N-des-iso has an extremely high addiction and overdose potential. Since 2019, an estimated 1,000 to 2,000 fatal overdoses in the U.S. have involved nitazene in some way. However, this number is likely much higher due to the lack of testing availability. [3]
Using laboratory evidence on the effect of similar synthetic opioids, we know that N-des-iso is highly addictive (similar to substances such as fentanyl). [10]
Overdosing on nitazenes is dangerous and far too easy. Seek emergency medical attention for any of these symptoms: [7]
- Blue/gray lips and finger discolouration
- Slowed and shallow breathing
- Loss of consciousness (passing out)
- Extreme drowsiness
Overdoses can quickly lead to serious medical complications, coma, or death if not treated urgently.
Some of the long-term consequences of synthetic opioid use include: [7]
- Increased tolerance to the substance (needing more and more to achieve the desired effect)
- Physical dependence and withdrawal
- Serious health consequences, including damage to vital organs and even death
If you are worried about the impact of opioid use and addiction, treatment is always available. Seek support from your healthcare provider or take a look at our rehabilitation clinic directory.
Treatment for N-desethyl isotonitazene overdose
If you suspect opioid overdose, call 911 (U.S.) or 112 (international) for emergency medical services. Follow the advice given to you over the phone.
The immediate treatment for opioid overdose is naloxone (Narcan). It will temporarily reverse the drug’s effects (preventing life-threatening respiratory depression). Synthetic opioid overdoses may require a higher dose of naloxone due to their high potency. [7]
Further investigations and inpatient hospital treatment may help prevent long-term health complications.
Nitazenes withdrawal
Anecdotal reports from people who have used nitazenes describe experiencing withdrawal symptoms similar to those of other severe opioid withdrawals. This can include:
- Flu-like symptoms (including shaking, sweating, nausea, and vomiting).
- Restlessness
- Fever
- Unsteadiness and dizziness
- Loss of consciousness (passing out)
- Anxiety and panic attacks
Minimizing the risk of N-desethyl isonitazene overdose
Due to its potency and variability, there is no reliable way to prevent a N-des-iso overdose. While this platform does not advise, condone, or recommend illegal drug activity, and while no drug use is “safe,” certain overall tips may help prevent overdose in these situations: [7]
- Avoid taking N-des-iso alone. Rely on a sober person present to provide help and support as needed.
- Keep naloxone (Narcon) on hand. Many drug prevention programs and treatment centres offer free naloxone safety kits.
- Try to reduce the amounts and frequency they are used to reduce the development of drug tolerance.
- Avoid purchasing drugs from unknown sources.
- Be aware of the potential for contamination or “lacing.”
- Do not take N-des-iso alongside other drugs, including other opioids (e.g., fentanyl).
This platform does not advocate or promote the use of illicit substances. These tips are intended for harm reduction and to aid individuals in finding the help they need.
Conclusion
N-des-iso is an emerging nitazene synthetic opioid that can be upwards of 20x more potent than fentanyl. It is cropping up as an unwanted contaminant in drug supplies and has a hazardous overdose potential.
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