As the United States and other countries have put restrictions on fentanyl and fentanyl analogues, criminal organizations are producing other synthetic opiates to meet demand. Benzimidazole class of drugs, including designer opiates Isotonitazene and Etonitazene, have gained popularity over the past two years.
Other Benzimidazole drugs are used in animal parasite control applications. Isotonitazene, Etonitazene, and similar opiate Benzimidazole drugs were developed as research chemicals but currently have no legitimate medical use in humans. These drugs bind well to the opiate receptors in the brain and are far more potent than morphine. Etonitazene is listed as up to 1000x more potent than morphine in animals and was used to research opiate addiction in animals. Isotonitazene is 2.5x more potent than the powerful opiate hydromorphone in humans and slightly more potent than fentanyl.
Wisconsin DOJ released a warning during May 2020 advising Isotonitazene contributed to overdose deaths in Southeast WI. At the time, Isotonitazene was not classified under DEA's Controlled Substance List, but Isotonitazene since has been included as a Schedule I drug under DEA emergency scheduling.
Isotonitazene, Etonitazene, and other Benzimidazole class of drugs are found in illicit online drug marketplaces. Criminal organizations and domestic drug dealers will buy a powder containing Isotonitazene or Etonitazene, use it as a substitute for or in conjunction with heroin or fentanyl, or in counterfeit medications like fake Oxycodone or Xanax. Isotonitazene, Etonitazene, and a similar drug, Clonitazene, are classified as Schedule I drugs by the DEA. Those drugs are also listed as Schedule I drugs in Wisconsin; see Chapter 961.14(2).
Since Isotonitazene, Etonitazene, and other designer opiate drugs work on the same opiate receptor sites as morphine in the brain and are more potent than traditional opiates, expect to see people under the influence of these drugs to exhibit a high level of narcotic analgesic impairment. Users should have constricted pupils, drowsy appearance, droopy eyelids, poor and slow coordination, and other classic signs of narcotic analgesic impairment. If these drugs are ingested orally as a counterfeit medication, the user may not have nonmedical injection sites, track marks, or other intravenous drug use signs.
Overdose potential is high from ingestion, and the opiate receptor antagonist drug Naloxone (trade name Narcan) should work on Isotonitazene to reverse an overdose. Still, there are reports of some designer opiates that don't respond to Naloxone or require more than the usual amount of Naloxone to reverse an overdose. Other opiates and drugs, either intentionally or unintentionally, are likely to be used in conjunction with Isotonitazene and will increase overdose potential for the user. Law enforcement, and our partners who work in social and criminal justice fields, should use extreme caution when handling and investigating illicit narcotics to prevent an accidental overdose.
To learn more about current drug trends, check out Route 961's list of classes in our link here: https://route961training.com/courses/.
Sources: Report on a novel emerging class of highly potent benzimidazole NPS opioids, Blanckaert, et al.
Information on New Psychotropic Substances, WI DOJ – May 2020