Nitazenes

All drug use has risks. This page is for information only and does not constitute or replace medical advice. If you have medical concerns about your drug use, please speak to a medical professional.

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Synthetic opioid drugs called ‘nitazenes’ have been detected in the European and UK drug supply. There are many types of nitazenes including metonitazene, N-pyrrolidino-etonitazene (NPE), etonitazepyne, etonitazene, isotonitazene and protonitazene. Most often they may be sold as or found in other drugs.

Other names

Metonitazene, N-pyrrolidino-etonitazene (NPE), etonitazepyne, etonitazene, isotonitazene and protonitazene.

Appearance

They have been found been found in powders (brown/yellow/white), contaminated heroin and pills/tablets such as Diazepam (a benzodiazepine) and liquids, including nasal sprays. There is also a concern that nitazenes could be found in other drugs, such as cocaine, due to accidental cross contamination. We also know that nitazenes have been involved in some drug overdoses and deaths in the UK and Ireland.

Drugs Wheel Category

Opioids

Legality

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ACMD has made a recommendation, which was last updated in December 2023 for 14 Nitazenes to be reclassified as Class A drugs under the Misuse of Drugs Act 1971.

How it’s taken

Nitazenes are currently being found in powders (brown/yellow/white), contaminated heroin and pills/tablets such as Diazepam (a benzodiazepine) and liquids, including nasal sprays, and as such people are taking them in different ways depending on what they believed they had purchased. If they had intended to take heroin, they are heating it for smoking/inhaling or injection. In Scotland, it is commonly injected but injecting is almost always the riskiest way of taking drugs and is strongly discouraged.

Be aware that when injecting, a smaller dose is required to achieve the intended effect than when smoking.

However, for those individuals whose purchase intent is benzodiazepines and are getting nitazenes then they may be swallowing the pills.

Dose

The amount of nitazene type drugs found in tablets, pills and powders varies so it would be almost impossible to judge an accurate dose. Nitazenes can vary in potency. Some are thought to be over 600 times more potent than heroin meaning that a fatal dose could be as small as two grains of sand.

General information on dosing.

Effects

The effects are similar to other opioid drugs such as morphine and heroin but the effects will be felt more strongly from much smaller amounts.

They can cause feelings of euphoria and relaxation. However, it is a downer drug and people may feel calm, relaxed, safe and warm. It can also cause constipation, nausea and vomiting.

Risks

In high doses heroin can cause respiratory depression (slowed/ shallow breathing and reduced heart rate) and death. As previously stated, Nitazenes can vary in potency. Some are thought to be over 600 times more potent than heroin meaning that a fatal dose could be as small as two grains of sand so carry naloxone (we would advise 2 kits).

Harm reduction

If you choose to take Nitazenes then the following steps can help to reduce harm.

Test your drugs – this allows you to be more aware of unexpected contents. Visit www.crew.scot/how-do-i-test-my-drugs for more information on how you can test your drugs
Remember that contents can vary even with in the same batch
Start with a test dose
Familiarise yourself with the signs of an opioid overdose so that you feel confident about what to do to help.
Overdoses involving nitazenes can be reversed using the life-saving medicine naloxone hydrochloride
You may need to administer multiple doses of naloxone before the overdose will be reversed
Doses should be administered one at a time, waiting 2-3 minutes between each dose
Prenoxad (intramuscular) and Nyxoid (intranasal) are two medical products containing naloxone hydrochloride
In Scotland the provision of naloxone is FREE and anyone 16 or over can grab a naloxone kit from the Crew Drop-in or visit www.crew.scot/what-we-do/get-naloxone