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In the fight to save people from addiction, we try to prevent drug abuse among adolescents, build rehab centers to bring people back to life, and do our best to get illegal, harmful and deadly substances off the market.

Taking these illegal substances off the market can become an international whack-a-mole game. Why? Because new and temporarily legal drugs often appear as soon as legal drugs have been banned beforehand. All too often, while we are trying to displace a substance from our drug supply, substitute drugs appear that are still legal.

In the most recent manifestation of this phenomenon, when America led China to ban the manufacture or sale of all types of fentanyl, a new type of opioid appeared in American medicines: isotonitazene.

What kind of drug is isotonitazen?

The World Health Organization states that isotonitazene is an opioid that is 500 times more potent than morphine. This easily equates the risk of abuse of isotonitazene with the risk of consuming drugs of the fentanyl family.

It’s usually found as a yellow, brown, or off-white powder. It’s a synthetic drug, which means it’s made in a laboratory and doesn’t rely on opium poppies or other plants to make it. As a light powder, it is easily added to heroin supplies. It can also be made into pill forms by drug traffickers, mimicking OxyContin or Dilaudid.

In 2020, the European Monitoring Center for Drugs and Drug Addiction (EMCDDA) reported that this drug was being sold online by a Chinese supplier. The product appeared as a powder, nasal spray, or pre-made fake pills. It was also found in Germany in liquid form.

It was developed as a pain reliever in 1957. Because of its addictive nature and its ability to fatally suppress breathing, it has not been approved as a pain reliever in either Europe or America.

If you need help with recovering from isotonitazene, you can learn more in this article.

Not illegal yet

Emergency room hospital

But isotonitazene had not yet been included in lists of prohibited drugs either. Initial reports that this drug was found in illegal drug shipments surfaced in late 2019.

In America, isotonitazen was added to an emergency list of controlled substances by the Drug Enforcement Administration (DEA) on August 20, 2020. As of September, isotonitazen was involved in 19 deaths in the United States.

In May 2020, the EMCDDA issued a risk assessment report that set the ball rolling for this drug on the lists of banned drugs in the European Union. The EMCDDA stated that “Isotonitazene can pose a health or social risk in the EU [European Union] Level.” As of the publication of this report, there have been five deaths from this drug in Germany, the UK and Canada.

By September 2020, the European Commission announced that it would ban the manufacture and sale of isotonitazene.

Why should isotonitazene be popular with drug traffickers?

A drug that is high, addictive, and not on a banned drug list is for a chemist involved in making illegal drugs, like catnip. This drug can be temporarily sold as a “legal high” to anyone who is concerned about being arrested with the drug.

As long as it takes legislative and law enforcement agencies to classify the drug as a banned substance, there are no significant penalties for making, transporting, selling, or owning it.

What it takes to get drugs off the market

Legislators and government agencies around the world are constantly catching up with new drugs. They try to identify new illegal substances as soon as possible and pass laws that make it illegal to possess or sell this drug.

Once such legislation is passed in the US, it will be up to the Drug Enforcement Administration or state and local authorities to seize the drug found and prosecute the traffickers and dealers.

However, this is a tedious and lengthy process in both the US and the EU.

Multiple levels of law make drug enforcement difficult

Quote DEA Executive
Photo by Artem Avetisyan / Shutterstock.com

In general, these efforts to get drugs off the market and out of the hands of the public are considered. designated Drug enforcement. At the federal level, these measures are led by the DEA. As mentioned above, the DEA has the power to temporarily list a drug as a controlled substance by emergency order. This gives federal law enforcement agencies the ability to seize the drug and prosecute manufacturers and sellers.

However, until state laws are caught up, state and local law enforcement officers may not have equal powers. It’s a tricky, multi-faceted problem that puts human lives at risk until all levels of drug control are on the same side.

The DEA put this drug on List 1, which means it has the potential for abuse and has no approved medical use.

As of this writing, federal law banning this drug has been introduced (but not passed), and the state of Ohio has added isotonitazen to its controlled substances list.

Who is at risk?

Basically everyone who abuses illegal drugs or is dependent on them is at risk. Here’s why:

  • It was found mixed with cocaine in Illinois and Indiana;
  • As mentioned above, it is shipped from China pre-packaged with prescription opioids so anyone who abuses pills is at risk.
  • In Germany it was found in a sample of a synthetic cannabinoid;
  • In Latvia it was found in combination with fentanyl;
  • In Wisconsin, police confiscated a bag of isotonitazene mixed with heroin and an illegal benzodiazepine.

Because it’s in so many different supplies, it’s a very difficult drug to avoid.

Why do we see isotonitazene on the market now?

Possibly due to the Chinese government’s 2019 ban on the manufacture of all fentanyl family drugs mentioned at the beginning of this article, Isotonitazen is now being marketed. Before this ban, dozens of forms of fentanyl could be legally manufactured in China. You could then be taken out of the country with false documents.

In reporting the ban, National Public Radio stated that the change was resulting “A significant reduction in the country’s illicit fentanyl trade.”

Drug traffickers want to maintain the same level of sales, so by this point they may have been searching the drug research and development records for a drug that was never approved for sale but was never banned from production. By changing their manufacturing processes to this new drug, they could keep sales going in a more or less legal manner.

This process has occurred hundreds of times. The EMCDDA found that between 2008 and 2020 more than eight hundred New psychoactive substances have appeared on the illegal market. Most of these drugs were designed or made to sell legal highs – at least for a while – until lawmakers and law enforcement agencies could catch up.


Reviewed by Claire Pinell, ICAADC, CCS, LADC, RAS, MCAP, LCDC-I

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