Florida’s attorney general has issued an emergency order making it a felony for an individual to possess, sell, manufacture, or deliver eight drugs in the class called nitazenes.
The move by the state’s top law enforcement officer is a response to the increased appearance of these synthetic drugs, including one that is up 20 times deadlier than fentanyl.
Synthetic opioids, including fentanyl, cause 66 percent of annual overdose deaths nationwide, according to the Drug Enforcement Administration (DEA).
The drug family of opioids includes the prescription painkillers hydrocodone and oxycodone, and the illegal drug heroin.
There’s no approved medicinal use for nitazenes.
The nitazene increasingly seen as a killer of Americans across the country is called isotonitazene, commonly known as ISO. It first appeared in the country in 2019, according to a DEA fact sheet.
The drug is most often encountered by law enforcement officers in powder form. It’s so lethal that it puts anyone near it at risk.
While fentanyl can kill an adult if only two milligrams—less than the weight of a small mosquito—are consumed, ISO can be fatal if an even smaller amount comes in contact with skin or is inhaled.
Law enforcement agencies have been increasingly worried about potentially deadly encounters with ISO.
In Pasco County, Florida, officers carry an antidote they hope can reverse an overdose—they’re armed with enough for the overdosing person, plus an accidentally exposed responding officer and any K-9 partner, said Britney Morris, a spokeswoman for the Pasco County Sheriff’s Office.
When someone shows signs of overdose, deputies can administer Narcan, a reversal treatment designed for fentanyl, Morris said.
The problem is that ISO is such a new threat, authorities aren’t sure Narcan actually can reverse an overdose, she said.
Within minutes of an ISO overdose, the victim may show symptoms that include blue or purple fingernails or lips, difficulty breathing, unconsciousness, clammy skin, vomiting, drowsiness, and unusually small pupils, according to the sheriff’s office.
Helping a person showing signs of a drug overdose can put officers’ lives on the line.
“It’s a risk that deputies face every day out in the field,” Morris said. “Will I have to use Narcan today? And will this be ISO that Narcan may or may not be responsive to?”
Even if someone does not use recreational drugs, it’s important to be aware of ISO, its high potency, and the signs of an overdose, Morris said.
“It’s something that sometimes people don’t realize could be in the room with them … let’s say somebody has this in their pocket, you know, it’s something that you could be breathing in.”
In Pasco County, two deaths were blamed on ISO in 2021.
Nitazene overdoses have resulted in at least 15 deaths in Florida since 2020.
The drugs methamphetamine, cocaine, and ounterfeit pills increasingly have been laced with fentanyl. But now, authorities are finding them laced with deadlier ISO.
Users of illicit drugs often have no idea that a lethal synthetic opioid is mixed in, until it’s too late, Florida Attorney General Ashley Moody said in a news release.
Further north, there were at least 40 fatal overdoses involving ISO during a six-month period in 2020 in Cook County, Illinois, and Milwaukee County, Wisconsin, according to a 2021 report by the American Society of Addiction Medicine.
Unsafe for Humans
Law enforcement officers have encountered ISO primarily in powder form, according to a DEA fact sheet (PDF).
In April 2019, U.S. Customs and Border Protection seized 1.6 grams of ISO in California.
By August 2020, there had been 98 encounters with ISO in the United States, according to the National Forensic Laboratory Information System database. These encounters involved ISO alone or in combination with other substances.
Florida forensic labs began identifying nitazene cases in 2020, according to Moody’s office.
Since then, 268 cases have been identified in the state, with 13 cases in 2020, 171 cases in 2021, and 84 cases as of March 18, 2022.
Nitazenes were developed in the 1950s as a safer alternative to other opioids, such as morphine. After testing, they were declared to be unsafe for human consumption.
In the past few years, they have been “rediscovered” and popularized due to their decreased detectability in drug-monitoring programs, according to the website for Aegis Sciences Corp., a forensic toxicology and healthcare laboratory based in Nashville, Tennessee.
Moody’s emergency order (PDF) filed on April 26 makes eight nitazenes, including ISO, controlled substances in the state, in the hopes of curbing their spread.
The order makes it a felony for an individual to possess, sell, manufacture, or deliver any of the eight drugs.
Moody said she will work with state lawmakers during the 2023 legislative session to codify the nitazenes permanently as Schedule I controlled substances in Florida “to prevent future deaths.”
Fentanyl Surge Continues
“We must make sure they do not become more prevalent in our state,” Moody said, “or I am afraid we will see overdose deaths skyrocket.”
The DEA recently seized 1.8 million fentanyl-laced pills in a two-month nationwide sting.
Since the start of 2021, officials have seized more than 9.5 million counterfeit pills—an increase of almost 430 percent since 2019, Moody said.
That’s a 50-fold increase in just three years, she added.
Fake pills containing fentanyl are being manufactured to look identical to prescription opioid medications like Xanax, Vicodin, Percocet, and Oxycontin, Moody said.
About 4 in 10 fake pills tested by the DEA contain a potentially deadly dose of fentanyl.
Fentanyl is 50 times more potent than heroin.
Florida deaths caused by fentanyl increased by 80 percent last year, Moody said.
About 21 people in Florida die from opioid-related overdoses every day, according to the latest Florida Department of Law Enforcement Medical Examiners Report, Moody said.
Nationwide, opioids were blamed for 93,000 fatal drug overdoses in 2020. Fentanyl overdose now is the leading cause of death for Americans ages 18 to 45, according to the Florida Attorney General’s Office.
The growing opioid crisis in the United States “should concern everyone, especially President Biden, who continues to ignore federal immigration laws—paving the way for these dangerous drugs to flood into our country,” Moody said May 10 in a prepared statement issued on the first National Fentanyl Awareness Day.
“For years, we have been warning about the dangers of fentanyl and how just one pill laced with this synthetic opioid can kill,” Moody said.
Most fentanyl comes across the border with Mexico, according to a report from the Commission on Combating Synthetic Opioid Trafficking.
Since October, fentanyl seizures at the U.S. southwest border have surpassed the amount seized in the previous fiscal year, according to the latest data available from U.S. Customs and Border Protection (CBP),
CBP data also show that since Biden took office, enough fentanyl has been seized at the U.S. southwest border to kill every man, woman, and child in the United States seven times over, Moody says.
“Please be especially warned that if you take a pill from anyone other than your doctor, you may be risking your life,” Moody said. “Just one dose of fentanyl can kill, and with an increasing number of these counterfeit pills circulating throughout the country, the message is more important today than ever before.”
For more information on opioid abuse, log on to DoseOfRealityFL.com.