BOULDER, Colo. — Just as the Boulder County Coroner's Office said they've seen a decrease in fentanyl deaths over the past year, they're now seeing the emergence of a class of synthetic opioids called nitazene.
There have already been two nitazene-related deaths in Boulder, according to the coroner.
Dr. Jeremy Dubin, chief medical officer at Front Range Clinic, said nitazenes can be 40 to 500 times more potent than fentanyl and morphine.
"We knew this was coming. So those that are in the treatment circles, this is the next drug on top of fentanyl for folks that are seeking opioids that is being sliced into our community’s drug scene," he said. "To the person that’s out there experimenting, to the regular user, or even to the tolerant individual who’s suffering from addiction, you might not have a second chance with this drug."
Besides being found in opioids like heroin, oxycodone and fentanyl, nitazenes are being detected in stimulants such as cocaine, methamphetamines and counterfeit benzodiazepines, sedatives and ketamine, Dubin said.
He said nitazenes were first created in the 1950s but were never accepted by the U.S. Food and Drug Administration (FDA) for any medical or veterinary use.
"It’s been very difficult to measure them, to detect them in the blood, and we’re still trying to get on top of that," Dubin said. "We don’t know how long these last in the blood. We don’t know how long this lasts in the urine."
He said nitazenes also don't show up on test strips, so users cannot detect it themselves. With the emergence of these substances in Colorado, it's more crucial than ever to carry the overdose antidote, Narcan or naloxone, Dubin said.
"However, we don’t know how much naloxone that person might need. So it’s important when someone ... gets this antidote, they’re on their way to the hospital," he said. "They might need more than one. They might need two, three, and ventilatory support in the hospital."
He said nitazenes can be yellow, brown, gray or off-white powders. They are most often sold as heroin or fentanyl and can be smoked/inhaled, as well as used nasally or vaporized. Street names include hearse, atco and "show and tell."
Dubin said nitazenes first emerged in 2019 on the East Coast. Since then, they've been found in the Midwest, the South and now here in Colorado.
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