The identification of the “nitazenes” in D.C., first reported by WTOP, comes as the District is reckoning with an opioid crisis that has never been worse. Centers for Disease Control and Prevention data released this month show that the District saw an estimated 498 fatal overdoses over 12 months during the coronavirus pandemic — an extraordinary figure that eclipses the city’s notably high homicide toll and is larger than the number of drug deaths in 13 states.
As yet, there is no indication that the new drugs are widespread, and fentanyl remains the primary threat to opioid users in D.C. But their discovery is an ominous development because the drugs could be less vulnerable to some of the primary tools used to prevent overdoses, according to Alexandra Evans, a chemist at the D.C. public health lab.
It is unknown whether fentanyl testing strips — which alert users to the possibly higher potency of their drugs — pick up the presence of the nitazene family of substances. And more of the overdose antidote naloxone, commonly known as Narcan, may be needed to revive someone who has used the new drugs.
“For us, it is concerning,” Evans said. “Naloxone should work, but because of the potency additional doses might be required.”
Alex Krotulski, associate director at the Center for Forensic Science Research and Education in Willow Grove, Pa., said protonitazene is three or four times more powerful than fentanyl — whose extreme potency has helped drive record-breaking overdose deaths in the United States — and isotonitazene is about 10 times more powerful. Krotulski, who has studied the nitazene substances closely in conjunction with forensic labs across the country, said they have been identified in the Midwest, South and Southwest, as well as on the Eastern Seaboard.
“The majority of them that we see are more potent than fentanyl — sometimes way more potent than fentanyl — which is really scary,” Krotulski said.
He said there are no signs that the drugs are on the verge of displacing fentanyl, which is a primary commodity in the international drug trade. But he said the nitazenes’ emergence is a reminder that even if the flow of fentanyl into the country is stanched, other opioids could take its place.
Fatal overdoses have soared across the country, driven by the omnipresence of fentanyl and exacerbated by the stressors of the pandemic, including shutdowns that affected many people’s jobs and isolated drug users from support systems.
The drug epidemic has similarly ravaged the District, Maryland and Virginia. Federal grant money has poured into D.C. to help combat the problem, and Mayor Muriel E. Bowser (D) several years ago laid out a plan for reducing overdose deaths.
But in a city where most of the victims are older Black men in impoverished neighborhoods on the east side, the problem is still not getting the attention it warrants, said D.C. Council member Charles Allen (D-Ward 6).
“The numbers should be staggering to the city,” Allen said. “And it still feels invisible to so many people.”