ANEW CULPRIT has surfaced in America's seemingly endless game of opioid Whac-A-Mole: the research chemical isotonitazene. The drug, which has no approved clinical uses, began appearing in autopsy reports in the U.S. within the last year, likely as a result of efforts to curtail the importation of illicit fentanyl.
"Isotonitazene is the most persistent and prevalent new opioid in the U.S.," forensic toxicologist Barry K. Logan told Vice in March. Logan is now reportedly seeing "40 to 50 isotonitazene-related deaths per month in the U.S. compared to about six per month last summer."
In the November 2019 issue of Drug Testing and Analysis, Peter Blanckaert and his team at the Belgian Early Warning System on Drugs identified isotonitazene as a highly potent analog of a pain reliever called etonitazene, which was developed in the 1950s. Etonitazene is currently in Schedule I of the Controlled Substances Act, a category that is legally reserved for dangerous drugs with a high abuse potential and no accepted medical use. Isotonitazene is nevertheless sold online in undiluted form. Blanckaert et al. wrote that the drug "represents an imminent danger" to users.
Isotonitazene seems to have arrived in the United States following an aggressive global crackdown on illicitly made fentanyl. The timing makes sense: When governments focus their supply Interdiction efforts on...