New Synthetic Opioid "ISO" Emerges as Deadly Threat

A new synthetic opioid known as isotonitazene, or "ISO," is raising alarm among law enforcement and health officials across the United States. This potent drug, which is 20 to 100 times stronger than fentanyl, has been linked to numerous overdose deaths and is rapidly spreading through illicit drug markets.

ISO belongs to a class of drugs called nitazenes, originally developed by Swiss researchers in 1957 as potential pain medications. However, they were deemed too potent and addictive for medical use. The drug resurfaced in 2019 when it began appearing in toxicology reports of overdose victims. Key features of ISO include:

• Typically found as a white or off-white powder
• Often mixed with other drugs or pressed into counterfeit pills
• Can be ingested, snorted, smoked, or absorbed through the skin

Initially identified in the Midwest in 2019, ISO has since spread to Southern states and along the Eastern seaboard6. It has been detected in multiple Florida counties since 2020, with two deaths linked to the drug in Pasco County in 20211. More recently, ISO has been found in West Palm Beach, Philadelphia, and even San Francisco.

The emergence of ISO poses significant risks:

1. Extreme potency: ISO is approximately 500 times stronger than morphine and at least 20 times more potent than fentanyl.
2. Overdose risk: Due to its potency, ISO carries a high risk of overdose, especially when users are unaware of its presence in other drugs.
3. Resistance to Narcan: Multiple doses of naloxone may be required to reverse an ISO overdose, unlike with other opioids.
4. Lack of medical approval: ISO was never approved for medical use, potentially carrying unknown dangers even for short-term use.

Authorities are working to raise awareness about ISO and combat its spread:

• The DEA Washington Division has issued warnings about the drug's presence in the D.C. metropolitan area.
• Florida Attorney General Ashley Moody has alerted the public about ISO's dangers.
• Law enforcement agencies are increasing efforts to detect and seize ISO in drug busts.
• Health officials are calling for enhanced monitoring and testing capabilities to track ISO's prevalence in overdose cases.

As the opioid crisis continues to evolve, the emergence of ISO represents a new and dangerous chapter. Public health experts stress the importance of education, prevention, and access to addiction treatment services to combat this latest threat in the ongoing battle against drug abuse and overdose deaths