Nitazenes, opioids far stronger than fentanyl, spread across the US
Nitazenes, a class of synthetic opioids first developed in the 1950s and never approved for medical use, are spreading quickly through the US drug supply, STAT reported on June 18 . Some are many times more potent than fentanyl, and they are frequently mixed into other drugs, raising overdose risk for users who do not know they are taking them.
CDC data show confirmed nitazene-related overdose deaths climbing from 27 in 2020 to 409 in 2024, with more than 1,100 confirmed through the agency’s surveillance system and the true toll likely higher. Lab detections rose from 43 positive tests in 2019 to roughly 2,000 in 2024, and seizures have now been reported in 48 of 50 states. Ohio alone accounts for more than a third of positive laboratory reports.
Enforcement is tightening — China placed most nitazenes under national control in July 2025, and the US has scheduled dozens as illegal substances — but manufacturers are adapting. They have begun marketing chemically similar compounds called “orphines” that fall outside the new controls, with more than 150 cases reported in 2024 and 2025. The pattern mirrors the earlier fentanyl wave: each time regulators schedule one molecule, suppliers pivot to a structurally distinct analogue, leaving detection and policy a step behind.