Synthetic drugs stronger than fentanyl are coming to Denver

This is the third in a series of stories about fentanyl and overdoses in Colorado. Click to read Part One, “Fentanyl and Other Drugs Killing Most Coloradans,” and Part Two, “Why Denver Heroin Users Are Switching to Fentanyl.”

A bipartisan group of lawmakers is crafting bills to tackle the fentanyl crisis in Denver and Colorado even as the tragedies continue to pile up; the latest involves three suspected fentanyl-related deaths in a motel room in Cortez. However, most reports suggest lawmakers are more focused on tougher penalties than on public health.

Lisa Raville, executive director of the Harm Reduction Action Center, whose mission is “to educate, empower, and advocate for the health and dignity of Denver’s injection drug users,” hopes that’s not the case. for various reasons. She sees crackdowns like this epitomized by a Denver Police Department sweep of Union Station last month as emblematic of policies that have repeatedly failed. And such legislation could also be rendered ineffective or obsolete by the continued influx of newer and more potent synthetic opioids, including protonitazene, abbreviated to nitazene, which began appearing on the East Coast a year or two ago. and appears to be heading west in the same way fentanyl has taken over Colorado.

“We told people, ‘Look, these new synthetic drugs are going to come here, they’re definitely coming here,'” Raville notes. “So far there’s been a lot of ‘I don’t know. I doubt it.’ But of course they come here.”

“New synthetic opioid protonitazene rises in prevalence as ‘nitazenes’ gain traction in the United States and Canada,” published in December by the Pennsylvania-based Center for Forensic Science Research & Education, offers an introduction to the substance. . Its abstract describes protonitazene as “a potent new synthetic opioid” that is structurally “different from synthetic opioids commonly encountered in medical-legal records (e.g., fentanyl, heroin)” but is “approximately three times stronger potent than fentanyl”. The first case was reported to NPS Discovery, an open-access drug early warning system, last May, with between nine and fifteen more examples appearing before the end of 2021.

The Washington/Baltimore High-Intensity Drug Trafficking Zone is also issuing an alert about protonitazene, whose November warning mentions a WTOP News article that month about a chemist in Washington, D.C., identifying a sample during a used syringe testing program.

A concern with various members of the nitazene family, including substances such as butonitazene, etodesnitazene, flunitazene, metonitazene, and metodesnitazene, is that they may be resistant to Narcan, which is widely used to reverse effects of overdoses.

Also on the Washington/Baltimore HIDTA radar is isotonitazene, which “activates mu-opioid receptors in the same way as fentanyl and hydromorphone.” Narcan appears to work on isotonitazene, HIDTA acknowledges, but three deaths involving the drug were reported in Europe last year, and there was at least one seizure of the drug in California.

Raville thinks Colorado lawmakers will get nowhere trying to play Whac-a-Mole with fentanyl and other synthetic opioids because new ones are popping up regularly.

“We’ve always had drugs, but in the United States we’ve never had a very good conversation about it,” she says. “The last fifty years of the War on Drugs have been racist and classist – then we had DARE and ‘Just Say No’. When I show people around the center, it takes a while to get them to a neutral place because there’s so much misinformation out there.”

She adds: “We want to be innovative in this time of overdose crisis because we know law enforcement will never stop fentanyl. That’s some of the rhetoric I’ve heard, but it’s is here, baby, and it’s been here for years.”

And other synthetic drugs are undoubtedly on the way.

Alvin J. Chase