Responding to reports of nitazene toxicity in Australia
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Responding to reports of nitazene toxicity in Australia N itazenes are a class of synthetic 2-benyzlbenzimidazole opioid receptor agonists that can be several hundred times the potency of morphine.1 Clonitazene and etonitazene were initially developed in the 1950s as potential analgesics, but were never approved for therapeutic purposes due to their high potency. 1 Isotonitazene was first notified as a drug of concern to the United Nations Office on Drugs and Crime (UNODC) in 2019.By the beginning of 2024, 13 different nitazene analogues across six global regions had been reported, highlighting the potential for continued proliferation of chemically modified structures into the drug market.2 Nitazeneassociated harms and deaths have been reported in North America and Europe, with toxicity symptoms being similar to those from other opioids, including respiratory depression and decreased level of consciousness.
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Nitazene-associated overdoses and fatalities are increasingly reported across North America and Europe, reflecting the growing presence of these substances in illicit drug markets.
“Nitazene-associated overdoses and fatalities are increasingly reported across North America and Europe, reflecting the growing presence of these substances in illicit drug markets [34].”
From Novel 2-Benzylbenzimidazole Opioids: Emerging Drugs of Abuse and Pharmacological Considerations with Nitazene Analogs (2026) · cites this paper as [34]
The opening section (page unavailable) reports nitazene-associated harms and deaths in North America and Europe, and describes the potential for nitazenes to proliferate into drug markets. It does not say that overdose and fatality reports are increasing in those regions, so the claimed trend is not supported. (LLM, conf=0.84)
Experimental — accuracy not yet measuredClinical manifestations of nitazene toxicity are similar to those of other opioids and consist of respiratory depression, hypoventilation, and decreased levels of arousal.
“Clinical manifestations of nitazene toxicity are similar to those of other opioids and these symptoms consist of respiratory depression, hypoventilation, and decreased levels of arousal [29, 34].”
From Novel 2-Benzylbenzimidazole Opioids: Emerging Drugs of Abuse and Pharmacological Considerations with Nitazene Analogs (2026) · cites this paper as [34]
The rise of nitazenes within illicit drug markets has introduced a new generation of highly potent synthetic opioids associated with significant toxicologic and public health concerns.
“The rise of nitazenes within illicit drug markets has introduced a new generation of highly potent synthetic opioids associated with significant toxicologic and public health concerns [34].”
From Novel 2-Benzylbenzimidazole Opioids: Emerging Drugs of Abuse and Pharmacological Considerations with Nitazene Analogs (2026) · cites this paper as [34]
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Cites
Global patterns of opioid use and dependence: harms to populations, interventions, and future action
Degenhardt, L. J., Grebely, J., Stone, J., Hickman, M., Vickerman, P. T., Marshall, B. D. L., Bruneau, J., Altice, F. L., Henderson, G., Rahimi‐Movaghar, A., et al. (2019) · The Lancet · doi:10.1016/s0140-6736(19)32229-9 · Cited by 853 · see citing works
Drug checking services for people who use drugs: a systematic review
Maghsoudi, N., Tanguay, J., Scarfone, K., Rammohan, I., Ziegler, C., Werb, D., & Scheim, A. I. (2022) · Addiction · doi:10.1111/add.15734 · Cited by 261 · see citing works
Trust and people who inject drugs: The perspectives of clients and staff of Needle Syringe Programs
Treloar, C., Rance, J., Yates, K., & Mao, L. (2015) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2015.08.018 · Cited by 118 · see citing works
Montanari, E., Madeo, G., Pichini, S., Busardò, F. P., & Carlier, J. (2022) · Therapeutic Drug Monitoring · doi:10.1097/ftd.0000000000000970 · Cited by 89 · see citing works
Naloxone Use in Novel Potent Opioid and Fentanyl Overdoses in Emergency Department Patients
Amaducci, A., Aldy, K., Campleman, S. L., Li, S., Meyn, A., Abston, S., Culbreth, R. E., Krotulski, A., Logan, B., Wax, P., et al. (2023) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.31264 · Cited by 84 · see citing works
Bade, R., Eaglesham, G. K., Shimko, K. M., & Mueller, J. F. (2022) · Talanta · doi:10.1016/j.talanta.2022.123767 · Cited by 63 · see citing works
Schumann, J. L., Syrjanen, R., Alford, K., Mashetty, S., Castle, J. W., Rotella, J., Maplesden, J., & Greene, S. L. (2023) · Journal of Analytical Toxicology · doi:10.1093/jat/bkac062 · Cited by 61 · see citing works
Nitazene test strips: a laboratory evaluation
De Vrieze, L. M., Stove, C. P., & Vandeputte, M. M. (2024) · Harm Reduction Journal · doi:10.1186/s12954-024-01078-8 · Cited by 34 · see citing works
Volpe, I., Brien, R., Grigg, J., Tzanetis, S., Crawford, S., Lyons, T., Lee, N., McKinnon, G., Hughes, C., Eade, A., et al. (2023) · Harm Reduction Journal · doi:10.1186/s12954-022-00716-3 · Cited by 29 · see citing works
Isoardi, K. Z., Alfred, S., Weber, C., Harris, K., Soderstrom, J., Syrjanen, R., Thompson, A., Schumann, J., Stockham, P., Sakrajda, P., et al. (2026) · Drug and Alcohol Review · doi:10.1111/dar.13998 · Cited by 26 · see citing works
Acute metonitazene poisoning reversed by naloxone
White, A. J., Seah, V., Brown, J. A., McDonald, C., Tran, J., & Roberts, D. M. (2023) · Clinical Toxicology · doi:10.1080/15563650.2022.2164505 · Cited by 13 · see citing works
Emergence of deaths due to nitazene toxicity in <scp>Australia</scp>
Darke, S., Duflou, J., Farrell, M., Lappin, J., & Peacock, A. (2024) · Drug and Alcohol Review · doi:10.1111/dar.13920 · Cited by 12 · see citing works
Self-citationCorrelates of stocking naloxone: a cross-sectional survey of community pharmacists
Laing, R., Xia, T., Grist, E., Dostal, J., Nielsen, S., & Picco, L. (2024) · International Journal of Clinical Pharmacy · doi:10.1007/s11096-024-01773-3 · Cited by 8 · see citing works
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Research works printed but not linked: 1
- [10]Man N, Sadaphale V, Barratt M, et al. Availability of nitazenes for purchase in Australia and internationally via cryptomarkets. Sydney: National Drug and Alcohol Research Centre, UNSW Sydney, 2024 (Drug Trends Bulletin Series).
Cited by
Sorted by citations
Vandeputte, M. M., & Stove, C. P. (2025) · Neuropharmacology · doi:10.1016/j.neuropharm.2025.110470 · Cited by 35 · see citing works
Clinical Experiences With the Nitazene Class of Synthetic Opioids: A Cohort Study
Roberts, D. M., Tisdell, B., Sajeev, M. F., Jiranantakan, T., Harvey, C., & Brown, J. A. (2025) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2025.06.619 · Cited by 20 · see citing works
Smith, J. L., Weber, C. C., Schumann, J., Ezard, N., Fatovich, D. M., McCutcheon, D., Isoardi, K., Dawson, A. H., Syrjanen, R., Harris, K., et al. (2025) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2025.104969 · Cited by 9 · see citing works
Self-citationSiefried, K. J., Hill, P., Clifford, B., Brown, J. A., Camilleri, A., Crawford, S., Dessauer, P., Dilkes‐Frayne, E., Freestone, J., Gobeil, J., et al. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1521911 · Cited by 7 · see citing works
Self-citationFreestone, J., Siefried, K. J., Peacock, A., Fletcher, K., Barratt, M. J., Sutherland, R., Ezard, N., Doumany, J., MacDonald, H., Kypri, S., et al. (2025) · International Journal of Drug Policy · doi:10.1016/j.drugpo.2025.104946 · Cited by 6 · see citing works
Self-citationEtonitazepyne in counterfeit oxycodone tablets—a fatal case report
Midttun, L., Skarshaug, L. J., Krabseth, H., Gundersen, P. O. M., Hansen, M., Brekke, M., & Frost, J. (2025) · Journal of Analytical Toxicology · doi:10.1093/jat/bkaf065 · Cited by 5 · see citing works
The Nitazene Era: A Critical Turning Point in the Synthetic Opioid Crisis Beyond Fentanyl
Dow, L. F., Abisogun, A. A., Berida, T. I., Krishnan, S. C., Rathnayake, U., & Lindsley, C. W. (2026) · Journal of Medicinal Chemistry · doi:10.1021/acs.jmedchem.6c00696 · Cited by 2 · see citing works
Availability of nitazenes via cryptomarkets and surface web shops: An observational study
Man, N. W. Y., Barratt, M. J., Sutherland, R., Bruno, R., Graham, C., Sadaphale, V., & Peacock, A. (2026) · Addiction · doi:10.1111/add.70350 · Cited by 1 · see citing works
Self-citationMaxwell, M. K., Anwar, A. I., Hasoon, J., & Kaye, A. D. (2026) · Current Pain and Headache Reports · doi:10.1007/s11916-026-01525-0
“Clinical manifestations of nitazene toxicity are similar to those of other opioids and these symptoms consist of respiratory depression, hypoventilation, and decreased levels of arousal [29, 34].”
Nursing Preparedness for Emerging Drugs of Concern
Clifford, B., & Searby, A. (2025) · International Journal of Addiction Nursing · doi:10.1097/jan.0000000000000668
Self-citationMartin, J. A., & Schumann, J. (2026) · Drug and Alcohol Review · doi:10.1111/dar.70081
Sajeev, M. F., Roberts, D. M., Wright, N. E., & Brown, J. A. (2026) · Clinical Toxicology · doi:10.1080/15563650.2025.2604852
Drug Use and Dependence: The Role of Community Pharmacy
Nielsen, S., & Ponton, R. (2026) · Elsevier eBooks · doi:10.1016/b978-0-443-26472-6.00013-9
Analytically Confirmed Opioid Detections From the Emerging Drugs Network of Australia
Soderstrom, J., Weber, C., Greene, S. L., Isoardi, K., Alfred, S., Tran, V., Stockham, P., Schumann, J., Thompson, A., Fatovich, D. M., et al. (2026) · Emergency Medicine Australasia · doi:10.1111/1742-6723.70284
Miskulin, A., Shkolnikov, I., Sboto, J. N. S., Kielty, C., Wallace, B. B., Gill, C. G., & Hore, D. K. (2026) · Drug Testing and Analysis · doi:10.1002/dta.70135
Diagnosis and Management of Nitazene Dependence in Sydney, Australia: A Case Series
Dutkiewicz, D., Wilson, H. H., Chisholm, P., Jiranantakan, T., Harvey, C. A., Fatema, K., & Hardy, M. A. (2026) · Drug and Alcohol Review · doi:10.1111/dar.70277
- Authors
- Clifford, B., Peacock, A., Siefried, K. J., Gobeil, J., Smith, J. L., & Ezard, N.
- Affiliations
- UNSW Sydney (AU)
- Australian Injecting and Illicit Drug Users League Canberra ACT
- The University of Western Australia (AU)
- Corresponding author
- Clifford, Brendan
- Venue
- Medical Journal of Australia
- Publisher
- Wiley
- Published
- 2025-02-12
- Volume
- 222
- Issue
- 5
- Pages
- 216-219
- ISSN
- 0025-729X (ISSN-L)
- 1326-5377
- PMC
- PMC11910947
- OpenAlex
- W4407555863
- Cited by
- 16
- References
- 13
- Citations by year
- 2026: 9 · 2025: 7
- FWCI
- 8.16
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The Medical Journal of Australia (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- UWA Profiles and Research Repository (UWA) (submittedVersion, cc-by)
- Funders
- Australian Government
- University of New South Wales
- Department of Health and Aged Care, Australian Government
- Seqirus
- Medical Research Council
- National Health and Medical Research Council (2001107, 1174630)
- National Drug and Alcohol Research Centre
- Topics
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Emergency Medicine › Poisoning and overdose treatments
- Keywords
- nitazenes, etonitazene, isotonitazene, synthetic opioids, opioid agonists, drug toxicity, respiratory depression, illicit drug markets, harm reduction
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