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. 2021 Sep-Oct;15(5):429-431.
doi: 10.1097/ADM.0000000000000775.

Emerging Characteristics of Isotonitazene-Involved Overdose Deaths: A Case-Control Study

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Emerging Characteristics of Isotonitazene-Involved Overdose Deaths: A Case-Control Study

Chelsea L Shover et al. J Addict Med. 2021 Sep-Oct.

Abstract

Objectives: Case reports of fatal overdoses involving the novel synthetic opioid isotonitazene have prompted the U.S. Drug Enforcement Administration to consider an emergency scheduling of the drug in June 2020. We aimed to epidemiologically characterize deaths involving isotonitazene.

Methods: We conducted a case control study using publicly available mortality records from January 1, 2020 to July 31, 2020 in Cook County, IL and Milwaukee County, WI. Cases (all deaths involving isotonitazene) and controls (all deaths involving other synthetic opioids) were compared on demographic characteristics, number of substances involved in fatal overdose, and co-involvement of other substances.

Results: We identified 40 fatal overdoses involving isotonitazene and 981 fatal overdoses involving other synthetic opioids. Isotonitazene deaths involved a significantly greater number of substances, and were significantly more likely to involve the designer benzodiazepine flualprazolam.

Discussion: Isotonitazene was involved in a substantial minority of synthetic opioid overdose deaths in the first 7 months of 2020. Future studies characterizing its prevalence in other markets are warranted. Emergence of highly potent novel synthetic opioids underscore the need for comprehensive health services for people with opioid use disorder.

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Conflict of interest statement

The authors report no conflicts of interest.

References

    1. Centers for Disease Control and Prevention. Products - Vital Statistics Rapid Release - Provisional Drug Overdose Data. https://data.cdc.gov/NCHS/VSRR-Provisional-Drug-Overdose-Death-Counts/xk....AccessedSeptember 19, 2020.
    1. Wilson N, Kariisa M, Seth P, Smith Ht, Davis NL. Drug and Opioid-Involved Overdose Deaths - United States, 2017–2018. MMWR Morb Mortal Wkly Rep 2020;69:290–297. - PMC - PubMed
    1. Blanckaert P, Cannaert A, Van Uytfanghe K, et al. Report on a novel emerging class of highly potent benzimidazole NPS opioids: Chemical and in vitro functional characterization of isotonitazene. Drug Test Anal 2020;12:422–430. - PubMed
    1. European Monitoring Centre for Drugs and Drug Addiction. EMCDDA technical report on the new psychoactive substance N,N- diethyl-2-[[4-(1-methylethoxy)phenyl]methyl]-5-nitro-1H- benzimidazole-1-ethanamine (isotonitazene). In: Luxembourg: Publications Office of the European Union, 2020a.
    1. European Monitoring Centre for Drugs and Drug Addiction. European Drug Report: Trends and Developments. In: Luxembourg: Publications Office of the European Union, 2020b.

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