A novel synthetic opioid with purported potency greater than fentanyl has emerged in the United States and is linked to a growing number of overdose deaths across at least five states.
This drug – called N-pyrrolidino etonitazene (also referred to as etonitazepyne) by forensic scientists – is the latest synthetic drug to emerge in the midst of the opioid epidemic and COVID-19 pandemic. The Center for Forensic Science Research & Education (CFSRE) is issuing a Public Alert from its NPS Discovery program to warn scientists, medical professional, and the public, among others, about the dangers associated with this new highly potent synthetic opioid.
Dr. Barry Logan, Executive Director at the CFSRE, touted his laboratory's work with synthetic drugs and its growing collaborations with medical examiner and coroner offices across the United States. "The discovery of newly emerging drugs is a complex arena that requires sophisticated science and thinking outside the box. Under grant funding from the National Institute of Justice, we are proud to work with the medicolegal death investigation community to assess these new drugs before routine forensic testing is available, and to share our information rapidly," said Logan.
Based in Willow Grove, PA, the CFSRE is a non-profit organization that operates a state-of-the-art laboratory with a mission to advance forensic science testing and knowledge. In 2018, the CFSRE launched a program called "NPS Discovery" as a response to the increased emergence and proliferation of deadly new synthetic drugs, especially those associated with increasing overdose and mortality rates within the opioid epidemic. NPS Discovery has grown to become the world's premier open access drug early warning system for timely information sharing among public health and public safety stakeholders. Our primary aim is to monitor the appearance of new illicit synthetic drugs in the United States and warn public health and safety agencies early on about our findings.
"The current drug landscape in the United States is unstable and unpredictable – especially the opioid market – which can ultimately lead to deadly outcomes," said Dr. Alex Krotulski, an Associate Director at the CFSRE and Program Manager for NPS Discovery. "The purpose of this Public Alert is to raise awareness about a new and already deadly synthetic opioid so that way people who use drugs are able to modify use patterns and so that laboratories know to test for this new drug in their states or jurisdictions. Our program is designed to be an early warning for these types of situations, and we take this responsibility very seriously as we interact with government, public, and private partners," said Krotulski.
Synthetic opioids are often accompanied with unknown potency and adverse effects or health risks. In the United States, an alarming increase in the number of deaths linked to synthetic opioid use has been reported, although it can be difficult for laboratories and scientists to predict what new drug(s) may be around the corner. N-Pyrrolidino etonitazene is a new high potency synthetic opioid which began appearing in the United States drug supply within the last month. This new opioid is dissimilar from fentanyl; however, preliminary data suggest it is ~20 times more potent than fentanyl. This increased potency means the drugs could present a high overdose risk for people using opioid drugs, and especially a high risk for those who use the drug unsuspectedly. N-Pyrrolidino etonitazene was first reported by our NPS Discovery program in May 2021 and since has already appeared in eight fatalities across five states (West Virginia, Pennsylvania, New York, Florida, and Colorado). Due to its potential to cause widespread harm, we are notifying public health and safety, law enforcement, first responders, clinicians, medical examiners and coroners, forensic and clinical laboratory personnel.
For more information, visit: https://www.cfsre.org/
