Metonitazene is a highly potent, synthetic opioid belonging to the 2-benzylbenzimidazole class (often referred to as “nitazenes”). It is a dangerous, illicitly manufactured drug with no approved medical use that has been found to be 30 to 200 times more potent than morphine. It has been detected in white, brown, and yellow powders sold as other substances, such as heroin, cocaine, or ketamine. Department of Health, Victoria +3
This substance is extremely hazardous and can cause life-threatening respiratory depression (slowed or stopped breathing) even in very small amounts. Department of Health, Victoria
Key Dangers and Identification
- Potency: Metonitazene is highly potent, with some reports suggesting it is as strong as or stronger than fentanyl.
- Appearance: It is commonly sold as a white, off-white, or beige/yellow powder.
- Misrepresentation: It is frequently mis-sold as other illicit substances, including cocaine, ketamine, or illicitly produced benzodiazepines/oxycodone.
- Appearance in Drug Market: It was first detected in forensic seizures in July 2020 and has since proliferated in North American and European markets.
High Alert +4
Overdose Risks and Symptoms
Metonitazene acts rapidly, with fatalities linked to its use in several regions, including the U.S. and Australia. Department of Health, Victoria +1
- Overdose Symptoms: Similar to other potent opioids, symptoms include: Department of Health, Victoria +1
- Reduced consciousness (hard to wake or unresponsive)
- Slowed or irregular breathing
- Pinpoint (tiny) pupils
- Blue lips or fingertips
- Overdose Reversal: Naloxone (Narcan) is effective at reversing metonitazene overdoses, but multiple or higher doses may be required due to the extreme potency.
- Drug Combinations: Using metonitazene with other depressants like alcohol, GHB, or benzodiazepines significantly increases the risk of fatal overdose.
Legal Status
- United States: The DEA has classified metonitazene as a Schedule I controlled substance, meaning it has a high potential for abuse, no currently accepted medical use, and lacks safety for use under medical supervision. National Institutes of Health (.gov)
Safety Advice
- Assume Contamination: Do not use any powdered substance unless its source is confirmed.
- Carry Naloxone: It is recommended to carry naloxone (Narcan) if you or anyone around you uses illicit substances.
- Never Use Alone: Use with others who can call emergency services if an overdose occurs.
Disclaimer: Metonitazene is a dangerous illicit substance, and the above information is for harm reduction and safety purposes.
