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Protonitazene and Next-Generation Synthetic Opioids

Jul 10, 2022

Synthetic opioids, including fentanyl, are becoming household names in the U.S. due to news coverage of arrests and overdoses. In the wake of their impact on people of all ages, the development of new synthetic opioids may go unnoticed. One of those new opioids synthesized in a laboratory is known as protonitazene, and it’s a next-generation drug worth learning about now.

Protonitazene is a next-generation opioid considered three times more potent than fentanyl. It’s been linked to overdose deaths in the U.S. and abroad, often due to respiratory depression. This chemically manufactured drug may be mixed with traditional opioids. Signs of an overdose on synthetic opioids include stupor, changes in pupillary size, cold and clammy skin, cyanosis, coma, and respiratory failure. Treatment for synthetic opioid abuse is strongly recommended. 

If you or a loved one need help, call our admissions team today at 561-841-1033.

What are Next-Generation Synthetic Opioids?

The idea behind a “next generation” of an opioid is to create something with the same potency for pain-killing without the same risk of addiction. Unfortunately, the manufacturing and distribution of unregulated synthetic opioids do not lower that risk. These next-generation opioids are typically created in labs overseas, then shipped to the U.S.

What Do These Drugs Look Like?

These drugs can take many different forms. For example, they may appear as a powder. Synthetic opioids may be sold as a tablet and look similar to legal pharmaceutical products. What’s impossible to determine easily is what the powder or tablet contains. The main opioid may be mixed with a secondary drug, such as fentanyl, heroin, or another substance.

What Is Protonitazene?

Protonitazene is a new synthetic opioid, unknown before appearing in a report in May 2021 following a toxicology case. Since then, it has been detected during post-mortem death investigations. Estimates put the drug’s potency at three times higher than fentanyl.

What Side Effects Do Synthetic Opioids Have?

Some effects of chemically-manufactured opioids may be similar to naturally-occurring opioids, including morphine, codeine, hydrocodone, oxycodone, and methadone.


  • Relaxation
  • Euphoria
  • Pain relief
  • Sedation
  • Confusion
  • Drowsiness
  • Dizziness
  • Nausea
  • Vomiting
  • Urinary retention
  • Pupillary constriction
  • Respiratory depression

What Does an Overdose of Synthetic Opioids Look Like?

There are signs to look for in someone who has overdosed on a synthetic opioid, such as protonitazene. They may appear to be in a stupor. You may see changes in the size of their pupils. Their skin may feel cold and clammy and appear bluish in color. A person who’s overdosed on a synthetic opioid may experience respiratory failure or become unconscious. Unlike other synthetic opioids, protonitazene overdoses have been documented to include a unique symptom: cardiac arrest.

How Does an Overdose of a Synthetic Opioid Get Treated?

Medical personnel can use naloxone, known by the common brand names Narcan and Evzio, to rapidly reverse an opioid overdose. It works in the body for 30-90 minutes, meaning a person may need multiple doses if the synthetic opioid is still in their system. While aiding in reducing the risks associated with overdose, naloxone also can create some unpleasant side effects, including shivering, sweating, tremors, and gastrointestinal disorders.

How Does Someone Find Treatment for Substance Use?

Treatment is available for someone who’s been abusing synthetic opioids. Medical detox is a recommended first step to safely experience withdrawal symptoms while under the care of professionals. Treatment itself can consist of individual counseling, group therapy, and evidence-based interventions to help a patient begin the process of recovery. For patients with existing or undiagnosed mental health needs, dual diagnosis treatment is recommended as treating underlying mental health issues ensures recovery is more likely to be successful. Continuing care is an essential element of the work needed to stay in sobriety long-term. A personalized plan for an individual may involve transitioning to an intensive outpatient program following a residential stay.

Hanley is a well-known care provider offering a range of treatment programs targeting the recovery from substance use, mental health issues, and beyond. Our primary mission is to provide a clear path to a life of healing and restoration. We offer renowned clinical care for addiction and have the compassion and professional expertise to guide you toward lasting sobriety.

For information on our programs, call us today: 561-841-1033.

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