Drug three times as potent as fentanyl kills three in Virginia; more naloxone may be needed to reverse overdoses of it

A synthetic opioid that's more deadly than fentanyl has arrived in Virginia, Luca Powell reports for the Richmond Times-Dispatch. The drug, nitazene, is three times as potent as fentanyl and is "popping up all over the country," said Nelson Smith, commissioner of the Virginia Department of Behavioral Health and Development Services. 

The drug has been linked to three deaths in Virginia so far, "a number that medical examiners believe to be an undercount," Powell writes. State forensics labs can't readily identify the drug and have to rely on outside testing agencies contracted by the state for toxicology reports. Because the drugs are more potent, several more doses of naloxone may be required to reverse an overdose, early Centers for Disease Control and Prevention research suggests.

Michelle Peace, a forensic toxicologist at Virginia Commonwealth University, said that it's now easier to buy synthetic drugs online and the more powerful nitazenes may be more appealing to users who have developed a tolerance for other opioids. "The piece that the public needs to know is that they can’t really trust what they’re buying on the internet," Peace said. "That sounds like it should be obvious, but it’s not." Nationally, overdose deaths have jumped since the start of the pandemic and synthetic opioids like fentanyl account for much of the deaths.