Pergolizzi Joseph, Raffa Robert, LeQuang Jo Ann K, Breve Frank, Varrassi Giustino
Anesthesiology, Nema Research, Inc, Naples, USA.
School of Pharmacy, Temple University (Emeritus), Philadelphia, USA.
Cureus. 2023 Jun 21;15(6):e40736. doi: 10.7759/cureus.40736. eCollection 2023 Jun.
Nitazenes are a group of compounds developed in the 1950s as opioid analgesics, but they were never approved to market. As such, they are not well known outside of academic research laboratories. A characteristic of nitazenes is their high potency (e.g., hundreds to thousands fold more potent than morphine and other opioids and tenfold more potent than fentanyl). In the past few years, several nitazenes, including "designer analogs," have been detected in the illicit drug supply and have been implicated in overdose mortality, primarily due to their exceptionally high potency. In the street drug supply, nitazenes are often found mixed with fentanyl or other agents but their presence is not always disclosed to drug buyers, who may not even be familiar with nitazenes. These drugs pose a particular challenge since there is little experience in how to reverse a nitazene overdose or potential drug-drug or drug-alcohol interactions. Public health efforts are needed to better inform street drug consumers, first responders, healthcare professionals, and the general public about these "new old drugs" that are infiltrating the recreational drug supply.
硝氮烯是20世纪50年代作为阿片类镇痛药开发的一类化合物，但从未被批准上市。因此，它们在学术研究实验室之外并不广为人知。硝氮烯的一个特点是它们的高效能（例如，比吗啡和其他阿片类药物效力高数百至数千倍，比芬太尼效力高十倍）。在过去几年中，在非法药物供应中检测到了几种硝氮烯，包括“设计类似物”，它们与过量用药死亡有关，主要是因为它们的效力极高。在街头毒品供应中，硝氮烯经常与芬太尼或其他药物混合在一起，但它们的存在并不总是告知毒品买家，买家甚至可能不熟悉硝氮烯。这些药物带来了特殊挑战，因为在如何逆转硝氮烯过量用药或潜在的药物-药物或药物-酒精相互作用方面几乎没有经验。需要开展公共卫生工作，以便更好地让街头毒品消费者、急救人员、医护人员和普通公众了解这些正在渗入娱乐性毒品供应的“新的老药物”。
