Across the United States and in other countries, health experts are warning about a new and very powerful type of synthetic opioids called nitazenes. Many people now refer to them as “Frankenstein Opioids” because they are extremely strong and often made in illegal labs. These drugs are showing up in street drugs without people’s knowledge, and overdoses involving nitazenes often need several doses of naloxone (NARCAN) to reverse.

Researchers say nitazenes can be several times stronger than fentanyl, which makes them especially dangerous.

Why This Matters

Nitazenes are becoming more common as illegal drug makers move away from fentanyl and start producing new synthetic drugs. These new drugs are often much stronger and less predictable. Health experts warn that nitazenes may become a major part of the next wave of the opioid crisis. Communities need more education, awareness, and access to naloxone to help prevent deaths.

What Are Nitazenes?

Nitazenes are man‑made opioids first created in the 1950s as possible pain medicines. They were never approved for medical use because they were too strong and too dangerous.

After being mostly forgotten for decades, nitazenes started showing up on the illegal drug market around 2019. They have been found in fake pills, powders, heroin, and other street drugs, often without the user knowing.

How strong they are can change a lot depending on the type. Some nitazenes, like isotonitazene and etonitazene, can be hundreds of times stronger than morphine.

Because their strength is unpredictable and they are often mixed with other drugs, overdose deaths involving nitazenes are increasing in the U.S. and in other countries around the world.

Why Are They Called “Frankenstein Opioids”?

People call nitazenes “Frankenstein opioids” because:

• They are extremely powerful—sometimes 2 to 40 times stronger than fentanyl, depending on the type.
• They are made in laboratories, not from natural plants like some other opioids.
• Their strength is unpredictable, so people often don’t know how strong the drug is or what type they are taking.
• They become even more dangerous when mixed with fentanyl, heroin, meth, or counterfeit pills.
• Law enforcement has found nitazenes in all 50 states, showing how quickly they are spreading.

In Yakima, the use of nitazenes is rapidly increasing.  “Some of our current people served are calling this ‘Frankenstein dope’ due to the uncontrollable body movements that are rigid and unpredictable.  They are noticing some severe cognitive impairments with this new form of ‘fentanyl,'” says Kristin Anglin, Substance Use Disorder Professional at Triumph Treatment Services.

Overdose Risks and Reversal Challenges

A nitazene overdose acts like other opioid overdoses but can get worse very quickly because the drug is so strong. Signs include:

• Trouble breathing
• Passing out
• Blue lips or fingernails
• Very small “pinpoint” pupils

Naloxone (NARCAN) can reverse an overdose, but people often need more than one dose. Many drug tests also cannot detect nitazenes, which means overdoses may be missed or treated too late.

Common Slang and Street Names for Nitazenes

People may not realize they are using nitazenes because they are often sold under different names.

Common slang terms/nicknames include:

• ISO
• Toni
• Oni
• Frankenstein Dope
• P2P Dope

Names Used When Mixed or Sold as Other Drugs

• Etazene
• Pyro
• Fake oxy (counterfeit pain pills)
• Synthetic heroin
• Blues (fake oxycodone pills that may contain fentanyl or nitazenes)

Nitazenes can look just like real oxycodone pills or other drugs, which makes it easy for someone to take them without knowing.

As nitazenes continue to spread and put more people at risk, learning the facts and staying aware can help protect you and your community. But if you or someone you care about is already struggling with substance use, you don’t have to face it alone. Support is available, and taking the first step can make all the difference.

Sources:

World Drug Report & Global Trend Data

• United Nations Office on Drugs and Crime – World Drug Report 2025 [nature.com]
• Colombo Plan / CFSRE – Emerging Global Synthetic Opioid Threat (2025) [dfaf.org] 

Clinical and Scientific Research

• ScienceDaily – Doctors warn of a stealth opioid 20x more potent than fentanyl (2025) [sciencedaily.com]
• Healio – Nitazenes emerge as a synthetic opioid threat (2025) [healio.com]

Law Enforcement & Public Safety Reports

• DEA – Nitazenes: Emerging Threat of a Diverse Group of Synthetic Opioids (2025) [dea.gov]
• HC DrugFree – Frankenstein Opioids: Stronger Than Fentanyl (2025) [hcdrugfree.org]

Public Health & Treatment Centers

• Woodhaven Treatment Center – Nitazenes: The “Frankenstein” Drug (2025) [woodhavenohio.com]
• PCOM – ‘Frankenstein’ Drug Presents Public Health Challenges (2024) [pcom.edu]

Additional Commentary & Analysis

• American Council on Science and Health – Nitazenes—The Latest Illegal Opioids Wreaking Havoc (2025) [acsh.org]
• Prestera Center Report – The Emerging Threat of Nitazenes (2025) [prestera.org]