Fentanyl& Nitazenes

The extreme potency of fentanyl and nitazenes means that even a milligram (one thousandth of a gram) can be enough to cause a fatal overdose!

You often hear about Fentanyl and Nitazenes and their link to the opioid crisis in the United States. But these substances are also increasingly related to overdose incidents across Europe, including the Netherlands. So far there were a number of fatal overdoses related to medically prescribed fentanyl plasters. But with the death of an Amsterdammer in march 2025, the first registered fatal OD due to illegally aquired oxicodon pills that contained nitazenes, there are increasing concerns about the circulation of these substances on the Dutch drug market.

There are about 13 different types of nitazenes that are classified in this category of drugs, with the most prevalent being Isotonitazene. Other common nitazenes include Metonitazene, Protonitazene, Butonitazene and Etonitazene.

effects

Fentanyl and nitazenes attach to opioid receptors in the brain and spinal cord—the same areas that regulate pain and emotion—shutting down incoming pain signals and producing strong pain relief (analgesia).When these receptors are activated, the brain’s reward pathway also releases a surge of dopamine in the nucleus accumbens, creating an intense feeling of euphoria.

Opioid receptors are present in the brainstem as well, where they control breathing. Fentanyl and nitazenes slow the breathing. Extreme slowing of the breathing is called respiratory depression, which is the main reason opioid OD’s are often fatal.

Because both drugs are extremely potent, even a few micrograms above a safe dose can trigger life-threatening respiratory depression.