Collaborative harm reduction efforts lead to the first detection of 5-cyano isotodesnitazene in illicit street drugs

Abstract

Abstract In the ongoing opioid crisis, regulatory restrictions on fentanyl and its derivatives have led to the emergence of nitazenes, a class of highly potent synthetic opioids synthesised during the 1950s but never approved for medical use. Structurally distinct from traditional opioids, nitazenes have gained increasing presence in illicit drug markets since 2019, contributing to a growing number of drug-related deaths across Europe, North America, and Australia. The rapid proliferation of novel nitazene analogues presents a significant challenge to law enforcement and public health systems. Drug-checking services (DCS) are currently one of the most effective tool for early detection and response, enabling real-time surveillance and consequently reducing the impact of overdoses due to Novel Synthetic Opioids. As a complement, universities can provide the scientific expertise and infrastructure necessary to confirm molecules detected by DCS. This study is the first report identifying and confirming 5-cyano isotodesnitazene in a street-sold drug, through an international collaboration involving two DCSs and three academic institutions. The structural elucidation was achieved through complementary analytical techniques comprising gas chromatography, mass spectrometry, and nuclear magnetic resonance spectroscopy. The present work highlights the essential role that cross-sector cooperation and analytical innovation play in tackling the rapidly evolving threat of novel synthetic opioids.