UNODC warns of lethal spread of isotonitazene synthetic opioid

The United Nations Office on Drugs and Crime (UNODC) has issued an alert regarding the rapid global expansion of isotonitazene, a potent synthetic opioid known on the streets as ‘ISO’. Belonging to the nitazene class, the substance is reported to be significantly more powerful than both fentanyl and morphine.

According to the World Drug Report 2026, 34 varieties of nitazenes are circulating in at least 37 countries, with significant presence in Europe, North America, and Oceania. In Estonia, for example, 35% of analyzed syringes were found to be contaminated with the substance. In the United States, ISO has been detected in 13 states and is linked to over one thousand deaths.

The UNODC warns that ISO poses a unique public health threat because traditional rapid testing methods and reagent strips often fail to detect it. This lack of detection, combined with the drug’s extreme potency, leaves users at high risk of fatal respiratory arrest and overdose. The shift from plant-based opiates to synthetic alternatives like nitazenes may represent a permanent change in the global opioid market.