An wastewater surveillance study has successfully detected the emergence and spread of highly potent synthetic opioids known as nitazenes, highlighting a significant public health risk across multiple continents. The comprehensive research, spanning two years and involving wastewater samples from 68 locations in 22 countries, represents one of the largest international efforts to date to monitor these dangerous substances.
The research team, led by Dr. Richard Bade from the Queensland Alliance for Environmental Health Sciences at the University of Queensland, Australia, conducted the study to identify the presence and estimate the consumption of nitazene opioids using advanced wastewater analysis techniques. Wastewater samples were collected and analyzed from countries including the United States, Australia, Canada, Germany, France, China, and Brazil.
Nitazenes, first developed in the late 1950s but never approved for medical use due to their extreme potency and toxicity, have seen a worrying resurgence in recent years on the illicit drug market. These synthetic opioids can be up to 45 times more potent than fentanyl, dramatically increasing the risk of fatal overdose.
The study found two nitazene analogues—protonitazene and etonitazepyne—in samples collected in the United States and Australia, with protonitazene detected consistently over two years. The highest levels of protonitazene were identified at one Australian site, with alarming concentrations reaching up to 300 ng/L, corresponding to mass loads as high as 100 mg/day per 1000 people. This finding is particularly concerning given the opioid's potency and its association with fatal overdoses.
Wastewater analysis serves as a powerful early-warning system for detecting new psychoactive substances like nitazenes. This method provides rapid insights into community drug consumption patterns, enabling public health authorities to respond swiftly to emerging drug threats.
Dr. Bade emphasized the potential of wastewater-based epidemiology, stating, "The detection of nitazenes through wastewater analysis offers an invaluable tool to complement traditional surveillance methods, giving authorities the chance to implement timely interventions before these drugs cause widespread harm."
The implications of this research are substantial, as nitazenes have been found mixed into a variety of illicit substances such as heroin, cocaine, methamphetamine, and counterfeit benzodiazepines, often without users' knowledge, leading to accidental and potentially fatal overdoses.
Looking forward, incorporating regular wastewater monitoring for nitazenes into existing drug surveillance programs worldwide could significantly enhance public health responses, providing critical data to inform policy and intervention strategies.
The full research article is freely accessible and can be found here:
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