New Synthetic Opioid Iso Drug Deadlier than Fentanyl

HHRC-Handful of White Opioid Painkillers

The Many Forms of ISO 

Like fentanyl, this deadly synthetic opioid is usually distributed in the illicit drug trade as a white or yellow powder. This powder can then be made into a tablet.

Because ISO drug bears a resemblance to heroin or cocaine, it is often mixed with other drugs before being distributed.

Cause for Alarm 

The warning was explained by Reta Newman, the Pinellas County Forensic Lab Director at the District Six Medical Examiner’s Office. She claims the numbers are misleading as “ISO”, the steet name for the drug, refers to a class known as “nitazenes.”

Isotonitazene is a cousin to many other drugs. Drug users might think they are getting “ISO”, but in reality, it could be another nitazene which is more potent and potentially more fatal.

Newman shared the picture of a sample that she had taken from a drug seizure and said one of those drugs was “N-pyrrolinido, etonitazene”. It contained both that and “metanitaze”. Both are more potent than fentanyl and can be deadly, she claims.

A 2021 American Society of Addiction Medicine report shows at least 40 fatal overdoses involving ISO drugs during a six-month period in 2020 in the counties of Cook County, Illinois and Milwaukee County, Wisconsin.

What Makes ISO Deadlier 

Although most of the risks associated with this dangerous synthetic opioid can be attributed to its intentional and direct consumption, there have been adverse effects from indirect contact.

The substance can be inhaled accidentally, especially when it is powdered. This synthetic opioid is potent enough to cause death even if the user does not know it.

How to Spot an ISO Overdose 

PCSO has released tips on how to recognize signs of overdose from ISO drug (also known as Metonitazene or Etonitazene):

  • Bluish fingernails

  • Bluish Lips

  • Trouble in Breathing

  • Unconsciousness

  • Damp Skin

  • Puking

  • Pinpoint pupils

  • Drowsiness

The sheriff’s office said the symptoms can occur within minutes of exposure.

More serious side effects may include ringing in the ears, changes in an individual’s mood or mental state, hallucinations, urinary complications, or changes in vision (i.e., seeing double, blurriness).

ISO drug usage can also have side effects that require immediate medical attention, including:

  • Rapid or irregular heart rate

  • Serious allergic reaction

  • Seizure

  • Trouble breathing

Why People Get Addicted

The ISO drug is a Schedule I drug and has a high risk of addiction. This drug, like any opioid, releases endorphins in the brain which can help relieve pain and increase pleasure.

Endorphins are your brain’s feel good neurotransmitters and opioids can trigger their release. Endorphins reduce pain perception and enhance feelings of pleasure. They create a temporary, but powerful sense of well-being. After an opioid dose has worn off, it is possible to feel the same feelings of elation as before. This is the first step on the road to possible addiction.

The body reduces the amount of endorphins it produces when you take opioids regularly over time. When you stop taking opioids, your body stops producing such strong feelings. This is called tolerance. Tolerance is one reason why opioid addiction can be so prevalent. It is possible for people to develop tolerance and feel driven to increase their doses in order not to feel sick.

Long-Term Opioid Use 

Iso is an opioid that can be addictive and highly potent. The long-term use of opioids can cause a host of health problems and even the development of addiction.

ISO drugs can cause neurological issues, cardiovascular problems and other chronic health problems. There may also be unknown side effects, as it has not been studied in clinical research.

Iso users may have a substance abuse disorder. The drug is addictive and can lead to addiction. Iso users who develop a tolerance to it are at risk of developing an ISO drug overdose and other health issues.

How the Pandemic Increased ISO Use

Coronavirus has brought a new dimension to the ongoing opioids crisis. This includes the increasing rates of isotonitazene or iso-consumption. Overdoses and deaths have increased in the United States since the COVID-19 pandemic.

This may partly be due to an increase in drug misuse and changes in drug suppliers. Experts are now seeing more cases of fatal ISO drug overdoses by known cocaine users who have ingested cocaine laced with iso. This is because iso is difficult to detect.

Many patients have been prevented from accessing the medication and opioid addiction treatment they require due to high unemployment, economic hardships, and social isolation. Legal opioid-based drugs such as ISO have become a convenient, but dangerous solution.

Before COVID-19, the opioid crisis was a major news story. The news media have stopped reporting on the dangers of drugs like ISO since the outbreak of the pandemic. Many people suffering from substance abuse disorders are unaware of the severity of ISO’s dangers.

How to Treat ISO Addiction  

ISO is an opioid, which means that the same treatment options that are effective in heroin or fentanyl addiction are ideal for opioid addiction. Suboxone (methadone), Vivitrol and Suboxone are all FDA-approved drugs for opioid addiction. Symetria has all these medications, as well as other promising drugs. Suboxone is still the most commonly prescribed.

Opioid addicts will feel withdrawal symptoms when they stop using. Withdrawal symptoms include fever, trembling or body aches, pains, nausea and vomiting.

Although opioid addiction can be difficult and painful, there is help. A safe and effective detox program is essential for people who are addicted to opioids. Detox can help users feel safe and comfortable while they focus on rebuilding their lives after a successful recovery. 


Officials are warning that a new, dangerous synthetic opioid is available in the illicit marketplace. Isotonitazene or ISO is stronger than fentanyl and more potent.

ISO is “20 times more toxic than fentanyl,” according to a “new dangerous drug alert” from the Pasco County Sheriff’s Office.

The attorney general of Florida has also sent a PSA film alerting people of ISO,  which provides information on the risks associated with opioid abuse, how to get opioid addiction treatment, and how to properly dispose of leftover prescription medication.

Haven House Recovery is here for you.

Are you, or someone close to you, struggling with the effects of ISO addiction? Haven House Recovery is an established drug rehab in Nashville, TN, that can provide the best and proper treatment for you or your loved one’s addiction recovery. We have compassionate and qualified staff available to help you.

We provide evidence-based and holistic treatments that result in positive outcomes for our clients. Our multi-faceted care plan and mental health-focused therapies ensure that we treat both the symptoms and the underlying causes.

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