Alert over rise in dangerous synthetic opioids in France

Health authorities in France have warned against the rise of ‘particularly dangerous’ synthetic opioids called ‘nitazenes’, which carry a significant risk of overdose. 

Nitazenes are substances of the ‘benzimidazole structural class’ of drugs, and are opioids, meaning that they act on the opioid receptors in the brain, and are originally derived from (or related to) the opium poppy.

They are stronger than the highly-dangerous fentanyl, and up to 500 times more potent than heroin or the painkiller morphine. Because of this, they have a high potential for overdose, and are not legally available.

Now, in a new alert, health authority the Agence nationale de sécurité du médicament (ANSM) has said “we have decided to add these compounds to the [official] list of narcotics” (stupéfiants in French), after finding that the drugs were spreading in France.

This means that “the production, sale and use” of nitazenes will be expressly banned from Tuesday July 9. 

The drugs are typically sold as a powder (white, brown, or yellow in colour), as a crystalline solid, or as a liquid.

Overdose risk

“[Nitazenes] carry a higher risk of fatal overdose, even at a low dose,” the ANSM said.

“They can cause overdoses that can come on very quickly, very soon after taking them, and become life-threatening.”

Opioid overdoses can come on between minutes and several hours of taking too much, and can cause breathing difficulties, nausea, narrowed pupils, and lethargy that can lead to coma and death.

Two deaths related to nitazenes have already been reported in France, and several dozen have been reported in the UK and Eastern Europe since 2023. 

The ANSM recommends that users always have “one or several naloxone kits” available at all times.

Naloxone is an opioid antidote that can ‘bring people back’ from overdose in many cases. However, nitazenes are so strong that people suffering from overdose may require several doses of naloxone to survive. 

Even someone who has received naloxone needs medical attention afterwards, and emergency services should always be called (on the numbers 15 or 112 in France) in the event of overdose, with or without naloxone.

Read more: 112, 15, 17: Do you know the emergency numbers to use in France?

UN concerns

The United Nations have also expressed concern about the rise of these new substances. 

These drugs “have recently appeared in high-income countries [and] are causing an increase in overdose deaths”, stated a June 26 report by the United Nations Office on Drugs and Crime (UNODC).

The office also said that "heroin users are turning to synthetic opioids that pose serious health risks”, such as fentanyl, opioid substitution treatments (methadone, Subutex), and now nitazenes. 

One expert, Angela Me, has said that the rise of synthetic drugs and new types of opioids may be linked to the decrease in production of poppies in Afghanistan, which has been banned by the Taliban.