ISO Drug: Rising Risks

What is Isotonitazene?

Isotonitazene, which is more commonly referred to as ISO, is a deadly synthetic opioid that has been gaining popularity as of late; but for all the wrong reasons. 

According to the Drug Enforcement Administration (DEA), the ‘ISO drug’ has been found to be an incredibly dangerous opioid. Predominantly dispersed in pill form, this substance has been linked to several adverse health effects resulting from its usage, including a concerning number of overdose fatalities. 

A Brief History of ISO

Having been pharmaceutically produced in the 1950s as a class of opioids known as nitazenes, this is not necessarily a new synthetic opioid. It is, however, a newly popular contender in the illicit drug market.

Initially spiking in popularity in 2019, ISO has been predominantly found in Florida. Furthermore, the Pasco County law enforcement crime lab has found this substance to be present in several counties across the state. Now, this not-so-new drug has sparked public concern once again, having kicked off the new year by re-establishing its fatal presence in the Sunshine State. 

While most commonly a deadly synthetic opioid found in Florida, the ISO drug is being introduced to the illicit drug market nationally. This substance has been linked to overdose deaths by law enforcement officers in several different states, including New York, Wisconsin, and Illinois. 

ISO vs Carfentanil: What is the Strongest Opioid Drug?

With a relative potency much higher than that of fentanyl, the ISO drug rivals a substance that is known as carfentanil, a drug used primarily as a pain reliever for elephants and other massive animals, that has found its way to the United States as an even more powerful alternative synthetic drug composition to its more widely known cousin, fentanyl.

Hundreds of deaths nationwide have been associated with carfentanil use and exposure, and with ISO rivaling Carfentanil in strength on the scale of opioid drug potency, if it begins to become found more widely in the US, then a true escalation of the opioid crisis may soon emerge.

The Various Forms of the ISO Drug

Similar to fentanyl and other opioids, this particularly deadly synthetic opioid is typically distributed throughout the illicit drug market in the form of a white or yellow powder. This can then be pressed into a tablet. 

Because of its resemblance to other drugs, such as heroin or cocaine, ISO is often mixed in with these substances before being distributed to consumers; whether they are aware of this combination or not. 

The Dangers of Counterfeit Pills, Fentapills, and ISO

As dangerous as counterfeit pills containing fentanyl are, the risks of consuming a pill made with ISO are that much more significant. For those using opioid drugs from ‘street’ sources, as well as their families and loved ones, the importance of harm reduction awareness is paramount.

Until you or your loved one are ready to enter detox and get treatment to escape this dangerous lifestyle, please be sure to carry Narcan (also known as Naloxone) to help limit the risk of overdose from fentanyl or the growing amount of ISO in the illicit drug supply nationwide.

Understanding the Dangers of ISO

Classified by the Controlled Substances Act as a Schedule I drug, this illicit drug has been found to be anywhere from 20-100 times stronger than fentanyl. This alone makes ISO a deadlier drug than most, as fentanyl is, by itself, an already incredibly dangerous opioid. 

An estimated 80 to 100 times more potent than morphine and serving as the leading drug linked to overdose deaths in the United States, fentanyl overdose can occur from taking even just one pill. Thus, because of how many times stronger than fentanyl this particular synthetic opioid is, just one pill laced with ISO can have not just similar, but even more severe effects. 

The Hidden Risks of the ISO Drug

While most of the risk factors associated with this deadly synthetic opioid are attributed to its direct and intentional consumption, it has been found to cause adverse effects through indirect contact as well. 

Particularly in its powdered form, this substance has been known to be accidentally inhaled on occasion. Because of its considerable potency, this synthetic opioid can kill its users, even when they are doing so unknowingly. 

Furthermore, individuals may accidentally purchase counterfeit pills containing ISO, under the assumption that they are receiving something else. Unfortunately, taking even the slightest bit too much of this particular substance can be fatal.  

Opioids: An Epidemic Within a Pandemic

After opioids were increasingly prescribed to patients for pain relief in the late 1990s, these drugs began to be misused and their addictive potential became undeniable. In 2017, the U.S. Department of Health and Human Services declared this opioid epidemic a public health emergency.

Now, ISO is paving the way for a resurgence of this epidemic, made even more problematic in combination with the continued devastation caused by the COVID-19 pandemic.   

Fentanyl and the Opioid Epidemic

Between 2018 and 2021 alone, the number of counterfeit pills and individual Fentanyl pills increased nearly 50-fold, with incidents of fentanyl-containing powder seizures drastically increasing as well.

As ISO gains more public recognition, these incidents are being increasingly revised in an attempt to determine if the substance may have a connection with this elevated presence of Fentanyl in the United States.

What are the Side Effects of Using the ISO Drug?

As an opioid, ISO is predominantly administered as a pain reliever. However, because much safer methods of treating pain exist today, it is rarely ever used in a clinic setting. Taking this substance can lead to the development of several side effects, with its abuse often resulting in death. 

Some of the non-lethal symptoms of ISO use may include:

• Drowsiness
• Dizziness
• Dryness of the mouth/nose/throat
• Headache
• Upset stomach
• Constipation
• Difficulty sleeping

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

Recognizing the Signs of Opioid Overdose

When it comes to ISO, overdose deaths due to this drug are becoming more common as this new synthetic opioid continues to pop up more frequently. Because of how potent this substance is compared to other drugs, accidentally taking too much of it is all too easy. Furthermore, an ISO drug overdose can occur within mere minutes of exposure to this drug.

This is why it is crucial to be aware of what an overdose looks like, as recognizing the symptoms early on can give individuals enough time to seek out emergency medical assistance. 

Some of these signs may include:

• Blue or purple tint in an individual’s lips/nails 
• Difficulty breathing
• Loss of consciousness
• Clamminess 
• Nausea, vomiting
• Tiny pupils
• Drowsiness, lethargy

Unfortunately, according to the Pasco County Sheriff’s Office, this drug has been found to be resistant to Narcan, which is a medication commonly used to reverse the effects of other opioids such as fentanyl. Thus, while knowing the signs of overdose can be helpful, it is always recommended to simply just not use the substance at all. 

Is the ISO Drug Addictive?

As a Schedule I drug, the ISO drug is considered to have a high potential for addiction. As with any opioid, this drug releases endorphins into the brain, which can help ease feelings of pain, as well as boost pleasurable sensations. 

This triggering of the brain’s reward system and an intense need to maintain this feeling is primarily responsible for the development of opioid addictions. 

Treating an ISO Addiction

Because ISO is an opioid, the same treatments that are effective for other opioid addictions (i.e., fentanyl or heroin) are the ideal choice for treating this particular substance use disorder. 

Currently, FDA-approved medications for opioid addiction include Suboxone, methadone, and Vivitrol, with Suboxone being the most commonly used. 

Finding the Right Treatment for Opioids

While predominantly found in Florida, ISO is becoming increasingly available across the country. Opioid addiction is, unfortunately, a particularly prevalent issue within the United States. If you or a loved one is currently struggling with addiction, whether to ISO or another substance, know that you are not alone, and help is available. 

Here at Find Addiction Rehabs, our team is dedicated to finding you the best treatment centers and addiction rehab programs for your care needs. We know that taking that first step to sobriety can be difficult, but that’s why we are here. Just by calling us at our 24/7 hotline, we can help you get started on your addiction recovery journey, and re-connect you with a happier, healthier you; today!

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