The iso drug is a somewhat obscure substance that is threatening to become a widespread public health crisis in the U.S. The more you know about this drug, the better prepared you will be to protect yourself and keep your loved ones safe.
What is the Iso Drug?
The iso drug is an extremely powerful synthetic opioid. This means that it is a lab-created substance with properties that are similar to morphine, heroin, fentanyl, and many prescription painkillers. It may appear as a powder, tablet, or liquid.
Iso is short for isotonitazene, which belongs to a subcategory of synthetic opioids called nitazenes. This subcategory also includes:
- Butonitazene
- Etodesnitazene
- Etonitazene
- Metonitazene
- Protonitazene
Isotonitazene is the second-most potent drug in this list, with studies indicating that it is 500 times more powerful than morphine. For purposes of comparison, fentanyl – which has fueled a recent spike in overdose deaths in the United States – is about 100 times more powerful than morphine.
History of Isotonitazene
The history of iso and other nitazenes dates to the middle of the previous century, when scientists were attempting to develop safer opioid analgesics (painkillers).
That effort led to the development of isotonitazene and the other drugs that share its subcategory. However, these drugs never earned approval from the U.S. Food and Drug Administration (FDA), in no small part due to their extreme potency and risk of catastrophic effects if misused.
For nearly 70 years, the iso drug and other nitazenes were basically forgotten substances. They were not incorporated into therapeutic or medical procedures, nor were they abused for recreational purposes.
That appears to have changed in the past few years:
- According to the United Nations Office on Drugs and Crime (UNODC), public health officials first noted the presence of street-level isotonitazene in 2019.
- By 2020, UNDOC reported, the drug had been found in seized samples or toxicology reports in the United States, Canada, the United Kingdom, Germany, Belgium, Estonia, Latvia, and Sweden.
- In December 2021, the U.S. Department of Justice (DOJ) temporarily classified isotonitazene and other nitazenes as Schedule I controlled substances. In August 2023, the DOJ announced that this classification would be permanent.
- As of February 2024, experts had determined that the iso drug and other nitazenes were involved in at least 200 overdose deaths in the U.S. and Europe since 2019.
Why Are People Using Isotonitazene?
Many people who have been using isotonitazene probably weren’t intentionally taking the drug.
The U.S. Drug Enforcement Agency (DEA) reports that iso may be pressed into pills that are intentionally mislabeled as hydromorphone (Dilaudid) or oxycodone. In other cases, it may be mixed with heroin or fentanyl.
When a person purchases what they believe to be heroin, fentanyl, or a painkiller from an illicit source, they may actually have just acquired the iso drug.
Dangers of the Iso Drug
The three biggest dangers of iso abuse are addiction, overdose, and death.
Isotonitazene and other synthetic opioids are highly addictive substances. Once you become dependent on these drugs, you may find it impossible to stop using them without professional help.
Given the extreme potency of the iso drug, overdose is an omnipresent risk for anyone who uses it. Symptoms of iso overdose include:
- Disorientation
- Slowed heartbeat
- Faint pulse
- Slow or shallow breathing
- Constricted (pinpoint) pupils
- Loss of consciousness
- Inability to be awakened
- Bluish coloration near lips and fingertips
- Cool, clammy skin
Anyone who exhibits these signs after using iso needs immediate medical help. In the absence of a timely intervention, iso overdose can be fatal.
Isotonitazene vs. Fentanyl
Isotonitazene is often compared to fentanyl, due to similarities such as:
- Both are synthetic opioids
- Both are extremely powerful, with high risk of addiction and overdose
- Street-level versions of both drugs are often produced in illicit labs with minimal safety standards, which means it can be difficult for a person to be sure how powerful the substances are or if they contain any adulterants.
- As we mentioned previously, iso and fentanyl are often mislabeled, which means that people may have no idea what they are taking.
Key differences between iso and fentanyl include:
- Isotonitazene is substantially more powerful than fentanyl, which means that even a miniscule amount can be deadly.
- At the moment, fentanyl poses a more widespread public health threat. As noted earlier, experts believe that iso was involved in about 200 overdose deaths since 2019. In 2022 alone, fentanyl was involved in more than 70,000 overdose deaths in the U.S.
Thankfully, addictions to both isotonitazene and fentanyl are treatable conditions. However, until a person receives the care they need and ends their use of these drugs for good, they remain at risk of catastrophic harm, including death.
Treatment for Isotonitazene Addiction
Treatment for isotonitazene addiction can occur at several levels, including:
- Residential rehab
- Partial hospitalization program (PHP)
- Intensive outpatient program (IOP)
- Outpatient treatment
Within these programs, your care may include a combination of medication and therapy.
Prescription medications such as methadone, buprenorphine, and naltrexone can alleviate drug cravings and other common opioid withdrawal symptoms, which can make it easier for you to stop using the iso drug.
These medications have proved to be safe and effective for both short- and long-term use. Some people take them during detox, then taper off. Others use them for an extended period to help them maintain their recovery. You can discuss your options with your treatment team and decide which approach is best for you.
Various forms of therapy can help you begin to build a foundation for a healthier future, free of compulsive substance abuse. Depending on your specific needs, the therapeutic part of your treatment for iso addiction may include elements such as:
- Individual psychotherapy
- Group and family therapy
- Cognitive behavioral therapy (CBT)
- Eye movement desensitization and reprocessing (EMDR) therapy
- Dialectical behavior therapy (DBT)
- Neurofeedback
- Equine therapy
Before you transition out of treatment, you should receive a detailed aftercare plan. This plan may include information about the resources and services that can help you maintain your sobriety and continue to progress in your recovery.
Contact Phoenix Rising to Treat Isotonitazene Addiction
Phoenix Rising Recovery offers a full continuum of customized care for adults who have become addicted to isotonitazene and other dangerous drugs.
Our iso addiction treatment center in Palm Desert, California, is a safe and welcoming place where you can receive personalized services from a team of highly skilled professionals. With our help, you can find your path to lifelong recovery.
To learn more about how we can help you or a loved one, or to schedule a free assessment, please visit our Contact page or call us today.