What is isotonitazene? A drug more powerful than fentanyl is circulating in Montreal

Isotonitazene, a synthetic opioid, is circulating in Montreal and its effects are devastating.

Most recently, a 15-year-old boy died on Dec. 21 after ingesting the drug, which is considered more potent than fentanyl.

Mathis Boivin apparently thought he was taking oxycontin.

Isotonitazene is an opiate "like any other. [It is] very powerful," Dr. Alain Vadeboncoeur, an emergency physician, told Noovo Info.

"It appeared in 2020, but we didn't talk about it much," he said. "They are drugs that can make you sleep if you give them in high doses in the ER, but they're not designed for that at all, and they're much riskier than drugs for sleeping."

Montreal police (SPVM) acknowledge there has been a significant increase in fatal and non-fatal opioid overdoses since the start of the COVID-19 pandemic.

In addition, the quality of drugs has declined.

"Some dealers cut their merchandise further with various products, including fentanyl in the case of heroin," said the force.

STRONGER THAN MORPHINE

Isotonitazene was first synthesized in the mid-1950s in an attempt to develop safer opioid analgesics with levels higher than morphine.

It has since emerged on the illicit drug market in North America and Europe, according to the United Nations Office on Drugs and Crime.

It was first identified in Europe in April 2019.

One year later, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) started receiving reports specifying isotonitazene in seized drug samples and toxicology cases across the European Union.

Around the same time, the substance was linked to eight deaths in the United States.

More locally, traces of the drug have been found in the autopsies of 14 people since August 2020, according to the Montreal Public Health Department (DRSP).

In fact, the department issued an overdose alert in November 2020 about the circulation of tablets that look like oxycodone but actually contain isotonitazene.

The drug can appear in numerous forms, including tablets and powder, and carries a high risk of overdose.

"Use of this substance can cause respiratory distress up to and including respiratory arrest and even death," the DRSP stresses.

Naloxone can be used to reverse the effects of isotonitazene, but given its potency, more than one dose may be needed to save a person's life.

Vadeboncoeur argues anything bought on the street is dangerous and could potentially kill.

"There can be stuff out there that can take your life," he stresses.