Local health officials concerned about new synthetic opioid in Tennessee

Posted at 5:44 PM, May 28, 2020
and last updated 2020-05-28 22:50:00-04

NASHVILLE, Tenn. (WTVF) — A new synthetic opioid that can be just as deadly as fentanyl has local health officials on the lookout.

Isotonitaneze first emerged in the U.S. last summer, but it has since made its way to Tennessee earlier this year. The Tennessee Bureau of Investigation (TBI) said "iso" is on its radar after recently receiving samples of the drug to its crime labs.

While there are no reported cases in Nashville so far, the Metro Public Health Department started alerting local law enforcement about the drug this month to help identify and keep track. Trevor Henderson, the Metro opioid response coordinator, also asked the medical examiner's office to start screening for the drug.

"Hearing there's another potentially deadly and complicating drug appearing could make things an awful lot more difficult for public health, first responders and hospitals, and it's very concerning," Henderson said.

The number of fatal overdoses in Davidson County is already up compared to the same time last year. Since March, around the time COVID-19 hit, there have been 116 drug-related deaths. The number was 67 in 2019.

While fentanyl remains the biggest driver of fatal overdoses, isotonitazene should be of public concern because it has the potential to cause widespread harm, according to the Center for Forensic Science Research & Education (CFRSE). Its chemical structure resembles etonitazene, an analgesic drug first identified in the 1950s.

Isotonitazene first appeared in the U.S. in the Midwest last summer after it was first detected in Canada in March 2019. Overall, the amount of cases remains low.

The drug is so new it requires more research to determine the potency. So far it's not in the Drug Enforcement Agency's (DEA) list of controlled substances nor was it mentioned in the First Quarter 2020 Emerging Threat Report. However, Chris Thomas of the Knox County Regional Forensic Center said it's important to pay close attention.

"It shouldn't be ignored," Thomas said. "While it's a minimal amount of cases, it's one of those things if left undocumented, unregulated and unresearched, it can easily take over in the next few years as the emerging drug."

"Iso" first appeared in Tennessee in Knox County in January where overdose cases have nearly doubled since 2019. Eight people who died of an overdose had "iso" in their system. Usually, overdose cases have more than one type of drug involved.

Thomas said the presence of isotonitazene was so new, the department needed a specialized test to confirm the drug. A normal test is $200, but "iso" needed a different testing tool that was an additional $325.

"The toxicology company that we work with, which is on a national level, had seen only relatively a few cases of this in the country in general," Thomas said.

The last confirmed case was in late April, but with pending toxicology results, the number is expected to go up.

Around the same time isotonitazene hit the market in January in Tennessee, another drug also appeared.

Flualprazolam tested positive in 12 deadly overdoses in East Tennessee, four of them mixed with isotonitazene. Sometimes referred to as designer benzodiazepenes, this drug is described as souped up Xanax.