In the 1950s, Swiss company CIBA Pharmaceuticals developed a class of synthetic opioids known as Nitazenes. Designed to target µ-opioid receptors in the brain, they were intended as next-generation painkillers with greater efficacy than morphine. However, their extreme potency and high risk of respiratory depression led to their rejection for medical use.
For nearly six decades, Nitazenes remained confined to academic research as “tool drugs” for studying opioid receptor pharmacology. That changed in 2019 when illicit labs began producing analogues (a drug that shares structural or pharmacological similarities with an existing drug) based on historical pharmacological research. These powerful compounds quickly infiltrated drug markets, particularly in Europe and North America, with little public awareness compared to heroin or MDMA. Nitazenes soon became a significant addition to the evolving landscape of “new psychoactive substances” (NPS).
The United Nations Office for Drugs and Crime (UNODC) defines NPS as substances not controlled under the 1961 or 1971 international drug conventions but posing potential public health risks. Dubbed “research compounds”, “legal highs” or “bath salts”, many of these drugs originated in labs decades ago but only recently emerged in illicit markets.
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On March 13, 2024, the UN Commission on Narcotic Drugs, following WHO recommendations, placed five NPS and one medicine under international control; four of these were Nitazene derivatives. Since the first reported case in 2019, the number of identified Nitazenes has surged from one to 13 by 2023, with detections across Asia, Europe, North America, Oceania and South America. Drug agencies warn that illicit producers are increasingly shifting to NPS derivatives to evade regulation.
According to the European Union Drugs Agency, between 2016 and 2022, around 50 new NPS emerged annually, but this dropped to 26 in 2023. Meanwhile, about 400 previously identified substances continue to circulate each year. So far, NPS abuse has been reported in over 134 countries and territories. Since December 2021, the UNODC Early Warning Advisory has tracked over 1,124 such substances through governments, laboratories and partner agencies.
India lacks a dedicated early warning system for detecting and responding to emerging drug threats like NPS or synthetic opioids such as Nitazenes. Existing frameworks focus more on reducing the public desire for illicit drugs rather than specialised early detection of novel substances.
According to Abdul Rasak T., who heads the forensic science department at the Kerala Police Academy, even when highly dangerous psychoactive substances are reported to the UNODC Early Warning Advisory, banning them under the NDPS Act takes time. “A drug might be on the streets, but without NDPS Act recognition, there is no screening. What we need is an immediate incorporation system when a substance is flagged by UNODC or other agencies. Regular inspections of pharma labs are also crucial in preventing legal facilities from producing precursors for illicit drugs.”
The lack of awareness among users, health care providers and law enforcement, combined with gaps in legal frameworks, raises the risk of an undetected or misdiagnosed synthetic opioid crisis in India.