Nitazine comes in powder, pill and liquid form and requires time-consuming lab work to trace. Often laced into substances that users think is fentanyl or heroin, it is potentially lethal or can cause a more severe onset of withdrawal symptoms, the Axios website reported.

Its arrival comes as law enforcement and public health authorities are grappling with the increased use of “tranq dope” – a mix of animal sedative and fentanyl that´s drawn the White House´s attention and been found in at least 36 states plus Washington, D.C.

However, most hospitals and medical examiners do not regularly test for either substance, and hospital data does not distinguish nitazene from cases of fentanyl poisoning.

A Centers for Disease Control review of overdose deaths in Tennessee concluded nitazene-related overdoses could require up to four doses of naloxone, the opioid reversal drug that usually comes two to a pack.

Tennessee saw its nitazene-related overdoses go from 10 to 42 between 2020 and 2021, per the CDC report, which noted the figures are likely an undercount.

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