KANSAS CITY, Mo. — Nitazenes, a highly potent class of synthetic opioids, were detected at 26 Missouri schools during a voluntary school wastewater monitoring program led by the Missouri Department of Public Safety.
The Missouri Department of Health and Senior Services said nitazenes have recently been identified in counterfeit pills, illicit powders, unregulated cannabis products and vape liquid, often without the user knowing.
Some nitazenes are over five to 10 times more potent than fentanyl, officials said.
“Nitazenes are a hidden killer,” DPS Director Mark James said. “Even a tiny amount of nitazenes can cause someone to stop breathing, and they’re increasingly being detected in counterfeit pills – but most people have never heard of them. Protect yourself: avoid using all illicit substances and only use medications obtained directly from a pharmacist with a valid prescription.”
Health officials warn that traditional drug detection tests do not identify nitazenes, which makes it more difficult for people, including providers, to know when they are present.
Officials are urging vigilance, prevention and expanded access to resources such as naloxone, also known as Narcan, a medication that reverses an opioid overdose.
“Having access to and knowing how to administer naloxone is becoming increasingly important in our communities,” DHSS Director Sarah Willson said. “It is easy and safe to use and can reverse an opioid overdose and allow a person’s normal breathing to be restored.”
Nitazenes were implicated in 14 Missouri overdose deaths in 2024, more than triple the total number recorded between 2019 and 2023, according to DHSS.
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