Carolyn Beeler: So, they’re emerging the same way fentanyl did, being mixed with other drugs. Your reporting indicates that as many as 2,000 people in the US may have overdosed on nitazene since 2019. That is just a tiny fraction of the nearly 70,000 overdose deaths the US had last year alone, according to the CDC. Is the concern here that this number will grow?

Jonathan Moens: Yeah, there’s a serious concern that this will grow. There’s a serious concern that these drugs are coming in through the borders in ways that are very easy for them to flood in because it’s such small quantities. And there’s a concern that the people who are making these drugs can constantly innovate and constantly bypass regulations so that they can keep coming into the country or different countries. But you’re right to say that this is not the bulk. Like, in terms of public health issues in the United States, for instance, fentanyl is the biggest problem. Nitazenes constitute a very small fraction, but because of their potency and because they could be laced into other drugs, including fentanyl itself, all the sources I’m speaking to are very concerned.

So, tell me more about where these drugs are coming from. I understand predominantly China. How are they being bought and sold internationally?

How is it possible that people are posting this just on the open web, on places like LinkedIn, as you said? Is it not illegal in China or here?

No, it’s totally illegal. The problem is just the lack of regulations around. I mean, these marketplaces find it hard to track all of this. People post all the time, and all these people who are posting, they sort of hide behind fake emails, fake websites, fake domains. So, it’s very hard to actually identify who these people are, and they can just sort of come up and create new accounts if they’re deleted. So, it’s about the fact that it’s sort of a Wild West scenario in these marketplaces, especially the ones that are lesser known.

Now, I know China was previously a major source of fentanyl. The country then banned all variants of fentanyl back in 2019. I’m curious if that ban worked. Did producers stop making fentanyl? Now, they’re moving to these other drugs like nitazenes? Or are they still making fentanyl but also adding this new opioid?

There’s definitely some evidence suggesting that this effective ban on fentanyl has really reduced, decreased the amount of fentanyl supply, at least when it comes to arriving in the US. The fentanyl, the number of different kinds of fentanyl, basically, dropped significantly after that ban. But what happened as a result potentially is that nitazenes suddenly started to increase in terms of the different kinds. So, you would have 4 or 5 different kinds of nitazenes in 2019 when they were first being tracked. And then, suddenly, now you have about 26 in the US alone, different kinds. That’s much higher than fentanyl now. It’s surpassed the fentanyl number.

But still, the volume is still less. So, more varieties of nitazenes coming into the US, but less volume overall than fentanyl?

The volume will almost certainly still be much higher for fentanyl than it will be for nitazenes, mostly because of the history of how much fentanyl has been used and spread and proliferated in general in the United States versus nitazenes being a relatively new drug and it requiring very small quantities to actually cause harm.

Why is China the source of these synthetic opioids?

That’s a very good question. I think it comes down to the development of these makeshift labs that have learned how to do very sophisticated things and make a lot of money by hiding behind websites, emails. Even if China cracks down on these drugs, which it has, on the one hand, it sometimes crack down by trying to focus on one drug at a time, which is not the most effective way. But even when it tries to do more of a sort of sweeping attack on nitazenes, these makeshift labs, these individuals, these networks in China have just learned how to be very dexterous and work around it. So, it’s not so much about the government, in my opinion. It’s much more about how easy it is to ship these drugs and how sophisticated these networks can be.