Nitazene-linked overdose deaths in the U.S. rose from 27 in 2020 to 409 in 2024

Overdose deaths confirmed to involve nitazenes rose from 27 in 2020 to 409 in 2024, according to Centers for Disease Control and Prevention data. Nitazenes are synthetic opioids developed in the 1950s but never approved for medical use. They are sold online and frequently mixed with fentanyl, methamphetamine, or cocaine.

Spread and detection The U.S.

By March 2026, more than 8,000 nitazene-positive laboratory reports had been logged since 2019. The United Nations Office on Drugs and Crime data show the United States has identified 26 different nitazenes since 2019, second only to Canada. More than 1,100 deaths have been confirmed through the CDC’s State Unintentional Drug Overdose Reporting System, though experts estimate the true total since 2019 may reach 2,000.

Ohio impact Ohio recorded more than one-third of all positive nitazene laboratory reports from 2019 to 2024 and the highest number of nitazene-related deaths since 2021. In 2020 the state had four such deaths; the figure rose to 90 in 2021 and added 200 more between 2022 and 2024.

In 2024, Ohio Gov. Mike DeWine issued executive orders scheduling nine nitazenes and authorized expanded drug-testing tools. Local groups are distributing naloxone and drug-checking strips.

Cleveland died in 2023 after toxicology tests detected protonitazene and metonitazene. Her father, James Taylor, said she had been prescribed OxyContin after a leg injury and later used other substances. Alex Krotulski, director of the Center for Forensic Science Research & Education, said many laboratories do not routinely test for nitazenes, leading to undercounting in official data.