In 1957, the pharmaceutical research department of Ciba AG published the discovery of the (low) analgesic effect of 1-(β-diethylaminoethyl)-2-benzylbenzimidazole (desnitazene). This led, in the late 1950s and early 1960s, to the development of a group of opioid analgesics known as nitazenes, but these were never approved through to market. A characteristic of nitazenes is their high potency, often hundreds to thousands of times more potent than morphine and other opioids.
In 2019 we received a human blood and urine postmortem paired sample for analysis along with a request to look for a compound called isotonitazene which had been tentatively identified in a drug sample from the scene of death. Traces of parent drug and metabolites were identified at very low levels and now 6 years later we have seen more than 15 nitazene variants in over 300 toxicology cases in the UK.
The methodologies used, metabolism, analytical challenges encountered and the rapid changes in detected nitazenes will be presented.