A dangerous new drug, isotonitazene, known on the streets as ISO, is wreaking havoc in San Francisco. This synthetic opioid is 20 times more potent than fentanyl and has already claimed its first life in the city in April, according to San Francisco Health Department officials.
ISO is often blended with other synthetic opioids, such as cychlorphine, making it even more lethal. Health officials warn that a single pill can contain a fatal dose. Compounding the danger, ISO does not show up in standard fentanyl tests, leaving users unaware of what they are consuming.
Shocking video footage posted online by Manhattan Institute writer Christopher Rufo shows users in San Francisco's Tenderloin district stooping over from the drug's effects or lying motionless on the sidewalk. Rufo reported that dealers say ISO is becoming more popular on the streets, describing an ongoing arms race in opioid potency from heroin to fentanyl and now to ISO.
According to the Center for Forensic Science Research and Education, isotonitazene, also known as Nitazine, is roughly 20 times more potent than fentanyl. It can be smoked, injected intravenously, or taken in pill form. The U.S. Drug Enforcement Administration (DEA) issued a warning about ISO and other synthetic drugs, noting that they may be mixed with fentanyl and greatly increase the risk of fatal overdose. Alarmingly, naloxone, the standard overdose reversal drug, may not be effective against these new substances.
ISO first emerged in U.S. illicit drug markets in 2019 and has since been identified in over 900 reports to the DEA, with a peak of 358 reports in 2021. The drug has no approved medical or industrial use, making it a serious public safety concern.
In Los Angeles, law enforcement officials say ISO has not yet become a major threat, but they note an increasing trend of mixing fentanyl with other drugs, including animal tranquilizers. Fentanyl is blamed for over half of all drug and alcohol deaths in Los Angeles. Police have intensified efforts to clean up MacArthur Park, a known hub for drug use.
Jacqui Berlinn, cofounder of Mothers Against Drug Addiction and Deaths in San Francisco, criticized the police for not doing enough to address the crisis. She emphasized that ISO is particularly frightening because it is so powerful and undetectable by standard test kits, catching addicts off guard.
