[Intoxication with a nitazene; new potent synthetic opioids on a rise]

Nitazenes, a class of highly potent synthetic opioids, have emerged as a significant public health concern in Europe. This highly potent opioid can cause severe, potentially life-threatening intoxications even at small dosages. This case describes the first nitazene intoxication reported in the Netherlands, specifically with isotonitazepyne. We present a case of a 60-year-old male with a history of substance use disorder, who experienced respiratory and cardiac arrest after nasally ingesting self-prepared isotonitazepyne. Prompt administration of naloxone reversed respiratory depression, and the patient fully recovered. Nitazene intoxications resemble opioid toxicity but tend to have a more severe course due to their high potency. Treatment involves supportive care and naloxone. Increased awareness of nitazenes is crucial as their presence in Europe grows. This report highlights the clinical presentation and management of a nitazene overdose and the importance of vigilance, reporting, and collaboration for managing emerging psychoactive substances effectively.