Known as nitazenes, these cheap synthetic opioids are used to “bulk out” or replace more expensive drugs. But what makes them especially dangerous is their potency: Some variants are 5 to 10 times stronger than fentanyl and up to 500 times more powerful than morphine.
The drugs have already been found in oxycodone pills, cocaine, and even cannabis products and vape liquids—often without the user ever knowing. And now, after sweeping across Europe and killing 333 people in a single year in the UK, nitazenes are turning up in America’s wastewater.
In 2024, nitazenes were linked to 14 overdose deaths in Missouri—more than triple the total from the prior five years combined.
This year, Missouri’s Department of Public Safety detected nitazenes in the wastewater of 70 percent of monitored schools, indicating the drugs have reached children. Affected schools range from small communities like Fair Grove, Marshfield, Republic and Cassville to the Kansas City and St. Louis metro areas.
After state leaders informed Matt Copeland, a superintendent in Craig, of the results, he immediately organized a “One Pill Can Kill” school assembly for students in grades 6–12.
“We want to educate, not only our community, but all communities so that no one has to sit in an interview with [a reporter] when they’ve lost a kid,” Copeland said.
The warning signs were already there. In 2024, nitazenes were linked to 14 overdose deaths in Missouri—more than triple the total from the prior five years combined.
Meanwhile, as little as one dose of nitazenes can trigger vomiting, limp limbs, purple lips, cold and clammy skin, pinpoint pupils, deep coma, and slowed or stopped heartbeat and breathing.
State officials are urging parents and educators to warn children and teens about the dangers of counterfeit pills, illicit drugs and unregulated vapes—any of which may be laced with nitazenes.
“We have great kids. We have great parents. We have a great community here,” Copeland said. “But I’m also not naive enough to know that there aren’t drugs somewhere.”
“It’s definitely a wake-up call,” said Diana Jones, mayor of Craig, “proving that it can be anywhere, even in small towns.”
