The Pennsylvania Department of Health has criminalized nitazenes, a class of synthetic opioids that can be even stronger than fentanyl, as overdose deaths in the state mount.

Nitazenes are temporarily labeled a Class I controlled substance as of Saturday, meaning it’s illegal to possess, distribute or manufacture them in the state. The action puts Pennsylvania in line with federal policy.

The interim label can last up to two years. In its announcement, the Department of Health said it’s taking steps to place nitazenes in Class I permanently.

“Scheduling nitazenes, which have no acceptable medical use, as Class I substances provides law enforcement with the authority to crack down on its possession and distribution in Pennsylvania,” said Secretary of Health Debra Bogen. “Meanwhile, our focus remains on developing strategies that help connect people with substance use disorder with treatment and other resources.”

Nitazenes were first developed in the 1950s as an alternative to morphine, but were never approved for medical use. They were an obscure domain of pharmacological researchers until spilling into the illicit drug market in 2019.

Nitazenes have continued to become more prevalent in the state’s illicit drug supply, according to the department, contributing to 45 deaths in Pennsylvania since 2023.

Opioids remain the leading cause of fatal overdoses in the state and across the country. In 2023, 3,757 Pennsylvanians died of an overdose involving opioids, 3,470 of which were at least partly attributed to fentanyl.

Like other opioids, overdose reversal medications such as Narcan should be administered in cases of nitazene overdose.

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