{"references": ["EMCDDA (European Monitoring Centre for Drugs and Drug Addiction) (2020a), EMCDDAinitial report on the new psychoactive substance N, N-diethyl-2-[[4-(1-methylethoxy)phenyl]methyl]-5-nitro-1H-benzimidazole-1-ethanamine (isotonitazene), Initial reports, Publications Office of the European Union, Luxembourg.", "Alex J Krotulski Isotonitazene Quantitation and Metabolite Discovery in Authentic Forensic Casework J Anal Toxicol. 2020 Jul 31;44(6):521-530.", "EMCDDA (2020), EMCDDA technical report on the new psychoactive substance N,N-diethyl-2-[[4-(1-methylethoxy)phenyl]methyl]-5-nitro-1Hbenzimidazole-1-ethanamine (isotonitazene), EMCDDA, Lisbon.", "Timothy J. Shea, Schedules of Controlled Substances: Temporary Placement of Isotonitazene in Schedule I.Federal Register / Vol. 85, No. 162 / Thursday, August 20, 2020, / Rules and Regulations.Drug Enforcement Administration", "Hoffmann, K; Hunger, A; Rossi, A. (3 May 1960). Patent US2935514A \u2013 Benzimidazoles.", "PubChem Identifier: CID 134971785 https://pubchem.ncbi.nlm.nih.gov/compound/Clonitazene#section=Canonical-SMILES", "PubChem Identifier: CID 53316366 https://pubchem.ncbi.nlm.nih.gov/compound/Metonitazene", "PubChem Identifier: CID 13493 https://pubchem.ncbi.nlm.nih.gov/compound/Etonitazene"]}

Isotonitazene, chemically termed Ndiethyl-2-[[4-(1-methylethoxy)phenyl]methyl]-5-nitro1 Hbenzimidazole-1-ethanamine, is an opioid analgesic recently emerged in the illicit drug market.[1] In 2019, illicitly manufactured Isotonitazene Toxicological data from 18 cases in the unites states has indicated its use is inextricably linked with polydrug use.[2] The drug can be delivered via intravenous, intramuscular, or subcutaneous. The most common overdose symptoms are Apnea, stupor, miosis, bradycardia, suppression of the endocrine system, euphoria, and convulsion.[1] Although no clinical experience with isotonitazene toxicity has been reported to date but based on the pharmacological profile similarities of Isotonitazene with other opioids, Naloxone can be expected to work.[3] As the available data and information suggest a high risk of abuse, forensic professionals and toxicologists need to be aware of Isotonitazene.