Police say ‘ISO,’ a potent synthetic opioid, may have arrived in Jackson County

Published 9:45 am Wednesday, October 11, 2023

Members of the Medford Area Drug and Gang Enforcement unit suspect that a powerful synthetic opioid has entered the local illicit drug supply.

However, the substance — isotonitazene, aka “ISO” — has not yet been identified in any drug seizures in Jackson County, according to Det. Sgt. Josh Reimer of MADGE.

“We believe it’s here, but we have zero confirmation of that,” Reimer said.

Since late summer, police have seized drugs suspected of containing the substance between five and 10 times, but lab tests have turned up negative for ISO while still testing positive for other drugs that dominate the supply: fentanyl and its derivatives, methamphetamine, heroin and the animal tranquilizer xylazine (street name: “tranq”).

Reimer attends annual meetings in California on the topic of the fentanyl crisis with the state’s HIDTA (High Intensity Drug Trafficking Area) teams. These are multiagency task forces composed of local, state and federal agents. In the most recent meeting this summer, agents said ISO had hit the streets of San Francisco, where more than 99% of the drugs that reach Jackson County originate, Reimer said.

There is a chance that drugs sent to an Oregon State Police crime lab for analysis contain ISO, Reimer said, but a backlog in testing prevents results from surfacing.

“To the best of our knowledge, we have not seized ISO yet, but there are months of cases that are still sitting at a drug lab waiting to be tested,” Reimer said.

Dr. Kerri Hecox, medical director at Oasis Center of the Rogue Valley — an addiction treatment provider in Medford — said some of her patients claim to have used ISO. Oasis cannot confirm this: The agency does not yet have the capacity to test for the drug in people’s systems.

According to a 2022 article on the federal Centers for Disease Control and Prevention website, nitazenes like ISO are “linked to overdose deaths in several states. Nitazenes were created as a potential pain reliever medication nearly 60 years ago but have never been approved for use in the United States.”

Isotonitazine in particular, the article says, has a potency that “greatly exceeds that of fentanyl.” Fentanyl itself is “up to 50 times stronger than heroin and 100 times stronger than morphine,” the CDC says.

Because it is an opioid, ISO overdoses can be reversed with the nasal spray naloxone, though several doses may be needed, the CDC says.

But because nitazines have never been OK’d, medical providers are less certain of how ISO works on the brain than they are of fentanyl, which comes in a familiar pharmaceutical grade, Hecox noted.

It is possible that ISO is not yet in the community, Reimer acknowledged. Drug dealers have claimed their product contains ISO to raise the price. This was evident in a recent case, Reimer said.

“They were basically just defrauding all their customers, selling it for more than what fentanyl cost,” he said.

Reimer said he leans toward believing that ISO has arrived.

“If it’s being talked about in the medical, law enforcement and drug-user and -dealer communities that ISO’s around, I have to think it probably is,” he said. “But we haven’t been able to prove that yet.”

Reimer said that if ISO turns up, it will most likely be in powder form, but it can be mixed with binders and pressed into pills.

“I would hope that people know that we’re on it, that we’re trying, and that we’re well aware that it exists and trying to keep it out of our community,” Reimer said.

The county has had about 90 suspected fatal drug overdoses so far in 2023, according to MADGE figures.

A surge occurred in September, which saw 15 fatal ODs in the county. August saw 12.