In recent times, the numbers of synthetic opioids that are in fluxing the illicit drug market are on the rise and are not unconnected to the growing opioid crisis across North America and Europe. This is attributed to the negligence in the synthetic opioid connected deaths as many medical institutes either use screening laboratory methods that are direct or testing that are not specific for Isotonitazene and its  benzimidazole group which include etonitazene, metonitazene etc. 

As synthetic opioids are created to act on opioids receptors, these drugs are rapidly being sold in drug market and they benefit most of their users.    

The newest opioid to be identified is the Isotonitazene which is an analogue of benzimidazole family of analgesia. While others in the group include the etonitazene, clonitazene, nitazene, metonitazene. Among the synthetic opioids, it is highly potent eradicate pains as quickly as possible..  However, the etonitazene is averagely 1000 -1500 times potent of morphyl group in animal, about fifty times the potency in man. Nevertheless, it will be interesting to investigate and identify the reason behind such lesser degree in man. The Isotonitazene has a heavier molar weight than the etonitazene.

The forensic toxicological case study confirms and quantifies the presence of isotonitazene in the red blood cells, the urinary solution and body fluid through vitro and vivo metabolic profile investigation in the samples of users collected. Liquid chromatography mass spectrometry is very essential in obtaining quantitative analysis (LC-MS) while liquid chromatography time-of-flight mass spectrometry (LC-TSOF-MS) is adopted to obtain metabolite result.  

Research has shown that using these techniques the mean concentration of Isotonitazene in blood as well as the median and range to be quantified so also the mean, median and range concentration of Isotonitazene in urine of samples. The metabolites of the compound include the five-amino-isotonitazene most present in blood samples while the N-dealkylation and O-dealkylation were predominant in the urine.  The method provides clinical and forensic toxicological tool. The analytical method needs to be frequently revisited to keep up with the increasing new trend. Mediolegal practioners should always update themselves in the new rise trend of the synthetic opioids. Forensic investigators should enlighten the public and medical personnels on the need to include Isotonitazene to testing methodology about the new drug substances and the benefits the use of opioids portend to the global community.