Gaining Popularity: Street Drug “ISO”
ISO, short for isotonitazene, is a synthetic opioid. It can be up to twenty times more powerful than fentanyl. ISO has been mixed into other drugs and then sold as a more potent and cheaper illicit drug. Now there are reports about ISO being used on its own as a substitute for medications such as Dilaudid and Oxycodone.¹
When in doubt, send them out
ISO is not detectable by using tox screen test strips and can be lethal. If a detainee arrives to the jail looking intoxicated or sick, consider getting medical clearance before booking. Letting a detainee “sleep off” symptoms of intoxication can be dangerous. Withdrawal and detox from ISO can look the same as opioid withdrawal. As with any type of withdrawal and detox plan, medical should be involved to monitor for side effects. Refer to mental health as needed. When in doubt, send them out.
Treat ISO exposure the same as fentanyl
Much like fentanyl, ISO may be inhaled or absorbed through the skin. Naloxone (Narcan) may require multiple doses. Staff responsible for handling and processing contraband or home medication should:
Wear gloves
Consider a partner system so that someone is available to get help if needed
Treat ISO exposure the same as fentanyl.
References
DEA Washington, DC Division - Public Information Office. (n.d.). New, dangerous synthetic opioid in D.C., emerging in tri-state area. DEA. https://www.dea.gov/stories/2022/2022-06/2022-06-01/new-dangerous-synthetic-opioid-dc-emerging-tri-state-area
Fleischer, P. (2022, December 26). ISO, a dangerous synthetic opioid stronger than fentanyl, showing up in Florida. WINK NEWS. https://www.winknews.com/2022/02/17/iso-a-dangerous-synthetic-opioid-stronger-than-fentanyl-showing-up-in-florida/
Jamison, P. (2021, November 29). The Washington Post. https://www.washingtonpost.com/local/dc-politics/new-opioids-more-powerful-than-fentanyl-are-discovered-in-dc-amid-deadly-wave-of-overdoses/2021/11/29/680afb2c-4d43-11ec-94ad-bd85017d58dc_story.html
For more information on ISO exposure, contact training@sparktraining.us.
All materials have been prepared for general information purposes only. The information presented should be treated as guidelines, not rules. The information presented is not intended to establish a standard of medical care and is not a substitute for common sense. The information presented is not legal advice, is not to be acted on as such, may not be current, and is subject to change without notice. Each situation should be addressed on a case-by-case basis. WHEN IN DOUBT, SEND THEM OUT. ®
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