When Ashley Delgado was in high school in Cleveland, Ohio, she dreamed of becoming a doctor. She earned strong grades, excelled in science and Latin, and imagined a future where she could heal people and buy her father a Rolls-Royce. But years later, a leg injury and a prescription for OxyContin set her on a path that moved from prescription opioids to methamphetamine, heroin and eventually fentanyl.
With support from her family, Ashley entered rehabilitation and later moved into a sober living facility. In the summer of 2023, however, her body was found on a dead-end street outside Cleveland. She was 29 years old. A folded piece of paper containing tan powder was discovered inside her clothing, and toxicology tests later showed that her system contained protonitazene and metonitazene — synthetic opioids from a class of drugs known as nitazenes.
Her death was ruled accidental.
Ashley’s father, James Taylor, said he had never heard of nitazenes before his daughter’s death. Developed in the 1950s as potential painkillers, the drugs were never approved for medical use because they were considered unsafe. Some nitazenes are estimated to be significantly more potent than fentanyl and hundreds of times stronger than heroin.
A months-long investigation by Bellingcat, an investigative journalism organisation, examined the spread of nitazenes across the United States through criminal court records, medical examiner reports, public records requests and open-source research. The investigation found that nitazenes are increasingly appearing in the US drug supply, despite government efforts to restrict their production and distribution.
The drugs are commonly sold online, including through clear web platforms and dark web marketplaces, and are frequently mixed with other substances. Experts told Bellingcat that users seeking more familiar drugs, including fentanyl, oxycodone, cocaine and stimulants, may unknowingly consume nitazenes, increasing the risk of fatal overdoses.
According to figures provided to Bellingcat by the United Nations Office on Drugs and Crime, the United States has reported 26 different types of nitazenes since 2019, second only to Canada globally. Data from the US Centers for Disease Control and Prevention shows more than 1,100 confirmed nitazene-related overdose deaths through its State Unintentional Drug Overdose Reporting System, while experts estimate the actual number could be significantly higher due to limited testing capacity.
Alex Krotulski, director of the Centre for Forensic Science Research and Education in Pennsylvania, told Bellingcat that many cases may go unidentified because not all forensic laboratories test for nitazenes. He said deaths involving the drugs could remain unrecorded when laboratories do not include them in toxicology screenings.
The investigation found that nitazene-related deaths reached their highest levels in 2023 and 2024, with 747 confirmed fatalities recorded during those two years. As of this year, 48 of the 50 US states have reported nitazene seizures.
The data also highlights Ohio as a major centre of nitazene activity. Drug seizure records obtained from the US Drug Enforcement Administration’s National Forensic Laboratory Information System show confirmed nitazene reports increasing sharply from 43 in 2019 to nearly 2,000 in 2024. Ohio accounted for more than one-third of all positive nitazene laboratory reports during that period.
Separate CDC data showed Ohio recording the highest number of nitazene-related overdose deaths since 2021. The state recorded four deaths linked to the drugs in 2020, followed by 90 in 2021 and around 200 additional deaths between 2022 and 2024.
Health and harm-reduction groups in Ohio have warned that the changing drug supply is creating new risks. AmandaLynn Reese, chief programme officer at Harm Reduction Ohio, told Bellingcat that reports of nitazenes in local communities had increased and that wider access to drug testing and overdose-reversal medication remained important.
Medical examiner reports from Cuyahoga County reviewed by Bellingcat identified 45 people who died after taking nitazenes in 2023 and 2024. The victims included men and women aged between 29 and 72, including university graduates, former athletes, an Army veteran, an ironworker and an addiction counsellor. In every case reviewed, nitazenes were detected alongside fentanyl and often other substances such as heroin, cocaine, methamphetamine and benzodiazepines.
Drug enforcement officials say the combination of substances has made the illegal drug market increasingly unpredictable. Frank Tarentino, associate chief of operations for the Drug Enforcement Administration’s Northeast Region, told Bellingcat that dealers mix substances to increase potency and maintain demand, creating what he described as a dangerous environment for users, families and communities.
Bellingcat’s investigation also found that nitazenes continue to enter the United States through international supply chains. Data from US Customs and Border Protection showed 41 intercepted nitazene shipments in 2024 and 2025, with many arriving through mail routes from mainland China, Hong Kong and the United Kingdom.
Online access has remained a central challenge. Bellingcat previously identified more than 1,000 nitazene advertisements across online marketplaces, forums and dark web platforms. Court records show buyers have obtained the drugs from online suppliers, including chemical companies, and arranged shipments through international delivery networks.
US authorities have taken enforcement action against suppliers and online marketplaces, while China introduced additional controls on many nitazenes in 2025. However, experts say manufacturers continue to adapt by developing chemically similar substances designed to bypass existing regulations.
Jared Brown of the United Nations Office on Drugs and Crime said new synthetic opioids known as “orphines” were already emerging as another concern. Drug enforcement officials have described synthetic opioid producers as constantly changing their methods to exploit regulatory gaps.
As authorities continue efforts to control the spread of nitazenes, the drugs remain present in communities across the United States, appearing alongside fentanyl and other substances in an increasingly complex and dangerous illicit drug market.
