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Through eight lenses

01

Science

Alpha-2 agonists (xylazine, medetomidine — veterinary sedatives), nitazenes as μ-opioid agonists (synthesized in 1950s, never approved, re-emerging), kratom mitragynine partial μ-agonist + alpha-2, tianeptine atypical antidepressant with opioid activity at high doses.

02

Biology

Xylazine causes necrotic skin ulcers characteristic + prolonged sedation not reversed by naloxone; nitazenes act like high-potency fentanyl analogs (naloxone-reversible, higher dosing may be needed); kratom has its own withdrawal syndrome; tianeptine "gas station heroin" causing emergency-dept surges.

04

Policy

DEA scheduling scramble — xylazine FDA-declared emerging threat, nitazene analogs being scheduled piecemeal, kratom DEA deferred twice, tianeptine state-by-state patchwork.

Other substances in Novel & Emerging Psychoactives