Expanded Test Menu - New Synthetic Opioids

Fentanyl Analogs & Isotonitazene

Synthetic Analog Facts

Assurance Laboratories has worked with its partner organizations to identify high prevalence synthetic opioids in our local community. The opioid crisis has continued to evolve, especially during covid-19, requiring physicians and laboratories to be more aware of the ever changing landscape.

Over the past several years, there has been an increasing trend of death caused from synthetic opioids. Synthetic opioid-involved death rates increased by over 15% from 2018 to 2019 and accounted for nearly 73% of all opioid-involved deaths in 2019. In 2020 through April of 2021, more than 100,000 deaths from overdose occurred which was the highest in U.S. history. Of the 100,000, more than 60% of the deaths involved synthetic opioids.

Assurance Laboratories has researched commonly seen synthetic opioids in our local communities and continues to pursue the most impactful compounds to your patient care. According to the Milwaukee County Medical Examiner’s office, 79% of overdose cases in Milwaukee involved a form of fentanyl, and further 78% of heroin that was tested included a version of fentanyl.

As many as 4 out of 10 illicit substances that contain fentanyl, have a lethal dose of fentanyl in them. In recent years, illicit manufacturing of fentanyl has occurred, making chemically similar substances more readily available on the street. These compounds are known as analogs and can range in potency.

Among the latest non-fentanyl opioids to be detected, are the drugs referred to as “nitazenes”. Nitazenes date back to early day pharmaceutical development of alternatives to morphine. However, the risk of taking these medications was too high and they were found to be not suitable for use. With increased regulations on fentanyl and other schedule 1 drugs, a high demand of illicitly used opioids has triggered the development of “nitazenes” once again.

In Wisconsin and Illinois, Istonitazene alone is believed to have contributed to more than 40 deaths in Cook county and Milwaukee county in the first 7 months of 2020.

As a trusted partner, Assurance Laboratories helps you stay in the KNOW. The testing we provide will always remain cutting edge and focused on new and emerging compounds so that you don’t have to worry.

Frequently Asked Questions 

What are the coupounds you have added?
We have validated four high prevalence Fentanyl Analogs that are present within our community. We have systematically added these based on how frequently they have been seen in local overdose cases. We have also added the most commonly seen “nitazenes” locally, into our menu.

Fluoro Fentanyl (O-Isomer)
Cyclopropyl Fentanyl
Methoxyacetyl Fentanyl


How do I order these drugs?
These analogs are available to everyone! You can order these compounds ad-hoc, or add them to any work-up of YOUR choice. Talk with your account manager to learn more!
What sample type is this available for?
Assurance performs testing for these compounds exclusively in urine. We plan to bring this up in other matrices in the near future.
How long does it take to get results?
Results are posted within 48 hours. If you need results faster, please call us and we will expedite it for you.
Will this cost more to get these substances?
Any order that requests we test for fentanyl, will receive the additional fentanyl analogs we have as part of their work up. Since the new fentanyl analogs are part of the existing fentanyl drug class, there is no additional cost to know more!

Isotonitazene is an ad-hoc synthetic opioid available upon request. This substance will be classified as an opioid analog, and may result in an additional drug class being ordered depending on your current ordering practices. Contact your Account Manager to learn more!

Fentanyl Analog Education

Isotonitazene Education

Contact Us

Contact us to see how we can partner with you to meet your patients’ and clients’ needs.

1630 Miller Park Way, West Milwaukee, WI 53214



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