Coordinated Subpocket Engagement Underlies Nitazene Potency at the μ-Opioid Receptor

Nitazenes are emerging synthetic opioids that exhibit exceptionally high potency at the μ-opioid receptor (MOR) and contribute to rising overdose fatalities worldwide. Despite extensive in vitro profiling, the structural determinants underlying their structure–activity relationships (SARs) remain unresolved. Here, we combine functional profiling with quantum mechanical calculations and molecular dynamics (MD) simulations to establish a MOR structure-based SAR for nitazenes. Across functional assays, systematic variation at the R1, R2, and R3 positions revealed nonadditive effects on potency and identified optimal R1 chain length, R2 N-desethylation, and retention of the 5-nitro group as key determinants of high MOR potency. Consistent with this framework, N -desethyl isotonitazene emerged as the most potent analogue. Structural analysis of the cryo-EM MOR–G i –fluornitrazene complex, together with MD simulations of multiple nitazene analogues, revealed a conserved trivalent binding architecture in which each substituent engages distinct subpockets. N-desethylation at R2 increases the positive electrostatic surface at the protonated amine, reduces steric constraints near transmembrane helix (TM) 7, strengthens R3 interactions, and allosterically modulates R1 engagement in a substituent-dependent manner. Additionally, optimal R1 chain length and shape stabilize the TM5–TM6 interface and influence activation-relevant TM6 dynamics, defining a unified SAR at R1 across nitazene and fentanyl scaffolds. Together, these findings indicate that nitazene potency reflects substituent-dependent coupling among R1, R2, and R3 within the MOR binding pocket, with R3 engagement distinguishing nitazenes from fentanyl. This framework establishes a coherent structural model of nitazene–MOR recognition that accounts for their unusually high potency and efficacy.