A highly potent opioid, more dangerous than fentanyl and heroin, is being mixed into the popular party drug MDMA, prompting emergency warnings and renewed calls for pill testing.
Three people were taken to Sydney hospitals on the weekend after taking a form of nitazenes, which are strong synthetic opioids that can cause severe overdose or death.
Those hospitalised ingested half a pill, with one person treated in the intensive care unit. Tests on one pill – which was stamped with the Red Bull logo – found traces of nitazene and no MDMA.
The same drug was detected after heroin overdoses on the New South Wales central coast in late December, prompting a separate warning from the state’s health department. It was also detected in black market vape juice, which was linked to three overdoses and a death last year.
Nitazene overdose symptoms are often unpredictable but include a loss of consciousness, skin turning blue or grey, snoring, drowsiness and pin-point pupils. Alcohol can also increase the risk of overdose.
Chris Gough, chief executive of the nation’s only pill testing venue in Canberra, said the detection of nitazenes in pills sold as MDMA showed the need for similar services in other states.
“In this case, where a nitazene has been sold as MDMA and therefore people are completely unprepared and potentially opioid naive, the risk of overdose is extreme,” said Gough, who is the executive director of the Canberra Alliance for Harm Minimisation and Advocacy.
“As we have now seen nitazenes in several jurisdictions in Australia it is time to act swiftly to provide drug-checking services throughout Australia so that we can respond to these drug trends as they emerge and thereby save lives and inform the community.”
Gough said nitazenes were “a serious problem” and that they had already been detected in Canberra.
Jennifer Schumann, head of the drug intelligence unit at the Victorian Institute of Forensic Medicine, said the detection of nitazene in the drug sold as MDMA was “very concerning”.
“There are a number of different nitazenes that have been detected in Australia and overseas and they range in potency, with some being similar to morphine and some much stronger than fentanyl – the drug that’s fuelled the North American opioid epidemic.”
Darren Roberts, medical director at the NSW Poisons Information Centre, urged anyone experiencing symptoms to call an ambulance and receive naloxone, a life-saving medicine that reverses the effects of opioids.
“Nitazenes can be as strong or stronger than fentanyl and may be more likely to impair breathing than other opioids,” Roberts said.
“It’s important people recognise the signs of an opioid overdose early and know how to respond. Taking the appropriate action early can save a life.”
The Victorian Greens have also renewed calls for pill testing at music festivals in response to the recent hospitalisations in NSW.
“These dangerous pills risk the lives of many young Victorians. Taking even half of one of these ‘Red Bulls’ has been shown to put people in hospital,” the party’s drug harm reduction spokesperson, Aiv Puglielli said.
“Sniffer dogs will not save lives. Tough talk from cops and politicians will not save lives. Pill testing will.”
Schumann was part of a study published in the Journal of Analytical Toxicology that studied the presence of nitazenes in presentations to Victorian emergency departments.
“Since then, drug monitoring data has detected further instances of these drugs circulating in the Australia community,” Schumann said.
In September last year, Australia’s drug regulator, the Therapeutic Goods Administration, warned the nitazenes were becoming increasingly common in Australia.
“While these reports are largely limited to overseas jurisdictions thus far, I note with concern the recent reports of the detection of nitazenes in seizures of heroin and other illicit and counterfeit drugs in Australia,” a TGA spokesperson said at the time.
Nitazene was linked to numerous deaths in the UK last year along with the sedative xylazine. It is believed the drugs were cut into, or sold as, heroin without users’ knowledge.
