Nitazenes can be stronger than fentanyl and can be up to 500 times more potent than heroin. Nitazenes are more likely to decrease or stop breathing than other opioids. The purity of nitazenes can vary greatly even in the same batch, and the risk of overdose is very high. They are commonly found in powders or crystals - some are white, brown or yellow. However, they can be indistinguishable from other drugs.
Nitazenes were first detected in Australia in 2021, and since then, there has been growing concern about this group of highly potent synthetic opioid drugs. Nitazenes were initially developed for research purposes in the 1950s as an alternative to morphine. However, the clinical development was abandoned due to the very high risk of overdose. This class of drugs have recently been illicitly synthesised and re-emerged in the global drug market. No drugs in this class were ever approved for medicinal use.
Who is at risk?
Anyone who is taking illicit drugs of any kind is at risk, even if they do not intend to take opioid-based drugs. Nitazenes have been detected across every state in Australia and have been found in a wide range of substances sold as heroin, MDMA, ketamine, vape refills, cocaine, and counterfeit pharmaceutical products.
According to the National Centre for Clinical Research on Emerging Drugs: “Nitazenes have been used intentionally or inadvertently through a range of routes of administration (oral, insufflation, inhalation, rectal, injection). The presence of nitazenes in non-opioid substances is of particular concern as people not intending to use an opioid may not use appropriate harm reduction measures such as carrying naloxone. They may also not be aware of harm reduction resources such as naloxone or how to deliver it.”
The Victorian Department of Health issued an alert for “A white powder sold in Melbourne as cocaine contains the potent opioid ‘protonitazene”. Several NSW public drug warnings regarding nitazenes have been issued for a variety of substances.
A NSW Health safety notice for clinicians was also issued in November 2023 following three opioid overdoses (including one death) linked to nitazenes in illicit vape juice. In one case, the person thought the vape refill liquid contained cannabinoids (similar to THC), but instead, it contained a nitazene.
What are some reasons for an increase in nitazene-related harms and deaths?
Coinciding with the increased detection of nitazenes globally, from 2022-2023 there has been a 95% decline in opium poppy cultivation in Afghanistan. This follows a ban in Afghanistan on poppy cultivation and all types of narcotics. While much of Australia’s heroin comes from Southeast Asia a global shortage may still have implications here. According to the United Nations Office on Drugs and Crime, a sustained reduction in opium production often leads to the “replacement of heroin or opium by other substances in retail markets, some of which may be even more harmful, such as fentanyl or other synthetic opioids.”
The increase of nitazenes detected within Australia and at the Australian border is a cause for concern, especially considering many people lack education about this class of drugs.
The AFP and Australian Border Force (ABF) recently issued a joint public warning over concerns of a rise in attempted imports of nitazene”. AFP Commander Paula Hudson said authorities had identified an increase in attempted imports of the drug throughout 2023 and anticipated further attempted imports in the future. over concerns that a “dangerous illicit drug could be hitting Australian streets following a rise in attempted imports of nitazene”. AFP Commander Paula Hudson said authorities had identified an increase in attempted imports of the drug throughout 2023 and anticipated further attempted imports in the future.
Naloxone is free, and it saves lives.
The lack of awareness around nitazenes and the increase in their prevalence in Australia has resulted in a much greater need for individuals to access and carry Naloxone.
Naloxone is a life-saving measure which can temporarily reverse an opioid overdose, including with nitazenes. Take-home naloxone is available in a very easy-to-use nasal spray and as a pre-filled injection. Anyone can access naloxone for free without a prescription and keep it in their home or bag for emergencies.
You should ensure you have naloxone available if:
You or anyone you are likely to encounter is using drugs such as cocaine, ketamine, methamphetamine, MDMA or opioids.
If you might experience or witness an opioid overdose, you can get naloxone for free without a prescription in NSW from some community pharmacies, needle & syringe programs, opioid treatment services and NUAA.
Nitazenes can last longer in the body than heroin and naloxone. Higher and repeated doses of naloxone and hospital treatment are often required. Anyone who uses naloxone should call Triple Zero (000) for an Ambulance immediately after use for follow-up care. You won't get into trouble for seeking medical care; police will not be contacted unless medical staff feel threatened. If you or your friend feel unwell, do something about it.
Naloxone is available from NUAA via mail in a discreet package. Order via their online shop or call (02) 9171 6650.
Take-home naloxone is available as an easy-to-use nasal spray or injection from some pharmacies and other health services. For more information on the take-home naloxone program visit: Your Room - Naloxone.
Anyone who has concerns about adverse effects from drugs should contact the NSW Poisons Information Centre on 13 11 26, at any time 24/7. For support and information on drug and alcohol problems, contact the Alcohol and Drug Information Service on 1800 250 015. This is a 24/7 service offering confidential and anonymous telephone counselling and information. NSW public drug warnings are available at Public drug warnings.
Learn more about nitazenes
To learn more about nitazenes, visit Your Room or download the nitazene fact sheet here
Getting help
If you think you might benefit from help with drugs or alcohol issues, it may be time to discuss with your doctor / GP, counsellor, or call the Alcohol and Drug Information Service (ADIS) 24 hours a day, 7 days a week on 1800 250 015 for free and confidential advice. Or start a Web Chat with an ADIS counsellor online Monday to Friday, 8.30am – 5pm.
Family Drug Support (FDS) provides 24 hours a day, 7 days a week telephone support to families and carers in crisis due to alcohol and other drug use issues. FDS is staffed by volunteers who have experience with family members with alcohol and other drug use. FDS also provides face-to-face support meetings and resources for family members. You can contact them on 1300 368 186
The Your Room website houses all the latest drug and alcohol news, trends, and information. Visit the A-Z of drugs to learn more and start a conversation with Yas, the chatbot who can help you find answers about alcohol and other drugs or tell you about available services.
A comprehensive list of resources and support information can be found here.
