Recent reports have revealed a concerning trend in Australia’s illicit drug market. Powerful opioids known as nitazenes have been found contaminating recreational drugs such as cocaine, MDMA (ecstasy), and ketamine. This contamination has led to several hospitalizations and overdoses, raising alarm among health professionals and drug users alike.

What Are Nitazenes?

Nitazenes are a group of synthetic opioids developed in the 1950s for pain management research. However, they were abandoned due to their extreme potency and danger. Key points about nitazenes include:

– They are entirely synthetic, made in labs rather than derived from natural sources like the opium poppy.

– Nitazenes have no current medical use.

– They can be up to 10 times stronger than fentanyl and 500 times more potent than heroin.

– Some users seek them intentionally for their strong effects, while others may consume them unknowingly as contaminants in other drugs.

The Dangers of Nitazenes

The extreme potency of nitazenes makes them particularly hazardous:

– There’s a very fine line between intoxication and overdose.

– They act quickly and can remain in the body longer than other opioids.

– Nitazene overdoses can progress to life-threatening situations within minutes, compared to the hour or more typical of heroin overdoses.

– They’re especially dangerous for individuals not accustomed to opioid use.

– Combining nitazenes with other drugs, particularly stimulants like cocaine, can mask initial overdose symptoms and increase risks.

Recent Incidents in Australia

Several recent events have highlighted the presence of nitazenes in Australia:

– In July 2024, cocaine in Melbourne was found to be contaminated with nitazenes.

– In May, four people in Sydney were hospitalised due to suspected nitazene use.

– In April, about 20 people in outer Sydney overdosed on drugs containing nitazenes.

Prevalence of Recreational Drug Use in Australia

The potential for nitazene exposure is concerning given the prevalence of recreational drug use in Australia:

– Cocaine use has increased significantly over the past two decades, with 4.5% of the population reporting use in the past 12 months in 2022-23, up from 1.3% in 2001.

– MDMA use, while decreasing during the COVID-19 pandemic, shows signs of increase. In 2023, 2.7% of the population reported using MDMA in the previous year.

– Ketamine use has grown in popularity, with 1.4% of the population reporting use in the past 12 months in 2022-23, up from 0.4% in 2016. Among Australians in their 20s, this figure rises to 4.2%.

Harm Reduction Strategies

To mitigate the risks associated with nitazenes, several harm reduction strategies are recommended:

1. Drug checking services: Currently available in the Australian Capital Territory and Queensland, with Victoria planning to introduce a service by the end of the year.

2. Nitazene test strips: These can detect the presence of nitazenes in drug samples and have shown good specificity in recent testing.

3. Cautious consumption: Users are advised to buy from known sources, start with small amounts (about one-quarter of the usual dose) when trying a new batch, and never use alone.

4. Naloxone availability: Regular users are encouraged to keep naloxone on hand, which can temporarily reverse opioid overdose effects.

5. Immediate medical attention: Calling emergency services at the first sign of trouble is crucial, even if naloxone has been administered.

“And of course the pro-drug normalisation groups don’t call for best-practice health and safety of stepping away from psychotropic toxins, but continue to entrench the narrative that this self-poisoning behaviour is somehow ‘normal’, and that people doing this new ‘normal’ should be promoted in their use by engaging harm reduction strategies to double down on use, not exit it… It’s important to note – yet again – that you cannot ‘overdose’ on a non-prescribed drug, as there is NO safe dose rates. What the person using substances for ‘fun’ is doing is self-poisoning, and governments are now being harnessed to support and even encourage this activity…”

Government Response and Future Directions

To prevent the escalation of nitazene-related harms, experts suggest governments should:

– Expand harm reduction services, including drug checking and supervised injecting facilities.

– Ensure adequate stocks of naloxone are available.

– Consider following the examples of countries like the United States, United Kingdom, and Ireland, which have seen concerning increases in nitazene-related overdoses in recent years.

Source: The Conversation