Novel Synthetic Opioids (NSO) are an emerging class of New Psychoactive Substances (NPS) that include fentanyl, nitazenes and their respective analogues.
Opioids act on the opioid receptors in the brain and produce a range of effects including: pain relief, sedation, euphoria, decreased heart rate and respiratory depression (dangerously slow breathing). Respiratory depression can occur more rapidly with NSOs which increases the risk of a life-threatening overdose.
Types of NSOs
Fentanyl – Can be prescribed for chronic pain, such as severe cancer pain, nerve damage or back pain. Fentanyl and fentanyl analogues are also illicitly manufactured and sold on the black market and added as a contaminant to other illicit drugs. In Australia, fentanyl has been found in drugs sold as heroin, alprazolam, ketamine, cocaine, and methamphetamine. Fentanyl is up to 100 times more potent than morphine, but fentanyl analogues (such as carfentanil) can be up to 100 times stronger than fentanyl.
There have been no official drug alerts involving fentanyl in Australia since 2021, however in 2024 three fentanyl test strips provided by Tasmanian Needle and Syringe Program (NSP) outlets indicated a positive result. In all three cases the substance tested was believed to be methamphetamine.
Fentanyl test strips are currently available from all primary NSPs in Tasmania.
Nitazenes – were initially developed as a pharmaceutical opioid but were never released due to their dangerously high potency and potential for overdose. Nitazenes can be up to 40 times stronger than fentanyl, and up to 1000 times stronger than morphine.
In Australia, nitazenes have recently been found in heroin, ketamine, cocaine, GHB and, 3C-P, MDMA and fake oxycodone and alprazolam. Concerningly, drug alerts and overdoses involving nitazenes have been increasing throughout 2024.
Unfortunately, nitazene test strips are unavailable in Tasmania but can be purchased online from www.drugpolicy.org.au
Are you at risk?
If you, or someone you know, consumes any illicit drug, you may be at risk of your drugs being contaminated with NSOs.
Minimise harm and stay safe:
Be aware – Fentanyl test strips are available from your local NSP outlet and, if used properly, they can detect for the presence of fentanyl. However, they do not test for other contaminants and there is no way to guarantee your drugs are completely safe to consume.
Check drug warnings – Pubic drug alerts are updated regularly on The Know website https://community.theknow.org.au/
Start out small – Start with a small dose of your drug to test how strong it is.
Never use alone – Overdose risk increases significantly if you use alone.
Carry naloxone – Naloxone is an opioid overdose reversal medication that comes in a nasal spray and is easy to administer. If you have consumed an NSO you may need multiple doses of naloxone to reverse the overdose. Always carry it with you.
Stagger use if using in a group – Wait 10-15 mins between each person having their dose to make sure someone can administer naloxone if needed. A group of four people fatally overdosed in Victoria recently after consuming what they believed to be cocaine.
Recognise the signs – knowing the early signs of overdose means you can act quickly.
Signs of an overdose include:
· Non-responsive.
· Difficulty walking or staying alert.
· Slow/Shallow breathing.
· Snoring or unusual gurgling sounds.
· Lips turning blue.
· Slow or no pulse.
· Cool, pale, and clammy skin.
· Can’t be roused – even when shaken.
If you suspect an overdose, call 000 and use naloxone straight-away.
