‘It’s A Matter Of Life Or Death’: AOD Sector Calls For Immediate Government Action On Opioids 

Drug harm reduction advocates launched a plan to reduce harm from nitazenes, a family of increasingly common super-strength opioid drugs, outside NSW Parliament yesterday morning. In front of an electronic banner reading “nitazenes are a ticking timebomb”, speakers told the crowd the NSW Government is turning a blind eye during an unfolding crisis.  

With the support of the Health Services Union and frontline drug harm reduction organisations, such as NUAA, advocacy organisation Unharm called for increased access and training for naloxone, a non-prescription medication that rapidly reverses opioid overdoses, as well as permanent fixed-site drug checking facilities in NSW and festival pill testing services.

Independent NSW MP Alex Greenwich and MLC Jeremy Buckingham from the Legalise Cannabis Party were also present and spoke in support of the “synthetic opioid preparedness plan”. 

Health Crisis At Our Doorstep

With increasing detections of nitazenes across the nation, this campaign by drug harm reduction workers and politicians is a timely reminder of the public’s need to remain vigilant. Speakers at the press conference emphasised the deadly threat that nitazene adulteration poses to both injecting drug users and party drug users. In Australia nitazenes have so far appeared in heroin supplies, MDMA, coke, ice, ket and vapes, as well as in pills sold as Valium and Xanax.  

Referring to the increasing presence of nitazenes locally, MP Alex Greenwich said, “This is a health crisis that has arrived on our doorstep very seriously”.   

Health experts fear delay. Unharm CEO Dr Will Tregoning said the time to act is now: “Lives are at risk right now. We can’t wait months for the drug summit before taking action. The cost of inaction will be measured in human lives.” 

 “The community is completely unprepared,” he continued. “Most people don’t know nitazenes exist, let alone how to avoid them and what to do if someone overdoses.” 

What Are Nitazenes?  

 Nitazenes are not a single drug but a class of extremely potent drugs with heroin-like effects. Like heroin, morphine, codeine and fentanyl, nitazenes are an “opioid”. But nitazenes are far far stronger than heroin, and almost always stronger than fentanyl. They are made in a laboratory from start to finish rather than from natural substances found in the opium poppy plant, as is the case with heroin production. 

Chemists first developed nitazenes in the 1950s as pharmaceutical products but they were not suitable for clinical use due to their intensity.  

Speakers at the press conference stressed there is no safe dose for nitazenes. The strengths of different nitazenes vary wildly. While ‘metonitazene’ is 50 times stronger than heroin, ‘etonitazene’ is 500 times stronger than heroin. It means tolerance doesn’t factor in here. Even for seasoned heroin injectors, they’re a serious danger.  

According to Users News, one service user from western Sydney who experienced a recent nitazene overdose told staff from the NSW Users and AIDS Association (NUAA) that he required 5 doses of naloxone along with CPR before he regained consciousness.  

Nitazenes Increasingly Popping Up In Australia 

Nitazenes are beginning to consistently hit Australian streets, causing concern among health experts. This is no rogue anomaly.  

In April, the National Centre for Clinical Research on Emerging Drugs (NCCRED) released a report on the increase in nitazene toxicity reporting within Australia. Detections of nitazenes have occurred in almost every single Australian state and territory across the last 12 months. They’ve attracted a lot of recent media attention following a spate of highly-publicised hospitalisations and deaths.   

The Australian Federal Police and Australian Border Force also recently published a joint media release highlighting the rise in nitazene importation and police seizures of the drug. 

In July this year, 4 people died from a nitazene overdose in a Melbourne home days after the Victorian Department of Heath issued a public drug warning about nitazenes entering local cocaine supplies as a contaminant.  

Press Conference Demands  

Speakers stressed that people in NSW need greater access to naloxone. They want to expand the range of frontline workers who carry, and know how to use, naloxone, demanding that police officers also carry naloxone at all times.

This recommendation adds to the recent proposal by local drug harm reduction experts that prison guards receive training to recognise overdose signs and carry naloxone. Experts also want naloxone and naloxone training to be consistently offered to all those exiting prison.  

Speakers called for the NSW Government to develop a communications plan for public education on nitazenes and embrace drug checking. They want a legal, permanent drug testing facility in NSW similar to CheQpoint in Queensland and CanTEST in the ACT. This would allow members of the public to get their drugs tested anonymously and for free. Since the start of April, staff from The Loop Australia have a run a drug checking trial at the Uniting Medically-Supervised Injecting Centre (MSIC) in Kings Cross. But the pilot program is only available to registered MSIC users and it finishes on 9 September this year.   

 “Drug checking is now a matter of life and death in NSW,” Alex Greenwich emphasised.  

NSW MLC Jeremy Buckingham, who represents the Legal Cannabis Party, said, “It is now time for [NSW Premier] Chris Minns to show courage”.

Evidence from CanTEST in Canberra shows that these services change user behaviours, ensure safer drug usage and reach audiences who have never discussed their drug usage with a health professional.  

At the end of the press conference, Caitlan Dooley, people and event management specialist at Dancewize NSW, gave a live demonstration on how to use naloxone to reverse the effects of an opioid overdose.

She emphasised that people must call for an ambulance if they see someone overdosing on a drug and stated they won’t be criminalised for doing so. Dooley also stressed that naloxone is a temporary intervention designed to keep someone alive until paramedics arrive. A nitazene overdose may require multiple doses of naloxone and hospital treatment because the drug is extremely strong and it stays in the body longer than heroin.  

 Nitazenes: A Sign Of What Is To Come?  

Caitlin Dooley from Dancewize NSW asserted that communities not usually exposed to opioid-focused harm reduction services are also now in harm’s way. 

“They’re in MDMA, they’re in ketamine, they’re in vapes,” she warned. “They’re everywhere.”  

Unharm CEO Will Dr Will Tregoning emphasised that local nitazene detections are not isolated incidents, telling the crowd present that their increasing prevalence is closely tied to global supply chain issues for heroin.  

United Nations reporting has shown that opium poppy cultivation in Afghanistan declined by 95 percent last year due to a blanket ban by Taliban authorities, who have chosen to focus instead on methamphetamine production. Almost overnight a major supplier of heroin in Europe ceased production. Now lab-manufactured opioids – nitazenes in particular – are beginning to flood European markets, filling the vacuum. In the UK, for example, current estimates suggest that almost 3 people die from a nitazene-related overdose every week.   

Nitaznes are a sign of the likely future of illicit drug production, which is slowly shifting away from plant-based drugs such as weed, coke and heroin and towards synthetic (lab-made) drugs. 

Robbie Mason is the publications coordinator at the NSW Users and AIDS Association (NUAA) where he manages Users News and Insiders News. He is also a previous City Hub news editor.