Warning: Strong opioids have recently been found in some fake Kalma tablets in NSW. They are white, rectangular tablets marked AL on one side, G2 on reverse.

Know the risks

• Testing of fake (counterfeit) ‘Kalma’ tablets found they contain a strong opioid, namely etodesnitazene. ‘Nitazenes’ can be as strong or stronger than fentanyl. Another synthetic opioid (O-desmethyltramadol) was also found in the same tablets.
• Tablets containing strong opioids can cause unexpected and severe overdose or death, even from a single tablet.
• Risk of harm is also higher if you:
  • Mix different sedative drugs. Alcohol, benzodiazepines (benzos) and opioids are very dangerous to combine.
  • Take a counterfeit product
  • Take a higher dose
  • Use drugs when you are alone
• Fentanyl test strips are unable to detect these opioids.
• Fake Kalma 2mg tablets are more likely to be rectangular in shape. Prescribed Kalma tablets purchased at pharmacies are oval.
• Fake benzos (often called street Xanax) may contain a variety of drugs and look very similar to real pharmaceuticals.

Effects to look out for

• Difficulty speaking or walking, drowsiness, loss of consciousness, slow breathing/snoring and skin turning blue or grey.
• Be on the lookout for unexpected effects.

Getting help

If you see the warning signs of overdose:

• Seek help immediately from your nearest emergency department or call Triple Zero (000).
• Start CPR if someone is not breathing.
• Use naloxone if you have it, repeat doses may be required. Call ‘000″ even if naloxone has been given.

Take home naloxone program​​

• Naloxone is an easy to use, life-saving medicine that can temporarily reverse an opioid overdose. People at risk of experiencing an opioid overdose or who may witness an overdose can get naloxone for free without a prescription from some NSW community pharmacies, NSW Health needle and syringe programs, opioid treatment services and NUAA.
• Naloxone is available in easy to use products: Nyxoid® nasal spray and Prenoxad® pre-filled syringe.
• For participating sites and more information on take-home naloxone visit Your Room – Naloxone.
  

Support and advice

For free and confidential advice:

• Call Alcohol and Drug Information Service (ADIS) on 1800 250 015 at any time 24/7. Start a Web Chat with an ADIS counsellor Mon-Fri, 8.30am-5pm.
• Call NUAA on 1800 644 413 (Mon-Fri 9am-5pm) to speak to a peer or visit NUAA/DanceWize NSW for a factsheet on fake benzos.
• Call the Poisons Information Centre on 13 11 26 for advice on adverse effects from drugs.
• Visit Your Room for information on benzos.

Reproduced by permission, NSW Health © 2023.