5-cyano-isotodesnitazene (isotocyanozene) has recently been found in toxicology and powder samples, in South-East Queensland.

There is limited potency or toxicity data available on 5-cyano-isotodesnitazene globally as it a novel nitazene only recently detected for the first time in Australia. Nitazenes are very strong synthetic opioids that work like heroin or fentanyl and could produce life-threatening toxicity in small amounts.

The appearance of the sample is a white powder in a plastic bag marked ‘opioid F5’.

Toxic Effects

The toxic effects of nitazenes are likely to be similar to other potent synthetic opioids and include:

• Extreme drowsiness or the person may even be impossible to wake (‘on the nod’)
• Small (‘pin point’) pupils
• Slowed or obstructed breathing
• Respiratory failure that can lead to death
• Blue or purple coloured skin (cyanosis), usually starting on lips and fingers

These effects should respond to naloxone, and it shoud be used if available. More information on accessing Naloxone below.

Information and Advice

Queensland Health advises that if you or someone you know suspects you have this substance, do not consume instead dispose of it safely. Seek medical attention immediately if you or someone you know experiences any toxic effects following drug use.

Harm reduction information

Naloxone is available for free from registered pharmacies and services through the national Take Home Naloxone program. Use this link to find your closest site participating in the program Take Home Naloxone (THN) Program Participating Site Locator (arcgis.com).

Nitazene test strips can be useful but are not entirely effective in screening for all nitazenes, they should be used with caution. This sample did not react with nitazene test strips.

For help

• Call Triple Zero (000) for emergency assistance
• Go to your nearest emergency department
• Call the Queensland Poisons Information Centre (13 11 26)
• ADIS 24/7 Alcohol and Drug support (1800 177 833 or www.adis.health.qld.gov.au)
• Peer Qnect confidential telephone peer support (1800 175 889)