A CAPSULE FILLED WITH WHITE POWDER expected to contain an unknown opioid was found to contain the novel nitazene isotocyanozene (5-cyano-isotodesnitazene). While nitazenes have been detected in several parts of Australia, including at CanTEST in Canberra, this is the first detection of isotocyanozene at a drug collection service in Australia. There is no readily available data on isotocyanozene globally.

Effects

The potency of isotocyanozene is unknown, however nitazenes are known to be 100s or even 1000s of times more potent than heroin or morphine.

All nitazenes carry a risk of fatal overdose – even in very small amounts. Nitazenes are known to cause opioid-like overdose (lowered/loss of consciousness, breathing slowly or not at all, tiny/pinpoint pupils, discoloured lips/ nails, cold or clammy skin, choking/coughing/gurgling or snoring sounds are all potential signs). Nitazenes can cause multiple overdoses over time

Information on this substance is extremely limited. If considering using, please note that there is no evidence-based information on safer use strategies for isotocyanozene. Being informed, carrying naloxone, and staying with others can reduce potential harm.

Test your stuff!

Always assume that your drugs may not be what you expect.

Naloxone

Naloxone can reverse an opioid overdose, and nitazenes are responsive to naloxone but several doses may be required. Never use alone and keep naloxone on hand. Search ‘Take Home Naloxone’ to get locations for free naloxone anywhere in Australia. Locals can get Nyxoid nasal spray naloxone for free from CanTEST, or visit cahma.org.au/services/naloxone to access their free postal naloxone service.

Responding to an overdose

Always call 000 immediately (even if you have and use naloxone). Learn first aid and CPR. Because opioid overdoses first affect a person’s breathing, rescue breaths are important when responding to a suspected opioid overdose.