Warning: ‘Red Bull’ tablets sold as MDMA (ecstasy) caused multiple hospitalisations in Sydney last weekend. Analysis of one tablet identified a potent opioid (a nitazene) and no MDMA.​

Tablet appearance is not a reliable indicator of drug contents.

K​n​​ow the risk

Nitazenes can be as strong as, or stronger than fentanyl and cause slow breathing or death.

• Naloxone can temporarily reverse an overdose from opioids, such as nitazenes. Higher doses of naloxone may be required to reverse nitazene overdose.
• You are at increased risk of harm if you:
  • Use drugs when you are alone.
  • Take opioids for the first time, or again after a break.
  • Mix different drugs. Alcohol, benzodiazepines and opioids are very dangerous to combine.
• Fentanyl test strips are unable to detect these nitazene opioids.
• Nitazene use has been linked to death and other serious harms.
• Exercise extreme caution with ‘Red Bull’ tablets. ‘Red Bull’ tablets have also been found to contain multiple other substances in the past 12 months.

Effects to look out for

• Opioid overdose symptoms include any of:
  • pin-point pupils, drowsiness, loss of consciousness
  • slow breathing/snoring and skin turning blue or grey.
• If you or others experience these symptoms after taking drugs, get help immediately.

Getting help

If you or your friends see the warning signs of overdose:

• Seek help immediately from your nearest emergency department or call Triple Zero (000). You won’t get into trouble for seeking medical care.
• Start CPR if someone is not breathing.
• Use naloxone if you have it. Call ‘000’ even if naloxone has been given.

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 for a range of resources on opioids and naloxone.
• Call the NSW Poisons Information Centre on 13 11 26 for information on adverse effects from drugs.
• Visit Your Room for fact sheets and other resources.

Take Home Naloxone program

• If you use any drugs you should carry naloxone. Drugs sold as cocaine and MDMA have been found to contain opioids.     
• Naloxone is an easy to use, life-sav​ing 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.
• Visit Your R​oom for participating sites and more information on take-home naloxone.
• NUAA can mail you naloxone for free in a discreet package. Order via their online shop or call (02) 8354 7343.

Reproduced by permission, NSW Health © 2023.