Rise in opioid overdoses after use of cocaine or methamphetamine

Source: NSW Health
Drug sold as: Cocaine, methamphetamine or MDMA

Reason for concern: Contains heroin

Warning: 11 people have experienced severe opioid overdose after use of drugs thought to be COCAINE or METHAMPHETAMINE since December 2023.

HEROIN was the opioid identified.

Know the risks

  • Heroin and other opioids may be sold as or found in cocaine, methamphetamine and MDMA.
  • Small amounts of opioids can cause life-threatening overdose in people who have never or rarely used opioids.
  • You cannot always tell the difference between heroin, cocaine and methamphetamine by appearance.
  • The risks of overdose are increased if you:
    • use a high dose, or re-dose when you are not getting the desired effect.
    • use with other drugs (for example alcohol, benzodiazepines, ketamine, GHB or opioids).
    • use new drugs alone.
    • use a new batch.
  • Fentanyl test strips do not detect heroin or many other opioids.

Effects to look out for

Unexpected drowsiness, pinpoint pupils, loss of consciousness, slow breathing/snoring, and skin turning blue/grey after using a stimulant (for example cocaine, methamphetamine, or MDMA).

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.

Take Home Naloxone program

  • Naloxone is a life-saving medicine that can temporarily reverse an opioid overdose.  Naloxone is availbale in a very easy to use nasal spray, and as a pre-filled injection.
  • You should carry naloxone if:
    • you are using drugs such as cocaine, methamphetamine, MDMA or opioids.
    • you are hosting or going to a party where drugs will be present.
  • If you are at risk of experiencing or witnessing an opioid overdose you can get naloxone for free without a prescription in NSW from some community pharmacies, needle and syringe programs, opioid treatment services and NUAA.
  • Visit Your Room – Naloxone for participating sites and more information on take-home naloxone.
  • NUAA can mail you naloxone in a discreet package. Order via their online shop or call (02) 8354 7343.

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 & DanceWize NSW’s PeerLine 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.

Reproduced by permission, NSW Health © 2024.