Warning: isotonitazene has been associated with serious harms in NSW. It is possibly related to recent deaths which remain under investigation.

Know the risks

• Drug samples in NSW have been found to contain isotonitazene, a potent opioid of the nitazene class.
• 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.
• You are at increased risk of overdose if you:
  • use drugs when you are alone
  • use drugs again after a break
  • mix different drugs. Alcohol, benzos and opioids are very dangerous to combine.
• Fentanyl test strips are unable to detect these nitazene opioids.

Effects to look out for

Opioid overdose symptoms include any of: pin-point pupils, drowsiness, loss of consciousness, slow breathing/snoring or skin turning blue or grey.

Getting help

If you 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 help.
• If someone is not breathing, start CPR if you know how.
• 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.
• 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

• 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.
• Visit Your Room 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.