Cocaine adulterated with tetracaine in Otago region

This notification is to let you know tetracaine (also known as amethocaine) has been found in a white powder that was sold as cocaine in the Otago region. People who consume this powder thinking it only contains cocaine are at risk of serious harm.

It is believed this powder is present in Dunedin, but may be available across the country. There is a concern that this powder may continue being sold as cocaine. It is important to never assume that the substance you have is what it has been sold as. Adulteration can occur anywhere along the supply chain.

High Alert urges caution should you choose to use white powders and drug checking is recommended to help minimise the risk. Drug checking services can identify when a substance is not what it has been sold as. Find upcoming clinics at The Level.

If you or someone you know takes a substance thought to be cocaine and starts to experience unusual effects, call 111. Be honest about your drug use. You won’t get in trouble, and it could save you or your friend's life.

How to recognise the drug

A sample of white powder was presented to a DISC Trust drug checking clinic in Dunedin. Preliminary testing by the Institute of Environmental Science and Research (ESR) confirmed this sample contained both cocaine and tetracaine.

Photo of sample found to contain tetracaine and cocaine

Tetracaine is used in health settings as a local anaesthetic. It does not produce psychoactive effects. While cocaine is sometimes mixed with other anaesthetic medication like lidocaine, tetracaine is stronger and not commonly used as a cutting agent.

The harmful effects of tetracaine are dose dependant. It can cause ringing in the ears (tinnitus), blurry vision, dizziness, and changes in your heart rate. High doses of tetracaine can result in seizures and cardiac dysrhythmias (abnormal or irregular heartbeat) which can be fatal.

Someone could experience negative effects due to tetracaine adulteration from a standard dose of what they believe to be only cocaine. The risks increase if multiple doses are taken.

The effects of consuming a mix of tetracaine and cocaine could include:

• Numbness, tingling, or burning on nostrils, gums or around the mouth
• Changes to heart rate
• Ringing in the ears (tinnitus)
• Blurry vision
• Dizziness or feeling lightheaded
• Difficulty swallowing
• Feeling very down, confused, or losing consciousness
• Seizures
• Sudden, extreme drop in blood pressure
• Breathing problems or not breathing
• Cardiac arrest

More general information on cocaine is available on the NZ Drug Foundation’s website, The Level.

How to reduce harm from the drug

High Alert urges caution should you choose to use white powders and drug checking is recommended to help minimise the risk.

KnowYourStuffNZ, the New Zealand Drug Foundation and the New Zealand Needle Exchange Programme's DISC Trust run regular drug checking clinics across the country. A calendar of upcoming clinics can be found on The Level.

If you choose to use this substance:

• Avoid using alone. Have a friend with you who can help and call an ambulance if things go wrong. If that’s not possible, use a buddy system where someone is on the phone with you or calls you to check you are ok.
• Lower doses are less risky. Start off with a small amount to check how it affects you – you can’t tell how much tetracaine may be in the substance. If you notice unexpected effects avoid taking more. Treat each dose with caution. Mixing the powder well before dosing can help to distribute the tetracaine more evenly, and lower the risks.
• In general, ‘gumming’ a substance has a slower onset than other methods (such as injecting) and means there might be more time to get medical help if needed.
• Avoid using it at the same time as other substances and medications, especially depressant drugs such as alcohol, opioids, GHB/GBL, ketamine, and benzodiazepines as these can increase the risk of problems with your heart and breathing.  

Call 111 and ask for an ambulance immediately if you or someone else are concerned or have any of the below signs after taking this substance. Tell them what has been taken and that it could contain tetracaine, it could save a life. Don’t leave the person alone and treat it as an overdose if unsure. 

• Their heartrate is very different from usual.
• They are breathing slowly or have difficulty breathing.
• They suddenly become extremely confused and have a lack of awareness of their surroundings (delirium).
• Their skin, lips, or fingernails have a blue colour.
• They have blurry vision, ringing in their ears (tinnitus), dizziness, slurred speech, numbing of the throat, difficulty swallowing, or feel drowsy.
• They have a seizure. 

If you have heard of any reports of this drug, please let us know through the Report unusual effects page, the alert ID is N25/0052. All submissions are anonymous.

Are you concerned about your own drinking or drug taking? Reach out to the Alcohol Drug Helpline on 0800 787 797, or text 8681. You'll be able to speak with a trained counsellor who can provide you with helpful information, insight and support. They’re available 24/7, all calls are free and confidential.

You can also chat to the Alcohol Drug Helpline team online through the website, or:

• Call the Māori Line on 0800 787 798 for advice and referral to kaupapa Māori services.
• Call the Pasifika Line on 0800 787 799 for advice and referral to services developed for Pacific people.
• Call the Youth Line on 0800 787 984 for advice and referral to services for young people.