Highly potent synthetic opioid misrepresented as heroin

This notification is to let you know a nitazene, a type of highly potent synthetic opioid, has been misrepresented as heroin. The substance was detected in an orange powder in the Auckland region and is possibly in circulation nationwide.

Although heroin and nitazenes are both opioids and produce similar effects, nitazenes are significantly more potent than heroin. People consuming this substance believing it to be heroin are at significant risk of harm, including death. 

High Alert urges extreme caution should you choose to take orange powders. Consumption of this powder could lead to serious harm, including death, even if you have experience using opioids. It is important to never assume that what you have is the same as what you are being told it is. Misrepresentation can occur anywhere along the supply chain.

If you or someone you know take this substance and start to lose consciousness or breathe slowly, call 111 immediately. Tell them what you think has been taken and that it could be an opioid overdose. 

Naloxone can be used to help reverse an opioid overdose. Given the potency and duration of effect, any person administered naloxone should continue to be monitored for at least 2 hours and seek medical advice. 

How to recognise the drug

A sample of this substance was submitted to a New Zealand Drug Foundation drug checking clinic in Auckland. Further analysis of the sample conducted by the Institute of Environmental Science and Research (ESR) confirmed the presence of a nitazene, but at this stage the specific substance remains unknown. No heroin was detected.

The powder did not react to nitazene test strips – while not all nitazenes can be detected with these strips, it’s still important to continue using them to detect other nitazenes that are circulation in New Zealand. Fentanyl test strips also cannot be used to detect nitazenes.

Photo of sample presented to drug checking

Nitazenes are highly potent synthetic opioids, and may have been linked to several deaths in New Zealand. It is very difficult to accurately dose these substances, and injecting has increased risk. Nitazenes have been found in a number of substances in New Zealand including cocaine, benzodiazepines, and other opioids like oxycodone. It has also been sold in various forms including powders, pressed pills, and blotter paper.

Overdoses from nitazenes can occur with very small amounts.  A dose of nitazene is significantly smaller than heroin, meaning people consuming this substance believing it to be heroin can inadvertently consume multiple doses increasing their risk of overdose.

The effects of nitazenes can include:

• Feeling euphoric or in a ‘dreamlike’ state
• Sedation (‘the nod’ – being drowsy and then jerking awake)
• Temporary relief of pain, stress, or low mood
• Severe nausea and/or vomiting
• Severe sweating or fever
• Slowed and/or difficulty breathing
• Blue lips and/or fingertips
• Cold and clammy skin
• Pinpoint (tiny) pupils
• Seizures
• Becoming unresponsive and/or losing consciousness

How to reduce harm from the drug

Nitazenes are very strong opioids and consumption can easily lead to an overdose, even among people with experience using opioids. High Alert urges extreme caution should you choose to use orange powders. 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 who can help, and call an ambulance, if things go wrong. Use a buddy system if needed - where someone is on the phone or calls you to check you are ok. 
• Lower doses are less risky. Start off with an extremely small amount (a typical dose is in micrograms) to check how it affects you. If you notice unexpected effects avoid taking more.
• In general, swallowing 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. The nitazene is unlikely to be evenly distributed, meaning some parts will be stronger than others. Crushing the powder, mixing it, and measuring out an extremely small amount can help to more evenly distribute the nitazene and avoid overdose.
• Avoid using it at the same time as other substances and medications, especially other depressant drugs such as alcohol, opioids, GHB/GBL, ketamine, and benzodiazepines, as these can increase the risk of slowing or stopped breathing.  
• Have naloxone with you – a medication that can temporarily reverse the effects of an opioid overdose and give you more time to get medical help. Talk to your local needle exchange or GP about this. High potency opioids like nitazenes may require more than one dose of naloxone. 
  • Remember, nitazenes can be fast acting and you may not initially realise you require naloxone. Have someone with you who can administer naloxone if needed because you will not be able to administer it by yourself.  
  • If you aren't sure whether someone is experiencing an opioid overdose, you should use naloxone anyway. Naloxone won't hurt the person if they aren't overdosing. There is no maximum dose of naloxone - meaning that you are not at risk of giving someone too much. 

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

The signs of an opioid overdose include: 

• They may not be completely awake or are unresponsive.
• They are breathing slowly or not at all (they may be snoring).
• The person’s face is extremely pale and/or feels clammy to the touch.
• Their body goes limp.
• Their fingernails and/or lips have a purple or blue colour.
• They start vomiting or making gurgling noises.
• Their pupils become very small.
• Their heartbeat slows or stops. 

If you have heard of any reports of this drug, please let us know through the Report unusual effects page, the alert ID is N25/0054. 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.