‘A matter of life or death’: AOD sector calls for immediate government action on nitazenes

Advocacy
Written By NUAA Admin

Thursday, 29 August, 2024.

Unharm CEO Dr Will Tregoning holds the "synthetic opioid preparedness plan" aloft. Photo courtesy: Unharm.  

  • Drug harm reduction advocates want: more access to naloxone (an overdose reversal medication), legal drug testing facilities in NSW and a government-supported communications plan to educate the public on nitazenes, a high-strength lab-made opioid.

  • Nitazanes can be up to 500 times stronger than heroin.

  • Signs of a nitazene overdose: unexpected drowsiness, loss of consciousness, slow breathing or snoring, and skin turning blue or grey.

  • A nitazene overdose may require multiple doses of naloxone (in other words: more naloxone than we usually use to reverse a heroin OD).

  • Fentanyl test strips cannot detect nitazenes.

Drug harm reduction advocates launched a plan to reduce harm from nitazenes, a family of super strong lab-made drugs with heroin-like effects, outside NSW Parliament on the morning of August 8. In front of an electronic banner reading “nitazenes are a ticking timebomb”, speakers told the crowd the NSW Government is turning a blind eye during an unfolding crisis.

With the support of NUAA, the Health Services Union and NADA (the peak organisation for drug services in NSW), advocacy organisation Unharm called for increased access and training for naloxone, a non-prescription medication that rapidly reverses opioid ODs, as well as permanent fixed-site drug checking facilities in NSW and festival pill testing services. Independent NSW MP Alex Greenwich and MLC Jeremy Buckingham from the Legalise Cannabis Party were also present and spoke in support of the plan.

With increasing detections of nitazenes across the nation, this public statement from drug harm reduction workers and politicians is a timely reminder of our need to remain watchful. Speakers at the press conference emphasised the deadly threat that nitazenes pose to people who use all kinds of drugs. In Australia they have so far appeared in heroin supplies, MDMA, coke, ice, ket and vapes, as well as in pills sold as Valium and Xanax. Even for seasoned heroin injectors, they’re a massive danger. Tolerance doesn’t factor in here due to the extreme, and variable, strength of nitazenes.

What are nitazenes?

Listen up. This is really important info that may save lives: nitazenes are a not a single drug but a family of extremely strong drugs made in a lab. Like heroin, morphine, codeine and fentanyl, nitazenes are what we call an “opioid”. You can think of nitazenes as a far far stronger version of heroin.

Detections of nitazenes have occurred in almost every single Australian state and territory across the last 12 months. They’ve attracted a lot of recent media attention following a spate of highly-publicised hospitalisations and deaths.

In July this year, 4 people died from a nitazene overdose in a Melbourne home days after the Victorian Department of Heath issued a public drug warning about nitazenes entering local cocaine supplies as a contaminant.

It is extremely difficult to try and work out a safe dose for nitazenes because  the strengths of different nitazenes vary wildly. While one particular nitazene is 50 times stronger than heroin, another is 500 times stronger than heroin. It is impossible to know which nitazene you have without proper drug testing.

What did the speakers at this press conference demand?

Speakers stressed that people in NSW need greater access to naloxone. They want to expand the range of frontline workers who carry, and know how to use, naloxone, demanding that police officers also carry naloxone at all times. This recommendation adds to the recent proposal by harm reduction and health experts that screws receive training to recognise overdose signs and carry naloxone. Experts also want naloxone and naloxone training to be consistently offered to all those leaving jail.

Speakers also called for the NSW Government to begin a communications plan for public education on nitazenes and embrace drug checking. They want a legal, permanent drug testing facility in NSW similar to CheQpoint in Queensland and CanTEST in the ACT. This would  allow members of the public to get their drugs tested anonymously and for free. Since the start of April, staff from The Loop Australia have a run a drug checking trial at the Uniting Medically-Supervised Injecting Centre (MSIC) in Kings Cross. But the pilot program is only available to registered MSIC users and it finishes on 9 September this year.

“Drug checking is now a matter of life and death in NSW,” Alex Greenwich emphasised.

MP Alex Greenwich speaking at the plan launch. Photo courtesy: Unharm. 

NSW MLC Jeremy Buckingham, who represents the Legal Cannabis Party, said, “it is now time for [NSW Premier] Chris Minns to show courage”.

Evidence from CanTEST in Canberra shows that these services change user behaviours, ensure safer drug usage and reach audiences who have never discussed their drug usage with a health professional. 

Further complicating things is the fact that fentanyl test strips cannot detect nitazenes. Nitazene test strips have recently become available and NUAA supports the use of test trips but they’re not fool proof and they may not detect all nitazenes entering illicit drug markets. Test strips are not a replacement for other harm reduction practices.

At the end of the press conference, Caitlan Dooley from Dancewize NSW gave a live demonstration on how to use naloxone to reverse the effects of an opioid overdose. She emphasised that people must call for an ambulance if they see someone overdosing. You will never be criminalised for doing so. Dooley also stressed that naloxone is a temporary intervention designed to keep someone alive until ambos arrive. A nitazene overdose may require multiple doses of naloxone and hospital treatment because the drug is extremely strong and it stays in the body longer than heroin.

Caitlan Dooley for Dancewize NSW. Photo courtesy: Unharm. 

One service user from western Sydney who experienced a recent nitazene OD told NUAA staff that he required 5 doses of naloxone along with CPR before he regained consciousness. These are the kinds of stories we’ve been hearing. So if someone drops right after doing a hit or a line, no matter the drug, seek medical help immediately.

What can you do about all this?

Firstly it’s crucial you can recognise signs of a nitazene overdose. These include unexpected drowsiness, loss of consciousness, slow breathing or snoring, and skin turning blue or grey.

It’s more important than ever for everyone who uses drugs to carry naloxone on them at all times.

Naloxone comes in two forms: as a non-prescription nasal spray or a non-prescription intramuscular injection. Both rapidly and effectively reverse the effects of an opioid overdose. In short: it can be a life-saving medication. NUAA can mail out naloxone for free. It’s also free at many community pharmacies and needle and syringe programs (NSPs). No prescription is needed.

If you’re having trouble finding free naloxone, it’s worth giving NUAA’s Peerline a call as we can help you find chemists that are taking part in the free take-home naloxone program. It’s a confidential peer-run phone service dedicated to supporting people who use drugs, who are on the OTP or who are seeking treatment across NSW. Call 1800 644 413 for help or email peerline@nuaa.org.au.

To help those at risk, Unharm is also encouraging the public to email bomb Chris Minns and demand change. Click on this link here to find out how to participate in this email campaign.

No time to wait: Urgent government intervention is crucial

Health experts fear delay. Unharm CEO Dr Will Tregoning said the time to act is now: “Lives are at risk right now. We can’t wait months for the drug summit before taking action. The cost of inaction will be measured in human lives.”

“The community is completely unprepared,” he continued. “Most people don’t know nitazenes exist, let alone how to avoid them and what to do if someone overdoses.”

We hope it is a source of comfort for our community knowing that NUAA and many like-minded folks are advocating for the safety of people who use drugs. We really want to see things change in NSW. You’re not alone out there!

Dancewize NSW staff. Photo courtesy: Unharm. 

NUAA Admin
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