Overdose warning as drug ’50 times more potent than heroin’ found in SA
Traces of a potent class of opioids have been found in syringes collected from sharps disposal bins across metropolitan Adelaide, sparking concerns of a wave of overdoses.
A new study has detected a class of synthetic opioids that can be lethal in small doses in used syringes across metropolitan Adelaide.
The opioids, known as nitazenes, were found in syringes collected from sharps disposal bins across the city, typically combined with traces of heroin. They are highly potent with a large potential for harm and have led to 32 overdoses across Australia between 2020 and 2024.
The study’s lead researcher from the University of South Australia, Associate Professor Cobus Gerber, described nitazenes as “among the most potent synthetic opioids in circulation today, some stronger than fentanyl, which is 50 times more potent than heroin.”
Originally developed in the 50s and 60s by medical researchers, nitazenes were found to be so potent that they could be lethal in tiny doses and were never approved for use.
Their emergence here is particularly concerning given that less than one in five nitazene-related emergency cases in Australia involve people who knowingly took the drug.
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“Accidental exposure is a key risk,” UniSA researcher and co-author Dr Emma Keller said.
She explained that when drugs were contaminated with nitazenes, “standard doses can become fatal, especially for people who don’t know what their product contains or who don’t carry naxolone, a medication that can rapidly reverse the effects of an opioid overdose”.
This is particularly dangerous in instances where a person thinks they are taking a stimulant like methamphetamine or cocaine, as they may not be conscious of the symptoms of an opioid overdose.
Some of the nitazenes identified in the study were combined the with the non-opioid sedative xylazine, which Assoc Prof Gerber found particularly alarming as it had been linked to “severe adverse effects, including necrotic skin lesions, prolonged sedation and depression.”
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It also mirrors a trend from overseas, particularly in the United States, where these drug combinations are leading to “a wave of overdose deaths and complex clinical presentations”.
The findings illustrate the importance of readily available drug checking services, in addition to the potential application of nitazene testing strips, the researchers said.
Statewide Clinical Director, Drug and Alcohol Services South Australia, Dr Victoria Cock said illicit drugs had “no quality control and it is impossible to know the purity or dose of any illegal substance”.
“Highly potent opioids such as nitazenes, fentanyl, and other dangerous drugs may be present in any illicit substance including tablets, powders, or liquids,” Dr Cock said.
“Naloxone is an easy-to-use medication that can reverse opioid overdose. It is safe to use even if you are not sure whether someone has taken opioids.
“If you experience adverse drug effects, or are present when someone has an unexpected reaction, seek help immediately by calling Triple Zero (000).”
Drug and Alcohol Services South Australia, who co-authored the study, has shared the findings with community advisory groups, healthcare providers and the state’s early warning system network.
