Fake oxycodone tablets containing potent synthetic opioid detected

This notification is to let you know a potent synthetic opioid was detected in fake oxycodone tablets seized by the New Zealand Customs Service. The tablets were found to contain either N-pyrrolidino isotonitazene OR N-pyrrolidino protonitazene.

These substances come from a class of highly potent synthetic opioids known as nitazenes. Pharmacological data suggest nitazenes exhibit potency similar to, and in some cases greater than, fentanyl. Nitazenes have been linked to serious harm and may have been linked to several deaths in New Zealand since 2022.

There are concerns these tablets will be represented as legitimate oxycodone tablets. Both N-pyrrolidino isotonitazene and N-pyrrolidino protonitazene are more potent than oxycodone meaning people consuming these tablets believing them to contain oxycodone are at significant risk of harm, including death, even from a single tablet.

It is unknown if these tablets are currently in circulation or if there will be further attempts to import these pills into New Zealand. 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.

High Alert urges extreme caution should you choose to take these tablets, 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.

Fentanyl test strips can't detect these substances. Nitazene test strips can be ordered directly from the New Zealand Drug Foundation. 

If you or someone you know takes a substance thought to be cocaine and starts to experience unusual effects, call 111. Tell them what you think has been taken and that it could be an opioid overdose. Be honest about your drug use. You won’t get in trouble, and it could save you or your friends’ life.

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 followed up by medical services.

How to recognise the drug

The tablets are yellow or green and circular. The tablets are inscribed with “40” on one side and “OP” on the reverse side. These inscriptions are found on legitimate 40mg oxycodone tablets. This substance could also be available as a yellow or green powder made of crushed tablets.

Fake oxycodone tablets seized by the New Zealand Customs Service.

These tablets were seized by New Zealand Customs Service and were confirmed to contain either N-pyrrolidino isotonitazene OR N-pyrrolidino protonitazene by the Institute of Environmental Science and Research (ESR). No oxycodone was detected in the tablets.

N-pyrrolidino isotonitazene and N-pyrrolidino protonitazene are both highly potent substances and there is no way to accurately dose this substance when using these tablets. Injecting and snorting have increased risk. Nitazenes have been implicated in several deaths internationally, with pharmacological data suggesting they can exhibit potency similar to or greater than fentanyl.

Illicitly pressed opioid pills often have little to no quality control meaning these tablets have unpredictable dosages, increasing the risk of unintentional overdosing. Many of these types of pills have been shown to have varying doses even within the same batch.

The effects of N-pyrrolidino isotonitazene and N-pyrrolidino protonitazene are likely similar to other synthetic opioids. These effects 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

N-pyrrolidino isotonitazene and N-pyrrolidino protonitazene are very potent 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 take these tablets. 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, and a drop off service is now available in Auckland. A calendar of upcoming clinics can be found on The Level.

If you choose to take pills you think may be this:

• 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. The nitazene is unlikely to be evenly distributed across the pill, meaning some parts will be stronger than others. Crushing the pill, mixing it, and measuring out an extremely small amount helps to distribute the nitazene more evenly, and avoid overdose.
• In general, swallowing a substance has a slower onset than other methods and means there might be more time to get medical help if needed.
• Avoid using it at the same time as other substances, especially other depressant drugs such as alcohol, opioids, GHB/GBL, ketamine, and benzodiazepines, as these can increase the dangerous effects of opioids (for example, slowing or stopping breathing).
• Have naloxone with you – a drug that can temporarily reverse the effects of an overdose and give you more time to get medical help. Talk to your GP about this. High potency opioids like N-pyrrolidino isotonitazene and N-pyrrolidino protonitazene 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.

Call 111 and ask for an ambulance immediately 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 be an opioid, 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:

• 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.
• They cannot be awakened or are unable to speak.
• Their pupils become very small.
• Their breathing and/or 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 N24/048. 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.