Fake oxycodone tablets linked to serious harm
- Notification
- Opioids
-
- Nationwide
Fake oxycodone tablets, containing metonitazene, may be linked to a recent death and serious hospitalisations in New Zealand
How to identify the drug
- Round yellow tablets
- Bevelled edge
- Break line through middle
- No other markings
- Could also be available as a yellow powder made of crushed tablets
This notification is to let you know fake oxycodone tablets may be linked to a recent death and serious hospitalisations in New Zealand. These tablets have been found to contain metonitazene, a highly potent synthetic opioid.
Metonitazene has a potency equivalent to fentanyl. Metonitazene acts quickly to produce strong sedative/depressant effects. This substance has been linked to drug related deaths internationally.
High Alert urges extreme caution should you chose to take these tablets. These tablets are not legitimate oxycodone tablets and are of unknown dosage. Taking these tablets could lead to serious harm, including death, even if you have experience using opioids.
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 overdose. Given the unknown strength, potency and duration of effect, any person administered naloxone should continue to be monitored for 2 hours.
These tablets have been offered for sale online and are possibly available throughout New Zealand.
The tablets are being sold online as ‘40mg oxycodone pills’ however are described as ‘metonitazene based oxys’. These tablets are not legitimate 40mg oxycodone tablets and the quantity of metonitazene present is not known. There is a concern this information may not be communicated to people not purchasing these tablets from the original online source.
A sample of this substance was submitted to the Institute of Environmental Science and Research (ESR) for analysis, which determined the sample contained metonitazene. No oxycodone was detected in the tablet.
If you have heard of any reports of this drug, please let us know! The alert ID is N22/0037. All submissions are anonymous.
How to recognise symptoms of the drug
The effects of metonitazene 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 fevers.
- Slowed and/or difficulty breathing.
- Blue lips or fingertips.
- Cold and clammy skin.
- Pinpoint (tiny) pupils.
- Seizures.
- Becoming unresponsive and/or losing consciousness.
How to reduce harm from the drug
Metonitazene is a very strong opioid and consumption can easily lead to an overdose, even among people with experience using opioids. High Alert urges extreme caution should you chose to take these tablets.
Metonitazene and other nitazene compounds are increasingly available in New Zealand and can come in a variety of forms including powders, gel caps and liquids. Fentanyl test strips cannot be used to detect metonitazene or other nitazenes.
Metonitazene is highly potent and there is no way to accurately dose this substance, and injecting has increased risk. Metonitazene has been implicated in several deaths internationally, with pharmacological data suggesting it exhibits potency similar to 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 pills have been shown to have varying doses even within the same batch.
If you choose to use this substance:
- Avoid using alone. Have a buddy who can help, and call an ambulance, if things go wrong.
- 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).
- Lower doses are less risky. Start off with a small amount to check how it affects you. 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. Remember, the quantity of metonitazene in a tablet can be very different. Don’t assume each tablet will produce the same effects.
- 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. Some pharmacies and needle exchanges stock naloxone and the Nyxoid nasal spray can also be purchased direct from the Pharmaco website. High potency opioids like metonitazene may require more than one dose of naloxone. Remember, nitazenes can be fast acting and you may not initially realise you require naloxone. Even if you have naloxone on hand, you may not be able to administer it by yourself. Avoid using nitazenes alone. Have someone with you who is familiar with and can administer naloxone if needed.
- Drug checking is recommended to help minimise the risk. KnowYourStuffNZ, the New Zealand Drug Foundation and the New Zealand Needle Exchange Programme are running regular drug checking clinics. Information on upcoming clinics can be found on The Level
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 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.
It can be difficult to recognise an opioid overdose. If you aren’t sure whether someone is overdosing, it is best to act like they are. It important to act quickly if you think someone is overdosing as it improves their odds of survival.
Find out more about nyxoid and naloxone on the NZ Drug Foundation’s website, The Level.
If you have heard of any reports of this drug, please let us know through the Report unusual effects page, the alert ID is N22/037. All submissions are anonymous.
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The National Poisons Centre is available 24/7 to help members of the public and healthcare professionals with clinical advice for exposures to this, or any other substance - please call 0800 764 766 (0800 POISON).
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.