Highly potent opioid found in fake oxycodone tablets

How to recognise symptoms of the drug

There is little information available about N-pyrrolidino etonitazene, however, the physical effects 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.
• Itchiness (in one area or across whole body).
• 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.
• Becoming unresponsive and/or losing consciousness.

How to reduce harm from the drug

High Alert strongly urges people not to take this substance at all.

Avoid combining with other depressant drugs including other opioids, alcohol, barbiturates, gabapentinoids, thienodiazepines, benzodiazepines, GHB/GBL and ketamine as these can increase the dangerous effects of opioids (for example, slowing or stopping breathing). 

A lethal dose of N-pyrrolidino etonitazene is equivalent in size to a few grains of salt. Pharmacological data suggests this opioid exhibits potency similar to etonitazene, which is approximately 20 times more potent than fentanyl. Fentanyl test strips can't detect N-pyrrolidino etonitazene or other ‘nitazenes’.

Fake oxycodone pills that have been illicitly manufactured often have unpredictable dosages, resulting in unintentional overdosing. Internationally, many pills have been shown to have varying doses even within the same batch.

Have the opioid overdose reversal drug naloxone with you and use it if someone is overdosing from opioids – it can save their life. High potency opioids like N-pyrrolidino etonitazene may require more than one dose of naloxone.

Check with your local needle exchange outlet to see if they have naloxone available.

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. Call 111 and ask for an ambulance immediately. Don’t leave the person alone.

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.

Find out more about nyxoid and nyloxone 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 N22/024. All submissions are anonymous.