The synthetic opioid nitazene was detected in Canberra by chemists at the Research School of Chemistry and CanTEST. Photo: Jamie Kidston/ANU.
The detection of deadly synthetic opioids known as nitazenes by CanTEST has shown how a well-resourced and supported drug checking service can tackle emerging drugs of concern.
A recently published scientific paper has drawn on an experience from September 2024 when a consumer had CanTEST analyse a drug believed to be oxycodone.
No oxycodone was found. Instead, the sample contained a nitazene derivative, which ANU expert and paper co-author Professor Malcolm McLeod said was one of the most “potent drugs of its class ever detected”.
“The variation of nitazene structure and potency poses a significant challenge to early warning systems that seek to protect public health by detecting and responding to the emergence of new high-risk substances,” according to the report.
“It is 1000 times stronger than morphine and 90 times stronger than fentanyl,” Prof McLeod said.
“This high level of potency significantly increases the risk of a fatal overdose … On the strength of that information, the client discarded the substance.”
The sample was taken to ANU labs for further tests.
The paper highlighted how quickly the public was notified, with an alert issued to clinical first responders to advise them on the harms of nitazene within 24 hours of the sample’s presentation at CanTEST.
“In the following 48 hours, a community notice was released by the CanTEST service, distributed on social media and covered by local media,” it noted.
“Similarly rapid responses attended earlier detections of nitazene drugs at the service … Together, this series of detections highlights the unpredictability and rapid change within drug markets, with a local trend towards increasing potency and potential for harm for the nitazene drugs identified.”
Wastewater analysis is one method for monitoring drug trends nationwide.
It has reported on the presence of nitazenes in Australia recently, but the paper noted it had limited coverage of ‘new psychoactive substances’ (NPS) and targeted only “representative members” of the nitazene drug family.
Prof McLeod said this method of tracking drug use and prevelance wasn’t as effective for nitazenes as the compound is so potent a person only needs to take a “vanishingly small” amount for it to have an effect.
“So that means it’s diluted [in your system] and hard to detect in the water if consumed,” he said.
“There is a question mark over whether [wastewater analysis] is reflecting consumption in the community or is the result of some disposal event, like at a clandestine lab.”
Prof McLeod said the paper also showed the importance of having a site that could not only detect harmful drugs and communicate that to the public, but could also provide wraparound services to the person who had brought in the samples.
“It is a fact that about one per cent of people prescribed oxycodone for pain relief get addicted,” he said.
“[We are seeing] fake oxycodone pills, I’m guessing being sourced by people dependent on opioids, buying them online because they can’t get them prescribed … it’s not just your typically perceived drug users.”
Prof McLeod advised that all nitazenes carried a risk of fatal overdose, and so urged people to test their drugs and avoid using a substance alone.
“There is an antidote available called naloxone, but several doses may be required in a case [like from September 2024] where you’re dealing with increased potency,” he said.
“Call 000 immediately if you suspect someone has overdosed.”
CanTEST Health and Drug Checking Service is open every Thursday from 3 pm to 6 pm and every Friday from 6 pm to 9 pm.
It is operated by Directions Health Services in partnership with Pill Testing Australia and the Canberra Alliance for Harm Minimisation and Advocacy. It has secured funding until mid-2027.
