Nitazenes and Synthetic Opioids in Australia

The rise of synthetic opioids like nitazenes in Australia requires an urgent response. Understanding solutions such as nitazenes test strips and other harm reduction strategies is crucial to preventing a catastrophic health crisis.

Nitazenes: Australia's Looming Health Crisis

Imagine a drug so powerful that a minute dose the size of few grains of sand can kill you in minutes. This is the grim reality of a new class of drugs called nitazenes which are synthetic opioids up to 1000 times stronger than Morphine.

Recently, nitazenes have turned up in Australia's illicit drug supply. Although usually found in heroin they have also been found mixed with other party drugs such as, cocaine, and MDMA. As one of the world's largest consumers of drugs, Australia stands on the brink of a health catastrophe, mirroring the American opioid overdose crisis.

The rise of nitazenes highlights the failures of our current approach to drugs, which incentivises the black market to trade in more potent and lethal substances. To avoid a catastrophe like America’s, we must think outside the box. We must prepare to mitigate and cope with the inevitable influx of synthetic opioids. 

Understanding Nitazenes

Nitazenes are a class of synthetic opioids developed in the 1950s as potential pain relievers; however, they were never used clinically due to their extreme potency. They belong to a class of compounds called benzimidazoles and are far more powerful than traditional opioids like morphine and heroin. "Nitazenes" is the generic term used for a class of synthetic opioids. The singular "nitazene" refers to a specific chemical structure within the nitazine class. For example, "protonitazene" is one specific nitazene. 

The Potency and Risks of Nitazenes

The danger of nitazenes lies in their incredible potency. Some variants can be hundreds of times stronger than morphine, significantly increasing the risk of overdose. The table below illustrates the comparative potency of different nitazenes relative to morphine:

Nitazene

Strength Compared to Morphine

Butonitazene 5
Etodesnitazene 70
Metonitazene 100
Protonitazene 200
Isotonitazene 500
Etonitazene 1000

Analgesic effectiveness compared to subcutaneous morphine in murine models (morphine = 1)

In recent years, nitazenes have been found in various heroin samples, counterfeit pills, and other recreational drugs across Australia. An emerging drug report from the NCCRED has spotlighted these nitazene detections through public drug alerts from various Australian states:

  • Australian Capital Territory: Metonitazene detected in 2022.
  • New South Wales: Etodesnitazene and another nitazene detected in 2022, Isotonitazene in 2023, and Protonitazepyne in 2024.
  • Queensland: Protonitazene detected in 2023.
  • South Australia: Protonitazene and other nitazenes detected in 2023.
  • Victoria: Protonitazene detected in 2022, Metonitazene in 2023, and Protonitazene again in 2024.

*Not all Australian jurisdictions issue public drug alerts

Met_pills_in_band_aid_boxes.jpg

5g of Metonitazene pills smuggled in band-aid boxes from the UK to the NT

The Rise of Nitazenes in the Drug Market

The rise of nitazenes and other synthetic opioids is deeply connected to global events. A significant factor is the situation in Afghanistan, which controls 80% of the world's opium production. Since the Taliban banned poppy cultivation in 2022, the supply of opium, which produces heroin, has drastically decreased. To fill the void and maintain profits, drug suppliers have turned to cheaper and more compact synthetic alternatives like nitazenes. 

The UN's Afghanistan opium survey 2023 supports this claim by stating that "a sustained reduction in opium production in the country may lead to a series of consequences: a displacement of opium production to other countries, overall decreases in opiate use (good luck), a reduction in purity or replacement of heroin or opium by other substances in retail markets, some of which may be even more harmful (such as fentanyl or other synthetic opioids)." 


The Impact of Prohibition Policies on Fentanyl and Nitazenes

The current drug laws exacerbate the problem. History tells us that when drug policies become stricter, the substances on the streets become stronger and more dangerous. Strict enforcement incentivises drug traffickers to trade in more potent products to evade detection and maximise profit. For example, during the American alcohol prohibition, high-strength spirits were traded rather than low-strength beer. Another example is the Australian market moving towards ice, a stronger form of methamphetamine as opposed to methamphetamine powder. 

How to prepare for Nitazenes and other Synthetic Opioids

Nitazene Test Strips are diagnostic tools that detect nitazenes in various substances. They work like fentanyl test strips, providing a quick and easy method to check if drugs have been adulterated with nitazenes. The use of these strips is part of harm reduction strategies aimed at preventing accidental overdoses and increasing awareness of the presence of dangerous substances in the drug supply. Although nitazene test strips may not detect all nitazene analogs, they are still an effective and crucial safety measure. 

Broad Distribution of Naloxone

Naloxone is a medication that can reverse opioid overdoses and should be made widely available and easily accessible to everyone, not just regular drug users. Studies have shown that widespread naloxone distribution can significantly reduce opioid-related deaths. Due to the potency of Nitazenes multiple doses of naloxone are required to revive overdose patients.

Increased Education and Awareness Campaigns

Informing the public about the dangers of synthetic opioids, the availability of Nitazine Test strips, and the importance of carrying naloxone is crucial. These campaigns can help save lives by ensuring that more people are prepared to act in the event of an overdose.

Conclusion

Nitazene overdoses are a human tragedy affecting our loved ones: daughters, sons, mothers, and fathers. It is our current drug policies that have left us unprepared. 

Immediate steps like widespread access to drug testing, availability of nitazene test strips, making naloxone available, and increasing education about synthetic opioids will save lives. We must act now to protect our loved ones and create a safer, healthier future. The lives of those we care about depend on our willingness to embrace change and implement harm reduction strategies.

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