A new group of drugs called Nitazen have been discovered in Melbourne, Australia, they are sold as heroin as well as other drugs such as ketamine.
Concerns about the potential harms associated with these drugs, and users not knowing what they are taking, have led to government health alerts and coroner recommendations for drug-screening.
Nitazane is similar to the drug fentanyl, which has caused an unprecedented number of deaths in North America. Fentanyl is the prescription opioid that caused Prince's death in 2016. Some are similar to fentanyl in strength, while others can be up to 50 times stronger than fentanyl.Australia has an opportunity to learn from the North American experience about the serious harms associated with highly contaminated drug supplies, before these drugs become commonplace here.
What is the difference between heroin, fentanyl, and nitazane?
Fentanyl and nitazane are highly potent “synthetic” opioids, meaning they are made in a laboratory. It is different from morphine or heroin which come from the opium poppy. Although fentanyl is a prescription opioid, most of the fentanyl in the US drug market is made illegally in laboratories. Illegally manufactured fentanyl has had a devastating impact in North America, accounting for the majority of drug-related deaths in the US and Canada.Fentanyl is estimated to be 50 times more potent than heroin, with a rapid onset of action, reducing the time available to respond to an overdose.
To date, there is limited evidence that Australian deaths due to fentanyl have declined as fentanyl becomes widely available in Australia. However, there are concerns that this new class of drugs, nitazane, may make a difference. Nitazane was developed and tested by pharmaceutical companies in the 1950s, but unlike fentanyl, did not proceed for therapeutic use due to a poor safety profile.
Deaths due to Nitazane are increasing in the United Kingdom and the United States.Some of the first nitazane identified include isotonitazane (2019) and metonitazane (2020). Many compounds have now been brought under international drug control.
Nitazane varies in strength, with some having less potency than fentanyl while most being similar to or stronger than fentanyl. Unlike fentanyl, where its effects have been well understood from medical use, nitazane has been comparatively There is limited research from. The limited ability to detect nitazane has also hindered our knowledge and understanding of the extent of harm associated with their use.Globally, and in Australia, Nitazane appears to be a contaminant in counterfeit pharmaceutical products (packaged to look like pharmaceutical pain medications) and drugs such as heroin, methamphetamine, MDMA and ketamine.
There are also reports of people knowingly purchasing Nitazane online. Accidentally or intentionally taking Nitazane can affect a wide range of people. This includes people who occasionally use drugs at music festivals, to people who regularly inject drugs.
This means that a wide range of strategies will be needed to meet the needs of different populations.What can we do about them? A range of proposed public health responses to the threat of fentanyl can be applied to Nitzen. Australia has not yet implemented or fully advanced most of these harm reduction responses, but they will work for Nitazen. These include:
drug testing
Testing medicines for nitazane or other toxic contaminants before use is an option in Canberra and parts of Queensland. There is also a small drug checking pilot running in Sydney, but drug checking is not available in most of Australia. Other options include instant drug checking strips that can be used at home.A rapid test strip for Nitazane has recently been made available overseas, but it cannot identify all drugs of concern.
Rapid test strips can be inaccurate, false positive results are related to the presence of other commonly used substances such as MDMA, and they can be difficult to read correctly. For these reasons, we don't yet know how helpful they will be in Australia.
Supervised injecting rooms Increasing access to supervised injection facilities means that if someone injecting drugs inadvertently takes Nitazine, medical care will be provided immediately. Antidotes such as naloxone can be administered immediately along with other life-saving care.Two such facilities operate in Melbourne and Sydney, so we will need to establish many more locations in different geographic areas to be effective if Nitazen becomes an issue in Australia.
Accessing NaloxoneNaloxone is a drug that reverses the effects of opioids, and it has been used for decades by hospitals and paramedics to treat overdoses. We have good evidence that trained laypeople can administer naloxone to successfully treat an overdose.
It is important to increase access to take-home naloxone along with opioid overdose education.
People may unknowingly consume nitazane contained in stimulant medications.This means that having naloxone on hand in a wide range of settings, including nightclubs, festivals, and concerts, will be important to respond quickly to unexpected overdoses.Drug Education
Since many drug-related deaths occur in people's homes, education about the signs and symptoms of opioid overdose, and providing naloxone to people who use stimulants or other drugs, is essential. For those who use or inject drugs, an existing harm-reduction service is ideally placed to deliver messages about Nitazane, including the increased severity of overdose risks and current public health alerts about these substances. Are.
Access to opioid dependence treatments like methadone and buprenorphine can be life-saving and can be expanded.
Nitzens present a unique risk in Australia.But drug checking, increased access to supervised drug consumption facilities and the expansion of take-home naloxone along with overdose education could help reduce the harm caused by these and other drugs in Australia. (talk) PYPY
Concerns about the potential harms associated with these drugs, and users not knowing what they are taking, have led to government health alerts and coroner recommendations for drug-screening.
Nitazane is similar to the drug fentanyl, which has caused an unprecedented number of deaths in North America. Fentanyl is the prescription opioid that caused Prince's death in 2016. Some are similar to fentanyl in strength, while others can be up to 50 times stronger than fentanyl.Australia has an opportunity to learn from the North American experience about the serious harms associated with highly contaminated drug supplies, before these drugs become commonplace here.
What is the difference between heroin, fentanyl, and nitazane?
Fentanyl and nitazane are highly potent “synthetic” opioids, meaning they are made in a laboratory. It is different from morphine or heroin which come from the opium poppy. Although fentanyl is a prescription opioid, most of the fentanyl in the US drug market is made illegally in laboratories. Illegally manufactured fentanyl has had a devastating impact in North America, accounting for the majority of drug-related deaths in the US and Canada.Fentanyl is estimated to be 50 times more potent than heroin, with a rapid onset of action, reducing the time available to respond to an overdose.
To date, there is limited evidence that Australian deaths due to fentanyl have declined as fentanyl becomes widely available in Australia. However, there are concerns that this new class of drugs, nitazane, may make a difference. Nitazane was developed and tested by pharmaceutical companies in the 1950s, but unlike fentanyl, did not proceed for therapeutic use due to a poor safety profile.
Deaths due to Nitazane are increasing in the United Kingdom and the United States.Some of the first nitazane identified include isotonitazane (2019) and metonitazane (2020). Many compounds have now been brought under international drug control.
Nitazane varies in strength, with some having less potency than fentanyl while most being similar to or stronger than fentanyl. Unlike fentanyl, where its effects have been well understood from medical use, nitazane has been comparatively There is limited research from. The limited ability to detect nitazane has also hindered our knowledge and understanding of the extent of harm associated with their use.Globally, and in Australia, Nitazane appears to be a contaminant in counterfeit pharmaceutical products (packaged to look like pharmaceutical pain medications) and drugs such as heroin, methamphetamine, MDMA and ketamine.
There are also reports of people knowingly purchasing Nitazane online. Accidentally or intentionally taking Nitazane can affect a wide range of people. This includes people who occasionally use drugs at music festivals, to people who regularly inject drugs.
This means that a wide range of strategies will be needed to meet the needs of different populations.What can we do about them? A range of proposed public health responses to the threat of fentanyl can be applied to Nitzen. Australia has not yet implemented or fully advanced most of these harm reduction responses, but they will work for Nitazen. These include:
drug testing
Testing medicines for nitazane or other toxic contaminants before use is an option in Canberra and parts of Queensland. There is also a small drug checking pilot running in Sydney, but drug checking is not available in most of Australia. Other options include instant drug checking strips that can be used at home.A rapid test strip for Nitazane has recently been made available overseas, but it cannot identify all drugs of concern.
Rapid test strips can be inaccurate, false positive results are related to the presence of other commonly used substances such as MDMA, and they can be difficult to read correctly. For these reasons, we don't yet know how helpful they will be in Australia.
Supervised injecting rooms Increasing access to supervised injection facilities means that if someone injecting drugs inadvertently takes Nitazine, medical care will be provided immediately. Antidotes such as naloxone can be administered immediately along with other life-saving care.Two such facilities operate in Melbourne and Sydney, so we will need to establish many more locations in different geographic areas to be effective if Nitazen becomes an issue in Australia.
Accessing NaloxoneNaloxone is a drug that reverses the effects of opioids, and it has been used for decades by hospitals and paramedics to treat overdoses. We have good evidence that trained laypeople can administer naloxone to successfully treat an overdose.
It is important to increase access to take-home naloxone along with opioid overdose education.
People may unknowingly consume nitazane contained in stimulant medications.This means that having naloxone on hand in a wide range of settings, including nightclubs, festivals, and concerts, will be important to respond quickly to unexpected overdoses.Drug Education
Since many drug-related deaths occur in people's homes, education about the signs and symptoms of opioid overdose, and providing naloxone to people who use stimulants or other drugs, is essential. For those who use or inject drugs, an existing harm-reduction service is ideally placed to deliver messages about Nitazane, including the increased severity of overdose risks and current public health alerts about these substances. Are.
Access to opioid dependence treatments like methadone and buprenorphine can be life-saving and can be expanded.
Nitzens present a unique risk in Australia.But drug checking, increased access to supervised drug consumption facilities and the expansion of take-home naloxone along with overdose education could help reduce the harm caused by these and other drugs in Australia. (talk) PYPY
