Opioid falsely sold as ecstasy MDMA hospitalises drug users in Sydney streets

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A life-threatening opioid is falsely being sold as MDMA in Sydney – but those who want to test for the deadly drug have no way to safely do so.

Three people were sent to Sydney hospital over the last weekend of January after taking what they thought was as little as half a pill of MDMA, also known as ecstasy.

Instead, one of them was sent to the intensive care unit at the risk of a deadly reaction.

No MDMA was detected in the drugs taken by the three, who were later discharged from the hospital.

The drug that was found was called nitazene: an opioid similar to fentanyl, which is currently the centre of a drug crisis in the US.

NSW Health warned the fake MDMA pills were being sold in a rectangular shape, an orange/red colour and a red bull logo.

NSW Poisons Information Centre Medical Director Dr Darren Roberts said in a release that nitazene could be “as strong, or even stronger than fentanyl”, and might be “more likely to impair breathing than other opioids”.

“It’s important people recognise the signs of an opioid overdose early and know how to respond,” he said.

“Taking the appropriate action early can save a life”.

There is only one government-funded facility in all of Australia that can safely test for drugs such as nitazene: CanTEST, the country’s first fixed-site health and drug checking service, which opened in July 2022.

CanTEST is a free and confidential service for those who want to be safe with the drugs they are taking, and offers consultations to citizens about general, sexual and mental health.

Professor Malcolm McLeod of the Australian National University is the Chemical Lead at CanTEST, and described just how deadly opioids can be for unaware users.

“A lot of these synthetic opioids like nitazene and fentanyl are much more potent than heroin or morphine, maybe 50 to 100 times more potent,” he said.

“And that makes them exceedingly hard to handle in dose, and makes the chances of overdose – and potentially death – much, much greater.”

Professor McLeod said neither nitazene nor fentanyl had anywhere near as large a presence in Australia as they did in the US, but they had seen a growing nitazene presence in recent years.

He said he was unsure why the opioid was marketed as MDMA, as the two drugs were entirely different in purpose: MDMA being a stimulant, and nitazene being a depressant.

“The potential for overdose with opioids is very high – and you can also become quite dependent or addicted,” he said.

CanTEST regularly tests for opioids and said hospitalisations such as those in NSW could be lessened with a larger range of drug checking facilities.

“If you were doing pill testing or drug checking, then you would certainly identify that the pill did not contain MDMA,” Professor McLeod said.

“I think if clients were expecting MDMA, that would almost certainly lead them to not take the drug, because it’s not what they’re after.”

But CanTEST is located in the second-smallest capital city in Australia, and can’t offer local services to the rest of the country.

Gino Vumbaca, president of drug safety organisation Harm Reduction Australia, said his website receives “at least two to three emails a day” from people who want to safely test the pills that they or their children have.

“Unfortunately, unless you’re in Canberra on a Thursday to Friday, we can’t help them at the moment,” he said.

“I’ve had two emails this week from parents … they’ve always got older kids who are talking about going to festivals, and would like them to be able to access pill testing before they go, because they’re worried about what might happen.

“And again, I have to say ‘I’m sorry, we’re not at that festival’, or ‘that festival’s in a state that doesn’t permit pill testing’.”

Harm Reduction Australia states on its website that it advocates for humane drug policy, and that it’s important to consider the harm of ineffective and unsafe laws against users.

“People who take drugs … they’re actually seeking a particular experience,” he said.

“They’re not actually hoping or don’t care if they get hurt.

“It’s like someone who enjoys a good scotch thinking, ‘I only drink to get drunk and hopefully crash the car’.”

NSW Health advises those who want support or information on drugs to contact The Alcohol and Drug Information Service, at 1800 250 015.

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