what are synthetic opioids?

Why are there concerns about synthetic opioids?

Synthetic opioids are highly potent. ‘Potency’ describes the concentration of a drug or medication that is needed to have an effect. Studies have shown that:

•    fentanyl is up to 100 times more potent than morphine 
•    nitazenes can be between 10 to 1000 times more potent than morphine.

Because of this high potency, it only takes a very small amount of these substances to have an overdose. In countries including Canada, the UK and the United States there have been thousands of deaths each year caused by an overdose of synthetic opioids. In Australia, there are recent tragic examples of people losing their lives by taking these drugs. 

Synthetic opioids can be produced cheaply and easily, which makes them attractive to people who sell drugs. Sometimes, they can be mixed with other drugs, including:  

•    heroin 
•    cocaine 
•    methamphetamine (also known as ice, meth, or shard)  
•    MDMA (also known as ecstasy) 
•    ketamine 
•    gamma hydroxybutyrate (more commonly known as GHB, G, juice, liquid ecstasy) 
•    pharmaceutical drugs like benzodiazepines (also known as benzos, including Xanax and Valium) and oxycodone (also known as oxy’s). As these drugs can be counterfeited, getting them from non-medical sources can lead to accidental exposure to synthetic opioids 
•    vapes - both THC based and nicotine based vapes

People don’t always know if their drugs contain synthetic opioids, which can be especially dangerous if the person using a substance isn’t expecting to take an opioid, or hasn’t used opioids before. They will not know, or be used to, the effects on their body and may not have a tolerance to these drugs. Even if a person has taken an opioid before, the effects of synthetic opioids can be difficult to measure because of potency differences.  

Synthetic opioids can also be more dangerous when used with other substances that can slow down the way our brains and bodies function. These include: alcohol, GHB, benzodiazepines, other opioids and ketamine.  

How to stay safer

Know what naloxone is and how to use it:

Naloxone (brand names include Narcan, Prenoxad, Nyxoid) is a legal and freely available drug that temporarily reverses the effects of an opioid drug and therefore can temporarily stop an opioid overdose. It is generally given by a spray through the nose (intra-nasally). You will not get into trouble for administering naloxone during a suspected overdose. Due to the potency of some synthetic opioids, multiple doses of naloxone may be required. Also, it is important to know that someone still needs urgent medical attention after receiving naloxone.

Anyone who is planning to use a substance should carry naloxone. You can find naloxone at no cost at many pharmacies, drug treatment facilities and hospitals and you do not need a prescription.

Have your drugs tested:

Synthetic opioids don’t look or taste very different from substances like cocaine, ketamine, methamphetamine or MDMA. The only accurate way to identify synthetic opioids is to have your drugs tested. The most accurate testing is done at dedicated testing pill facilities. If you are in Canberra, you can do this at CanTEST Canberra - Health & Drug Checking Service. Other states and territories are trialling pill testing at some festivals and events. Keep an eye out for state announcements about new pill testing facilities, as some states are considering making these services available in the future.  

You won’t get in trouble for testing your drugs. The people testing your drugs cannot say if it is safe to take the drug. They are testing to identify the make-up of the drug and identify substances like fentanyl and nitazenes.

Keep up to date with dangerous drug alerts:

You can visit The Know - Australian drug alerts, all in one place for up-to-date information about drug alerts from all Australian states and territories.  

Take harm reduction steps if you are going to use a substance:

This could include action like: 
•    telling people what substances you are expecting to use 
•    using drugs in a safe place with people who can help you if you need it 
•    starting with a small amount of the drug and waiting a while to see how it affects you (‘go low and start slow’) 
•    if possible, avoid mixing substances. Using multiple substances increases the risk of exposure to synthetic opioids, and makes the effects of each substance more unpredictable.

For more tips on harm reduction view our article on safer partying tips.