A dangerous synthetic opioid, up to 1000 times more potent than morphine, has been found in Adelaide’s street drug supply, raising fears of a deadly wave of overdoses.
The drug, called nitazene, is being mixed into substances such as heroin and fentanyl, often without the user’s knowledge, creating a high risk of fatal overdose.
In the first study of its kind in South Australia, researchers from the University of South Australia tested discarded drug equipment, including syringes, vials, plastic bags, and filters collected from public disposal bins at local needle and syringe program sites.
Using highly sensitive chemical analysis, they found nitazenes in 5% of 300 samples, mostly in syringes and often combined with heroin.
Nitazenes have already been linked to 32 overdose deaths in Australia between 2020 and 2024. Alarmingly, 84% of those who died had no idea the drug was in what they consumed.
This synthetic opioid is far more potent than fentanyl, which itself is about 50 times stronger than heroin. Even tiny amounts of nitazene can be lethal, especially when mixed with other substances.
Lead researcher Associate Professor Cobus Gerber warns that nitazenes are extremely dangerous because they are hard to detect and are often hidden in other drugs.
Several forms of nitazenes were identified in the study, with some samples also containing xylazine, a veterinary sedative not approved for human use. Xylazine has been linked to severe health issues, including deep skin wounds, long periods of sedation, and breathing problems.
Finding nitazene and xylazine together is particularly concerning. Similar drug combinations are driving overdose deaths in the United States, creating complex medical emergencies that are hard to treat.
In Australia, fewer than one in five emergency cases involving nitazenes involved someone who knowingly took the drug. Most believed they were using heroin, methamphetamine, or another familiar drug.
Co-author Dr Emma Keller explains that accidental exposure is one of the greatest dangers. When drugs are contaminated with nitazenes, even a dose someone is used to can quickly become deadly, especially if they don’t have naloxone — a medication that can reverse opioid overdoses.
The presence of nitazenes in Adelaide has led to growing calls for more drug-checking services. This could include nitazene-specific testing strips and wider public health alerts. Associate Professor Gerber says that testing discarded drug paraphernalia is a safe and effective way to identify new threats in the drug supply.
This information can be shared quickly with health agencies, treatment providers, and community networks, helping people make safer choices.
While wastewater analysis can also detect illicit drugs in the community, it does not always capture short-term or sporadic use. Direct testing of drug equipment provides a faster way to spot dangerous substances before they cause more harm.
The study was conducted with Drug and Alcohol Services South Australia, which has now shared the results with healthcare providers, community advisory groups, and the state’s early warning system network to help prevent further overdoses.
The detection of nitazenes in Adelaide highlights an urgent and growing drug safety issue. Their extreme potency, combined with the fact that they are often mixed into other drugs without the user’s knowledge, makes them a hidden threat capable of causing sudden mass overdoses.
Adding xylazine into the mix further increases the risks, as it complicates overdose treatment and can cause severe long-term damage. Public health authorities will need to act quickly, expanding drug testing and issuing clear warnings, to prevent a major crisis.
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The study is published in Drug and Alcohol Review.
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