Suspected opioid harm linked to presumed cocaine consumption in Wairarapa region

This notification is to let you know that High Alert has identified harm from presumed misrepresentation of cocaine in the Wairarapa region. The presumed cocaine is suspected to be misrepresented or adulterated with an unknown opioid. The symptoms displayed are consistent with an opioid overdose, and those involved responded well to naloxone – a drug that reverses an opioid overdose.

It's currently not known how widely this substance may be circulating. There are concerns people may already have this substance, or it may continue to be sold as cocaine in the Wairarapa or other regions. People consuming this substance believing it to be cocaine are at high risk of experiencing serious harm, including death.

It is important to never assume that what drug you have is what it has been sold as. Misrepresentation can occur anywhere along the supply chain.

High Alert urges extreme caution should you choose to use white powders. Drug checking is recommended to help minimise the risk. Drug checking services can identify when a substance is not what it has been sold as. Find upcoming clinics at The Level.

If you or someone you know takes a white powder and starts to experience unusual effects, call 111. Tell them what you think has been taken and that it could be an opioid overdose. Be honest about your drug use. You won’t get in trouble, and it could save you or your friend's life.

Naloxone can be used to help reverse an opioid overdose. Given the potency and duration of effect, any person administered naloxone should continue to be monitored for at least 2 hours and followed up by medical services.

How to recognise the drug

The substance is a white powder that was presumed to be cocaine.

While it's not currently known which substance was responsible, the harm experienced was consistent with an opioid overdose. It is possible this could be related to a synthetic opioid (a family that includes nitazenes and fentanyl) – these substances are usually very potent and have been linked to deaths in New Zealand. There is no way to accurately dose these substances, and injecting has increased risk.

The effects of opioids can include:

• Feeling euphoric or in a ‘dreamlike’ state.
• Sedation (‘the nod’ – being drowsy and then jerking awake).
• Temporary relief of pain, stress, or low mood.
• Slowed and/or difficulty breathing.
• Blue lips and/or fingertips.
• Cold and clammy skin.
• Pinpoint (tiny) pupils.
• Seizures.
• Becoming unresponsive and/or losing consciousness.

How to reduce harm from the drug

High Alert urges extreme caution should you choose to use white powders. Drug checking is recommended to help minimise the risk.

KnowYourStuffNZ, the New Zealand Drug Foundation and the New Zealand Needle Exchange Programme's DISC Trust run regular drug checking clinics across the country, and a drop off service is now available in Auckland. A calendar of upcoming clinics can be found on The Level.

If you choose to take a substance that you think may be this:

• Drug checking services can identify when a substance is not what it has been sold as, find upcoming clinics at The Level.
• Use fentanyl AND nitazene test strips to check if a substance contains synthetic opioids. These can be ordered here for free from the New Zealand Drug Foundation. Treat the substance as a synthetic opioid and not as cocaine or any other recreational drug if either test strip returns a positive result.
• Use a reagent test to check it first. Morris reagent will turn a bright blue colour if cocaine is present (including if cocaine is mixed with another substance), but will not change to bright blue if there is no cocaine present.
• Avoid using alone. Have a friend who can help, and call an ambulance, if things go wrong. If that’s not possible, use a buddy system where someone is on the phone or calls you to check you are ok.
• Much lower doses are less risky. Start off with an extremely small amount (a typical dose of synthetic opioids can be in the micrograms) to check how it affects you.
• In general, swallowing a substance has a slower onset than other methods and means there might be more time to get medical help if needed.
• Avoid using it at the same time as other substances, especially depressant drugs such as alcohol, opioids, GHB/GBL, ketamine, and benzodiazepines as these can increase the risk that your breathing will slow or stop.
• Have naloxone with you – a drug that can temporarily reverse the effects of an overdose and give you more time to get medical help. Talk to your GP or local needle exchange about this. High potency opioids may require more than one dose of naloxone. Remember, synthetic opioids can be fast acting and you may not initially realise you require naloxone. Have someone with you who can administer naloxone if needed because you will not be able to administer it by yourself.

Call 111 and ask for an ambulance immediately if you or someone else has any of the below signs after taking this substance. Tell them what has been taken and that it could be an opioid, it could save a life. Don’t leave the person alone and treat it as an overdose if unsure.

The signs of an opioid overdose include:

• They may not be completely awake or are unresponsive.
• They are breathing slowly or not at all (they may be snoring).
• The person's face is extremely pale and/or feels clammy to the touch.
• Their body goes limp.
• Their fingernails and/or lips have a purple or blue colour.
• They start vomiting or making gurgling noises.
• Their pupils become very small.
• Their heartbeat slows or stops.

If you have heard of any reports of this drug, please let us know through the Report unusual effects page, the alert ID is N25/0051. All submissions are anonymous.