Increasing risk of synthetic opioid overdose in Australia

A study appeared in Drugs: education, prevention and policy has uncovered alarming evidence of the dangers posed by fentanyl-contaminated drug supplies in Australia, including an increased risk of fatal overdose.

The study, entitled “Drug may be laced with fentanyl, an increasingly common occurrence in Australia: overdose survivors’ perspectives on toxic substance supply and safe use,” aimed to investigate the role of synthetic opioids in overdoses among Queensland residents.

Led by Dr Timothy Piatkowski, Emma Kill and Steph Reeve of Griffith University and in collaboration with Queensland Injectors Voice for Advocacy (QuIVAA), the study included in-depth interviews with 27 people in Queensland who had experienced an opioid overdose and aimed to identify appropriate harm reduction strategies.

Participants expressed concerns about the unpredictability and toxicity of the local drug supply, particularly with the introduction of fentanyl – a synthetic opioid that has been linked to a dramatic increase in overdose deaths in North America.

Dr Piatkowski said the presence of fentanyl in Australia's drug stockpiles was a growing concern and required immediate attention.

“Fentanyl can be 100 to 500 times more potent than heroin,” he said.

“Even a tiny amount can kill a person very quickly.

“It is much cheaper to produce and buy, and therefore it is also cheaper to intervene in any kind of medicine.

“It is similar with other synthetic opioids such as nitazene, which can be 500 to 1,000 times stronger than heroin.”

“They have not been seen much in Australia to date, but the Australian Federal Police made a significant seizure in 2022, followed by another in 2023 and several more this year, indicating they are starting to reach our shores.

“In Australia, an average of five people a day already die from drug overdoses, but if we add synthetic opioids like fentanyl into the mix, that number could rise dramatically.”

Although these substances are most commonly found in heroin, they can also be found in other recreational drugs, including pills and party drugs.

Another problem was the resistance of synthetic opioids to naloxone, a drug used to temporarily relieve the effects of an opioid overdose or side effect.

Dr. Piatkowski said someone who has overdosed on synthetic opioids may need two treatments of naloxone, while most people would only need one.

“Based on this information, we want to see safe consumption spaces created in Queensland,” he said.

“Sydney has a medical injecting room and Melbourne has a safe injecting room, but Queensland has been left out so far, even though about 300 people die here every year from an overdose.

“Even if someone carries naloxone, success depends on knowing how to use it. But if we had a safe place for drug users where medical professionals were available, that could definitely help prevent a lot of harm.”