Illicit cocaine and methamphetamine containing opioids

Following ongoing identification of cases of opioid overdose after use of substances expected to be cocaine or methamphetamine in NSW, a Safety Notice for Clinicians (012/26) has been published on the NSW Health website. The Safety Notice will also be distributed via the Clinical Excellence Commission’s Safety Alert Broadcast System.

Additionally, one person has died and multiple people in four separate incidents across Victoria have required emergency care because they experienced heroin overdose after using what they thought was cocaine or methamphetamine. Specialised blood tests showed evidence of heroin as well as cocaine and methamphetamine, suggesting that heroin may have been mixed into these drugs (‘adulteration’).

Please see the drug alert issued by the Victorian Department of Health.

Please share this information with your patients, peers, clients, and professional networks as appropriate. 

Know the signs of opioid overdose and access naloxone

Signs of opioid overdose include breathing slowly and reduced consciousness (meaning someone is hard to wake up). In some cases, the person may also have tiny pupils. More information about opioid overdose symptoms can be found on the Penington Institute website.

Naloxone is a life-saving medicine that can temporarily reverse an opioid overdose. Naloxone is available in an easy to use nasal spray, and as a pre-filled injection.

If you might experience or witness an opioid overdose you can get naloxone for free without a prescription in NSW from many community pharmacies, needle and syringe programs, opioid treatment services and NUAA.

Start low, go slow. Try a test dose first and never use alone.

Be alert for signs of an overdose. 

Think someone has overdosed? Call 000 for an ambulance immediately.