Increasing risk of synthetic opioid drug overdoses in Australia

A study appearing in Drugs: Education, Prevention and Policy has uncovered alarming insights into the dangers posed by fentanyl-contaminated drug supplies in Australia, including a heightened risk of lethal overdose.

The study, titled "The gear could be cut with fentanyl which is starting to happen more in Australia': Exploring Overdose Survivors' Perspectives on Toxic Supply and Safe Consumption," aimed to explore the role of synthetic opioids in overdoses among Queenslanders.

Led by Griffith University's Dr. Timothy Piatkowski, Emma Kill and Steph Reeve, in partnership with the Queensland Injectors Voice for Advocacy (QuIVAA), the research involved in-depth interviews with 27 individuals in Queensland who had experienced opioid overdoses and aimed to identify appropriate harm reduction strategies.

Participants voiced 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 rise in overdose deaths in North America.

Dr. Piatkowski said the presence of fentanyl in Australia's drug supply was a growing concern that demanded immediate attention.

"Fentanyl can be anywhere from 100 to 500 times stronger than heroin," he said.

"Just a tiny amount can kill a person very quickly.

"It's a lot cheaper to produce or buy, and therefore cheaper to cut into any type of drug.

"Similarly, we have other synthetic opioids such as nitazenes, which can be 500 to 1000 times stronger than heroin.

"We haven't previously seen them much in Australia, however the Australian Federal Police made a significant seizure in 2022, followed by another in 2023 and several more this year, which indicates they are starting to reach our shores.

"We already have an average of five people a day dying from drug overdose in Australia, but if we throw synthetic opioids like fentanyl into the mix, that number could drastically rise."

While most commonly found in heroin, these substances could be cut into any recreational drug, including pills and party drugs.

An additional issue was the level of resistance of synthetic opioids to naloxone—a drug used to temporarily reverse the effects of an opioid overdose or adverse reaction.

Dr. Piatkowski said someone who had overdosed on synthetic opioids might need two treatments of naloxone, whereas most people would only carry one.

"Based on this information, we'd like to see safe consumption spaces be established in Queensland," he said.

"There's a medical injecting room in Sydney and a safe injecting room in Melbourne, but Queensland has so far been left out, even though we see around 300 people a year dying from overdose here.

"Even if someone is carrying naloxone, a successful outcome relies on someone knowing how to use it, but if we had a safe space for people who are going to use drugs, with health professionals on hand, that's definitely going to help negate a lot of harm."