This fact sheet has been developed to support the community to know the signs of an overdose and to appropriately respond to an overdose in which nitazine is involved.
Nitazenes (often referred to as ‘zines’ or ‘zenes’) are a class of highly potent synthetic opioids. Originally developed by pharmaceutical companies in the 1950s, they were never approved for medical use due to their exceptionally high risk of fatal overdose.
Common variants include metonitazene, protonitazene, isotonitazene, and etonitazene.
Signs of overdose:
Nitazene depresses the central nervous system. High doses can impair consciousness, slow breathing and heart rate, and reduce the body’s natural reflexes. An overdose can lead to unconsciousness, brain damage, or death.
Signs of nitazine overdose can include:
- No response to stimuli
- Shallow, slow, or stopped breathing
- A person can seem like they are sleeping but can’t be woken up
- Slurred speech or loss of coordination
- Grey/ashen or olive-green lips if a person has a dark skin tone; blue lips if a person has a pale skin tone
- Cold or clammy skin
- Floppy arms and legs
If you cannot get a response from someone, do not assume they are asleep. Shallow breathing, deep unresponsiveness, or loss of coordination are common signs of nitazine overdose. Do not let people at risk ‘sleep it off’.
Overdose response:
Sometimes it can take hours for someone to die from a nitazene overdose, especially if other depressants are involved. Immediate action could save a life. If you think someone has overdosed, knowing how to respond is crucial:
- Follow the DRS ABCD order of first aid. Before you act, check for Dangers.
- Check for a response (AVPU consciousness scale – Alert, respond to Voice prompt, responds to Pain prompt-only, or Unconscious).
- Send for help by calling an ambulance. Stay on the line with emergency services.
- Put the person in the recovery position to protect the Airway or, if a person is trained and comfortable doing so, apply first aid including rescue Breaths, CPR/Compressions, Defibrillation.