Police are reissuing a warning after a highly potent opioid caused "serious harm".
In October, metonitazene was found in a yellow powder, likely from crushed tablets. It was also believed to be circling nationwide.
Drug Information and Alerts Aotearoa New Zealand website High Alert said metonitazene has a potency greater than fentanyl. They warn these tablets and powder have an unknown dosage and taking them could lead to serious harm, including death.
"Metonitazene acts quickly to produce strong sedative/depressant effects. This substance has been linked to drug-related deaths in North America," High Alert said in October.
"High Alert strongly recommends people do not take any yellow powder or tablets. Drug checking is recommended to help minimise the risk."
High Alert warned that if someone takes these tablets and begins to lose consciousness or breath slowly, 111 should be called immediately. Naloxone can be used to avoid the risk of overdose.
Auckland City District Police reissued advice from High Alert on Tuesday after "serious harm" linked to metonitazene occurred.
"High Alert urges continued caution, particularly in the Auckland region," police said in a Facebook post. "We strongly urge you to not take any unknown yellow powders or tablets."
October was the first time metonitazene was detected in New Zealand. High Alert said it may also be sold as isotonitazene, oxycodone, or an unspecified opioid. Fentanyl test strips can't detect metonitazene or other nitazenes.
While metonitazene was found in a yellow powder in New Zealand, it may also be found in round yellow tablets with no markings. These tablets or powder have been offered for sale online and are possibly available throughout New Zealand, High Alert said.
The effects of metonitazene are likely similar to other synthetic opioids, and 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
- itchiness (in one area or across whole body)
- severe nausea and/or vomiting
- severe sweating or fevers
- slowed and/or difficulty breathing
- blue lips or fingertips
- cold and clammy skin
- pinpoint (tiny) pupils
- becoming unresponsive and/or losing consciousness.
High Alert recommends that if people do choose to use metonitazene, they avoid using it alone, avoid using it at the same time as other substances, take a lower dose because this is less risky, and they have naloxone on hand to temporarily reverse the effects of an overdose.
The signs of an opioid overdose include:
- the person's face is extremely pale and/or feels clammy to the touch
- their body goes limp
- their fingernails or lips have a purple or blue colour
- they start vomiting or making gurgling noises
- they cannot be awakened or are unable to speak
- their pupils become very small
- their breathing and/or heartbeat slows or stops.