Tejal Somvanshi
NSW Health has issued an urgent warning about dangerous counterfeit oxycodone tablets circulating in NSW. These fake pills contain nitazenes – extremely potent synthetic opioids that can be hundreds of times stronger than real oxycodone.
“Nitazenes are extremely potent and can vary widely in their strength,” said NSW Poisons Information Centre Medical Director Dr. Darren Roberts. “As they are illicit and unregulated, there is no way of knowing what type of nitazene is present or what dosage is being taken. The strength and contents can vary widely, even within the same batch.”
How to spot the fake pills
The counterfeit tablets have been identified as green round pills marked with ‘OC’ on the front and ’80’ on the back. Unlike genuine pharmacy-dispensed oxycodone (sold as OxyContin), these fake pills lack a film coating. Genuine OxyContin tablets are now marked with ‘ON’ instead of ‘OC’.
The fake tablets specifically contain N-desethyl isotonitazene, a dangerous nitazene that drastically increases overdose risk.
Serious health risks
These counterfeit pills pose a severe health threat. Nitazenes can cause serious overdose or death because they strongly suppress breathing. They last longer in the body than oxycodone, heroin, and even naloxone (the overdose reversal medication).
Dr. Roberts stressed that people should know the signs of an opioid overdose, which include:
- Pin-point pupils
- Drowsiness or loss of consciousness
- Slowed breathing or snoring sounds
- Skin turning blue or grey
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Wider spread of danger
Health officials have found nitazenes not only in fake oxycodone but also in counterfeit benzodiazepines and drugs sold as heroin or MDMA.
Life-saving response
NSW Health strongly recommends that anyone who uses illicit drugs carry naloxone, which can temporarily reverse opioid overdoses, including those caused by nitazenes. However, because nitazenes are so powerful, higher and repeated doses of naloxone may be needed, along with hospital treatment.
“It’s strongly recommended that anyone who uses illicit drugs carry naloxone,” said Dr. Roberts.
Anyone who uses naloxone should immediately call Triple Zero (000) for an ambulance. NSW Health emphasizes that people won’t get in trouble for seeking medical care during an overdose emergency.
Where to get help
Take-home naloxone is available as a nasal spray or injection from many pharmacies and health services. NUAA (NSW Users and AIDS Association) can also mail naloxone in a discreet package to those who order through their online shop or call (02) 9171 6650.
For concerns about drug effects, the NSW Poisons Information Centre can be contacted 24/7 at 13 11 26. For support with drug and alcohol problems, the Alcohol and Drug Information Service offers confidential counseling at 1800 250 015 any time of day.
Public drug warnings and information about the take-home naloxone program are available through NSW Health’s website.
Frequently Asked Questions
The fake oxycodone tablets are counterfeit pills containing nitazenes (specifically N-desethyl isotonitazene), which are extremely potent synthetic opioids. They are dangerous because they can be hundreds of times stronger than real oxycodone, significantly increasing the risk of severe overdose or death. These counterfeit pills are made illicitly without quality control, making their potency highly unpredictable even within the same batch.
The fake oxycodone tablets currently circulating in NSW are green, round tablets marked with ‘OC’ on the front and ’80’ on the back. Importantly, they lack a film coating. Genuine pharmacy-dispensed oxycodone (OxyContin) now comes marked with ‘ON’ instead of ‘OC’ and has a protective film coating. If you see tablets matching the description of the fakes, do not consume them.
Signs of a nitazene overdose include pin-point pupils, extreme drowsiness, loss of consciousness, slowed breathing or snoring sounds, and skin turning blue or grey. Nitazenes affect breathing much more severely than other opioids and can cause respiratory arrest quickly. If you notice these symptoms in someone, treat it as a medical emergency and call Triple Zero (000) immediately.
Naloxone is a life-saving medication that can temporarily reverse opioid overdoses, including those caused by nitazenes. It’s available as a nasal spray or injection from many pharmacies and health services. You can also get naloxone mailed discreetly to you by NUAA (NSW Users and AIDS Association) by ordering through their online shop or calling (02) 9171 6650. With nitazenes, multiple doses of naloxone may be needed due to their potency and longer-lasting effects.
No, you won’t get in trouble for seeking medical care during an overdose emergency. NSW Health emphasizes that people should call Triple Zero (000) immediately if they or someone else experiences overdose symptoms. When using naloxone, always call an ambulance afterward, as nitazenes last longer in the body than naloxone, and the person may need additional medical treatment.
For concerns about drug effects, contact the NSW Poisons Information Centre 24/7 at 13 11 26. For support with drug and alcohol problems, call the Alcohol and Drug Information Service at 1800 250 015 for confidential counseling available 24/7. NUAA also offers peer support at 1800 644 413 (Monday-Friday, 9am-5pm). Additional information about public drug warnings and the take-home naloxone program can be found on the NSW Health website.
