A cluster of multi-drug intoxications involving xylazine, benzimidazole opioids (nitazenes) and novel benzodiazepines in South Australia

Emma Partridge; Peter Stockham; Michaela Kenneally; Andrew Luong; Chris Kostakis; Sam Alfred

doi:10.1111/1742-6723.14512

A cluster of multi-drug intoxications involving xylazine, benzimidazole opioids (nitazenes) and novel benzodiazepines in South Australia

Emerg Med Australas. 2024 Oct 10. doi: 10.1111/1742-6723.14512. Online ahead of print.

Authors

Emma Partridge^{1

2}, Peter Stockham^{1

2}, Michaela Kenneally¹, Andrew Luong¹, Chris Kostakis¹, Sam Alfred³

Affiliations

¹ Forensic Science SA (Toxicology), Adelaide, South Australia, Australia.
² College of Science and Engineering, Flinders University, Bedford Park, South Australia, Australia.
³ Emergency Department, Royal Adelaide Hospital, Adelaide, South Australia, Australia.

PMID: 39389919
DOI: 10.1111/1742-6723.14512

Abstract

Objective: To highlight the detection of xylazine and nitrazolam in conjunction with benzimidazole opioids (nitazenes) and other novel benzodiazepines in a cluster of patients after putative heroin use.

Methods: Deidentified clinical and analytical data were gathered from patients enrolled in the Emerging Drugs Network of Australia system.

Results: In December 2023, three adults presented to the ED with sedation following putative use of heroin. Toxicological analysis of blood samples identified xylazine, protonitazene, metonitazene, bromazolam and nitrazolam. Local health authorities subsequently issued an alert.

Conclusion: This is the first signal of xylazine and nitrazolam use in Australia. These results demonstrate toxico-surveillance programmes with analytical confirmation of drugs are invaluable in monitoring illicit drug use.

Keywords: early warning system; nitazenes; novel benzodiazepines; toxicosurveillance; xylazine.

Grants and funding

GNT2001107/National Health and Medical Research Council