Fentanyl and Nitazenes

How does fentanyl/nitazene make you feel?

Fentanyl and nitazenes are a group of potent synthetic opioids. There are many types of fentanyl, called ‘analogues’ such as carfentanil or paraflurofentanyl. Likewise, there are many different nitazenes such as metonitazene or etonitazene. Newer, stronger analogues appear on the drug market regularly, making them difficult to keep track of. These can vary in strength and potency, but are all active in very low doses, making them difficult to dose safely.  

How long the effects of fentanyl and nitazenes last can depend on which type you use, how you take them (e.g. smoke, inject) and whether they are mixed with alcohol, other drugs, or medicines.  

The effects of fentanyl and nitazenes can come on quickly, especially if they are smoked or injected. How long the effects last can vary depending on which type of fentanyl or nitazene you have, how you take it and your individual body. Overdoses from fentanyl or nitazenes can occur with very small amounts. At any dose you may experience:  

WARNING: Overdoses from fentanyl and nitazenes can occur very quickly, and people can rapidly lose consciousness and stop breathing. There is a very small window of time to respond to an opioid overdose.  

Have naloxone on hand. Naloxone is a drug that can reverse opioid overdoses. In New Zealand, naloxone comes as a nasal spray called Nyxoid, or in ampules (that are injected). If someone is experiencing an opioid overdose, naloxone can reverse the effects and give you more time to get medical help. You can be prescribed naloxone by a doctor, access it from some needle exchanges or you can buy Nyxoid online from PHARMACO.  

You will likely need at least two doses of naloxone to treat someone overdosing on nitazenes or fentanyl.  

Avoid using alone. Opioid overdoses can happen fast and can be deadly if they are not responded to quickly. If you overdose on an opioid, you won’t be able to call for help, or administer naloxone to yourself. It is a good idea to have a sober buddy around who knows the signs of an opioid overdose and can help you if things go wrong.  

 If someone is overdosing on opioids, it is important to call 111 and then administer naloxone as soon as possible.  

Start with a low dose. There are many types of fentanyl and nitazenes, all of which have different doses and duration of effects. However, they are all active in very low doses, meaning that it is important to start with a very small ‘tester’ dose, to see how it affects you before using more. We recommend avoiding redosing, however if you choose to do so, it is best to wait at least an hour to feel the full effects before taking more* 

*note some nitazenes are thought to last for over 10 hours, so redosing still poses an increased risk, even after 1 hour.  

Get your drugs checked. Fentanyl and nitazenes all have different doses, and they are sometimes sold as something else. It is a great idea to get your drugs checked before you use them. Knowing what type of fentanyl or nitazene you have and if it is mixed with anything else can help you understand how to dose in a safer way.  

Fentanyl and nitazenes are sometimes found in fake pills such as ‘M30s’ or sold as weaker opioids such as morphine. We recommend getting any opioids that are not prescribed to you tested at a drug checking clinic. You can find drug checking clinics in your area here.  

Order fentanyl test strips (FTS) from us. It is a good idea to test any substance you think may contain any opioid with fentanyl test strips, which can tell you if your substance contains fentanyl. These strips are easy to use, and you can order these for free on The Level.  

Remember that FTS will not detect Nitazenes or other opioids.  

Crush, mix and measure everything you plan on using. Because fentanyl and nitazenes are very potent in small doses, it is important that you try to distribute the active ingredient as evenly as possible. Otherwise, you can end up with the same ‘dose’ containing very different amounts of the drug - this is called the ‘chocolate chip cookie effect’.  

Fentanyl and nitazenes can cause overdoses in very small amounts. Someone may use these drugs and become unconscious or stop breathing very quickly.  

Long-term use of fentanyl or nitazenes can have impacts on your brain and body. Using these drugs regularly generally leads to increased tolerance, meaning you need more and more to feel the same effects, or to prevent withdrawal symptoms. The potency of these drugs and how quickly tolerance can develop means that they can difficult to stop using.  

Fentanyl and nitazenes can cause sexual dysfunction, affect the cycles of people who menstruate and cause fertility issues in all genders. These drugs can also cause kidney and liver diseases and increase your chance of developing pulmonary infections. Fentanyl and nitazenes affect your digestive system and often cause chronic constipation, which can lead to bowel obstructions if it is not treated early. They also can affect your bones, which can lead to early onset osteoporosis, more easily broken bones and increased tooth problems.  

Long-term use of fentanyl or nitazenes can affect your brain and your mental health. These potent opioids have been found to deteriorate white matter in your brain, which can lead to memory loss and difficulty controlling your behaviour and emotions. Long term use can also worsen mental health conditions such as depression, anxiety, and schizophrenia. 

While fentanyl and nitazenes can cause long term damage to your body and brain, it is important to remember that many of the long-terms effects can reduce significantly or go away completely after you cut down or stop using these drugs.  

See the 'Making changes' page for more information on how to manage withdrawal from drugs and alcohol.  

As fentanyl and nitazenes are such potent drugs, regular use can quickly result in dependence or tolerance. You may find you need to use more and more to feel the same effects. It also means that it can be very difficult to cut down or take a break from using them.  

Many people find that withdrawal symptoms start quickly after your last dose of fentanyl or nitazenes wears off. How unpleasant the withdrawal symptoms are depends on how long you have used, how much you use and your physical and mental health. Symptoms can last for several weeks from last use, sometimes longer.  

While the symptoms of withdrawal from fentanyl and nitazenes are rarely life-threatening, they are very unpleasant and can be difficult to manage alone. There are things you can do to make the process less challenging, such as going on Opioid Substitution Treatment (OST). OST services will transition you from fentanyl or nitazenes to prescription opioid agonists such as methadone or buprenorphine. People accessing OST often have an easier time stopping their use of fentanyl and nitazenes long-term. You can access OST through speaking with your GP, or directly to your local addiction service. You can see more information on OST here.  

If you are going through withdrawal, you might: 

For more information on getting support for drug and alcohol use, see Finding support.  

Fentanyl and nitazenes are strong depressant drugs and slow down your brain and body functions. They can very quickly make you drowsy, disoriented, and uncoordinated. The effects or aftereffects of some types of fentanyl or nitazenes can last as long as 24 hours.  

As these drugs significantly affect your thinking, judgement and motor skills and can quickly cause you to become unconscious, it is very dangerous to drive or operate heavy machinery while using fentanyl or nitazenes. As the effects of these drugs can be very intense, trying to work, socialize or complete everyday tasks can be very difficult.  

Will fentanyl/nitazene show up on a drug test? 

At some time in your life, an employer, a family member, or the NZ government, may ask you to take a drug test. It’s important to understand what drug tests can detect and what might happen if you fail one. 

Fentanyl and nitazenes may be tested for in several ways, such as blood, urine, or saliva. It is important to remember that people’s bodies are different and process drugs differently.  

Fentanyl may be tested for in routine tests, however nitazenes are harder to test for, and there is still limited information on how effectively they can be detected. Generally, fentanyl can be detected for 1-2 days in urine, 5-48 hours in blood and saliva and up to 90 days in hair. If you use fentanyl frequently, they may be more likely to show up for longer on these tests.  

If you are being prescribed fentanyl, it is a good idea to speak with your GP before you undergo a drug test.  

Is fentanyl/nitazene illegal? 

Medicinal fentanyl (i.e patches) is regulated under the Medicines Act. Therefore it is legal to possess or use fentanyl if you have been prescribed it by a doctor. However, it is still illegal to sell or import medical fentanyl, even if you have a prescription.  

Fentanyl and nitazenes are illegal under the Misuse of Drugs Act. Fentanyl and some Nitazenes are Class B drugs. Analogues of fentanyl and nitazenes these drugs are considered Class C drugs. This means that using, buying, selling/supplying, possessing, or importing fentanyl and nitazenes is against the law.  

To find out more about the law around legal and controlled drugs, including cannabis see Drugs and the law.