Fake yellow oxys: What you need to know

Yellow tablets sold on the dark web as oxycodone have been found to contain metonitazene, an extremely potent opioid that can be lethal at very small doses.

These tablets may be linked to a recent death and several hospitalisations in New Zealand, according to High Alert.

Here's what you need to know. 

What should you do?

Avoid taking yellow tablets, pills or powders and get your drugs checked if you can.

Drug checking is free, legal and anonymous way for you to find out what’s in your drugs. 

If you choose to take yellow tablets, pills or powders

• Avoid using alone
• Avoid mixing with other drugs, especially other depressants like alcohol, opioids, GHB/GBL, ketamine, and benzodiazepines
• Crush and mix your substance, start with a very low dose, and avoid taking more.
• Swallowing a substance means it has a slower onset than other methods and means there might be more time to get medical help if needed 
• Have naloxone with you (see below for where you can get it and how you can use it)

If you think you've been sold metonitazene or to anonymously report unusual effects from any drug, head to High Alert.

Metonitazene's symptoms and effects

The effects of metonitazene are likely similar to other synthetic opioids. These can 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.
• Severe nausea and/or vomiting.
• Severe sweating or fever.
• Slowed and/or difficulty breathing.
• Blue lips or fingertips.
• Cold and clammy skin.
• Pinpoint (tiny) pupils.
• Seizures.
• Becoming unresponsive and/or losing consciousness.

How to identify an opioid overdose

If someone shows any of these symptoms after taking a substance, call 111 and ask for an ambulance immediately. You should also give them naloxone if you have it (you may need more than one dose).

• The person's face is 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 or snoring noises.
• They cannot be awakened or are unable to respond 
• Their pupils become very small.
• Their breathing and/or heartbeat slows or stops.

How to get and use naloxone

Naloxone is a medicine that reverses the effects of an opioid overdose. You may need to give someone more than one dose to reverse the effects of metonitazene. 

Nasal spray naloxone (Nyxoid) can be purchased directly from Pharmaco.

Injectable naloxone is available at some needle exchange services, opioid substitution treatment (OST) clinics or can be prescribed by a doctor. It will usually come in a pack of several ampoules. 

We've got handy guides on how to use nasal spray naloxone (Nyxoid), and how to use injectable naloxone.