Harm reduction advice for people who use heroin

Nitazenes have been found on the drug market sold as a light brown/tan cloured powder. It has been sold as a 'new' substance as well as heroin without people knowing.

There is extra risk for people who use heroin at this time.

Whar are nitazenes?
‘Nitazenes’ are a type of synthetic opioid which have been recently found on the Irish heroin market, they are very new to the European drug market and there is very little known about some of them. Nitazene drugs were first developed in the 1950’s when scientists were trying to make safe painkillers, but they were never sold to the public because of how risky they are.

They are more potent and as dangerous as fentanyl and have a high overdose risk.
Nitazenes have been connected to a number of overdose outbreaks and overdose deaths worldwide.
They are currently circulating in Ireland as a light brown/sandy powder as ‘new’ or sold to a person as heroin without them knowing.
They have been found in the UK as fake benzodiazepines and oxycodone tablets as well as liquid.

It is important to prepare with steps to try and keep yourself as safe as possible during this time. Always follow harm reduction advice and steps recommended by official HSE alerts and from your
local services.

Be in the know: drug supplies can change

The contents and purity of drugs can change from time to time.
Nitazenes or other risky drugs could be sold to you without you knowing.
Nitazenes could also be sold to you as ‘new heroin’, or another new type of drug.
They could start to be sold as tablets or other drugs.
Be aware – this could mean you are at greater risk of overdose with these drugs.
If possible, you should to try to avoid buying new types of drugs.

Use less and wait

What’s in drugs can change and your dealer doesn’t always know what’s in them.
Start with a very small test amount, wait and see how you react before taking more.
Smoking and injecting are both an overdose risk
If injecting, go very slow and wait. Remember, it could take some time for you to feel the effects.
Have a safety plan: Buddy up, avoid using alone and let people know you are using
A safety plan is important in case you overdose
Prepare this plan with your key worker or peers
Create buddy systems to try and make sure no one is using alone
If you are using let people know, get them to text or call you, leave the door where you live open and ask someone to check in on you at a set time
If you live with family, make sure they are trained in giving naloxone and know if and when to check on you
Try to have one person in your group who isn’t using at the same time to keep an eye on you Naloxone: Get it, carry it and use it
If you overdose on nitazenes, naloxone can help save your life
Talk to your service provider about naloxone for you, your family and friends
Extra doses of naloxone may be needed with nitazenes
If someone overdoses: act fast, don’t wait to see if they will recover – you could save their life
Remember, call an ambulance immediately
Check the person is breathing, put them in the recovery position: on their side with their head resting on their ar
Give them naloxone as soon as possible

Consider treatment

Getting onto opioid treatment can help protect you from experiencing an overdose. Discuss with your local service provider

Look out for the signs of overdose and don't wait to respond

An overdose won’t always look the same but some of the signs to look out for are:

Falling unconscious
Very light shallow breathing or no breathing
Loud raspy ‘snoring’ or gurgling
Blue or pale lips or fingertips
Look out for any unexpected signs like cardia arrest (pain in chest, fast heart beat).

Don’t be afraid to get medical help in an emergency

This is a high risk time. It is important to respond and get help immediately if someone overdose