Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/30742
Title: Intoxications in an Australian Emergency Department Involving 'Nitazene' Benzylbenzimidazole Synthetic Opioids (Etodesnitazene, Butonitazene and Protonitazene).
Austin Authors: Schumann, J L;Syrjanen, R;Alford, K;Mashetty, S;Castle, J W;Rotella, Joe Anthony;Maplesden, J;Greene, Shaun L 
Affiliation: Victorian Poisons Information Centre
Emergency
Department of Emergency Medicine, Northern Hospital, Melbourne, Australia
Monash Addiction Research Centre, Melbourne, Australia
Department of Critical Care, University of Melbourne
Department of Emergency Medicine, Dandenong Hospital, Melbourne, Australia
Department of Emergency Medicine, St Vincent's Hospital, Melbourne, Australia
Department of Forensic Medicine, Monash University
Victorian Institute of Forensic Medicine, Melbourne, Australia
Issue Date: 19-Aug-2022
Date: 2022
Publication information: Journal of Analytical Toxicology 2022; 47(1):e6-e9
Abstract: Benzimidazole synthetic opioids are highly potent μ-opioid receptor agonists with heroin-like effects, including dose-dependent respiratory depression and a high risk of abuse and toxicity. Benzimidazoles were first detected in 2019 in Europe and Canada, with analytical confirmation of etodesnitazene, protonitazene and butonitazene in 2021. We report the first detections of these compounds in Australia, in two patients presenting with drug toxicity to Emergency Departments in the state of Victoria. Case 1 was a female in her 20s who rectally administered etodesnitazene and was found unconscious with a respiratory depression and hypotension. Case 2 was a female in her 30s who presented to the ED in a sedated state after taking a formulation of protonitazene which also contained butonitazene, in addition to methylamphetamine. She responded positively to naloxone. Novel synthetic opioids were used with prior experience of the formulations purchased, however the unpredictability of their effects was demonstrated by the acute toxicity experienced with this occasion of use. Toxicosurveillance of Emergency Department presentations with analytical confirmation of drugs is crucial in identifying emerging drugs in the community and informing harm reduction strategies.
URI: https://ahro.austin.org.au/austinjspui/handle/1/30742
DOI: 10.1093/jat/bkac062
ORCID: 0000-0002-7423-2467
0000-0003-2068-8757
Journal: Journal of Analytical Toxicology
Start page: e6
End page: e9
PubMed URL: 35983900
PubMed URL: https://pubmed.ncbi.nlm.nih.gov/35983900/
ISSN: 1945-2403
Type: Journal Article
Subjects: drug toxicity
early warning system
naloxone
novel psychoactive substance
novel synthetic opioid
Appears in Collections:Journal articles

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