¹South Western Sydney Local Health District, Drug Health Services, Sydney, Australia

Background: Nitazenes are synthetic benzimidazole opioids that have been increasingly implicated in overdoses internationally. Synthetic opioids form the largest representation of the emerging group of new psychoactive substances. Nitazenes were first synthesized in the 1950s as novel analgesic agents but were never marketed for human use due to their potency. The first nitazene was detected on the international drug market in 2019. Melbourne, Australia has increasing case reports of intoxication from nitazenes in recent years. Nitazenes induce euphoria, analgesia and respiratory depression due to their potent mu-receptor activity. Intoxication has required higher doses of naloxone with risk of re-narcotization.

Aims & Objectives: We present a series of cases of nitazene withdrawal. The management approach was varied for each case, including inpatient or outpatient settings and traditional or rapid induction of buprenorphine. This cluster of young adults from Sydney was exposed to nitazenes through street-sourced e-cigarettes that were initially advertised as cannabinoid products.

Method: Case Series

Results: N/A

Discussion & Conclusions: We describe different management approaches towards nitazene withdrawal syndrome.